[House Report 117-403]
[From the U.S. Government Publishing Office]
117th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 117-403
_______________________________________________________________________
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2023
----------
R E P O R T
of the
COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES
together with
MINORITY VIEWS
[to accompany h.r. 8295]
July 5, 2022.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2023
117th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 117-403
_______________________________________________________________________
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2023
__________
R E P O R T
of the
COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES
together with
MINORITY VIEWS
[to accompany h.r. 8295]
July 5, 2022.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
______
U.S. GOVERNMENT PUBLISHING OFFICE
47-923 WASHINGTON : 2022
117th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 117-403
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2023
_______
July 5, 2022.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Ms. DeLauro, from the Committee on Appropriations,
submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 8295]
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), and Education, and the 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 Social Security
Administration for the fiscal year ending September 30, 2023,
and for other purposes.
INDEX TO BILL AND REPORT
Page number
Bill Report
Summary of Estimates and Appropriation..................... 1
3
General Summary of the Bill................................ 1
3
Title I--Department of Labor: 2
11
Employment and Training Administration............. 2
11
Employee Benefits Security Administration.......... 22
23
Pension Benefit Guaranty Corporation............... 23
24
Wage and Hour Division............................. 24
24
Office of Labor-Management Standards............... 24
26
Office of Federal Contract Compliance Programs..... 25
26
Office of Workers' Compensation Programs........... 25
27
Occupational Safety and Health Administration...... 29
29
Mine Safety and Health Administration.............. 30
32
Bureau of Labor Statistics......................... 32
33
Office of Disability Employment Policy............. 32
34
Departmental Management............................ 33
35
General Provisions................................. 38
41
Title II--Department of Health and Human Services: 48
42
Health Resources and Services Administration....... 48
42
Centers for Disease Control and Prevention......... 58
70
National Institutes of Health...................... 66
95
Substance Use And Mental Health Services
Administration................................. 74
158
Agency for Healthcare Research and Quality......... 81
176
Centers for Medicare & Medicaid Services........... 81
178
Administration for Children and Families........... 85
196
Administration for Community Living................ 97
212
Office of the Secretary............................ 100
218
Public Health and Social Services Emergency
Fund................................... 104
235
Advanced Research Projects Agency for
Health................................. 105
242
General Provisions................................. 106
242
Title III--Department of Education: 145
246
Education for the Disadvantaged.................... 145
246
Impact Aid......................................... 147
251
School Improvement Programs........................ 148
252
Indian Education................................... 150
257
Innovation and Improvement......................... 150
258
Safe Schools and Citizenship Education............. 151
265
English Language Acquisition....................... 152
268
Special Education.................................. 152
269
Rehabilitation Services............................ 158
272
Special Institutions for Persons with Disabilities. 159
274
Career, Technical and Adult Education.............. 159
275
Student Financial Assistance....................... 160
277
Federal Direct Student Loan Program Account........ 279
Student Aid Administration......................... 161
280
Higher Education................................... 162
283
Howard University.................................. 163
295
College Housing and Academic Facilities Loans...... 163
296
Historically Black College and University Capital
Financing Program Account...................... 164
296
Institute of Education Sciences.................... 164
296
Departmental Management............................ 165
300
General Provisions................................. 166
303
Title IV--Related Agencies: 176
305
Committee for the Purchase from People Who Are
Blind or Severely Disabled..................... 176
305
Corporation for National and Community Service..... 177
305
Corporation for Public Broadcasting................ 183
309
Federal Mediation and Conciliation Service......... 184
310
Federal Mine Safety and Health Review Commission... 185
310
Institute of Museum and Library Services........... 186
311
Medicare Payment Advisory Commission............... 186
312
Medicaid and CHIP Payment and Access Commission.... 186
313
National Council on Disability..................... 186
313
National Labor Relations Board..................... 187
313
National Mediation Board........................... 187
313
Occupational Safety and Health Review Commission... 187
314
Railroad Retirement Board.......................... 187
314
Social Security Administration..................... 189
315
Title V--General Provisions: 195
320
House of Representatives Report Requirements
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriations, including trust funds for fiscal year 2023, the
budget request for fiscal year 2023, and the Committee
recommendation for fiscal year 2023 in the accompanying bill.
2023 LABOR, HHS, EDUCATION BILL
[Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal Year-- 2023 Committee compared to--
-------------------------------------------------------------------------------
Budget Activity 2023
2022 Enacted 2023 Budget Committee 2022 Enacted 2023 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............. $13,189,218 $14,900,363 $15,030,743 +$1,841,525 +$130,380
Department of Health and Human 108,625,224 123,894,211 124,218,951 +15,593,727 +324,740
Services.......................
Department of Education......... 76,424,255 88,326,976 86,717,384 +10,293,129 -1,609,592
Related Agencies................ 15,906,903 17,656,312 17,288,922 +1,382,019 -367,390
----------------------------------------------------------------------------------------------------------------
General Summary of the Bill
For fiscal year 2023, the Committee recommends a total of
$224,399,000,000 in current year discretionary funding--the
302(b) allocation--and $242,105,000,000 in overall programmatic
funding, including offsets and adjustments. The fiscal year
2023 recommendation is an increase of $28,536,000,000 above the
fiscal year 2022 enacted level.
The Labor-HHS-Education bill supports some of the nation's
most critical programs that touch individuals and families
throughout their lifespan, from Early Head Start to Social
Security.
Through this bill, the Committee continues to build on
progress from the fiscal year 2022 Consolidated Appropriations
Act, such as significant investments in education, including
strong funding increases for schools serving students in low-
income communities and students with disabilities, as well as
programs to expand access to post-secondary education.
The fiscal year 2023 Labor-HHS-Education bill continues to
build on investments in public health, including flexible
resources for State and local governments to strengthen core
public health infrastructure and capacity. And the bill
continues to build on progress in biomedical research--
following a 50 percent increase in funding for the National
Institutes of Health over the past seven years--and expands the
subcommittee's investment in the Advanced Research Projects
Agency for Health (ARPA-H), which was established in fiscal
year 2022, to accelerate the pace of scientific breakthroughs
that have the potential to transform health care and address
our most complex health challenges.
The bill continues to address our nation's most urgent
health crises, including maternal health, mental health, gun
violence, and substance misuse, while making strides to reduce
persistent and unacceptable health disparities.
And the Committee invests in workforce training and worker
protection agencies, including significant new investments to
rebuild capacity to enforce federal labor laws to protect
workers' paychecks, benefits, and ensure the health and safety
of our workplaces. The Committee also makes a major commitment
to retired workers by including an increase of $1,100,000,000
for the Social Security Administration's operating expenses,
which will restore federal capacity to provide earned benefits
and services through Social Security, one of the cornerstones
of the federal safety net.
Some of the most notable initiatives in fiscal year 2023
include:
Elementary and Secondary Education
The Committee is committed to increasing investments in
core Federal programs that support high-quality public
education opportunities for all students. Our nation's public
schools serve more than 50 million children, more than 50
percent of whom come from low-income families. Research shows
that low-income students are more likely to struggle
academically and often attend high-need schools with fewer
resources, less experienced teachers, and more limited access
to advanced coursework. At the same time, there is overwhelming
empirical evidence on education spending and student outcomes
that finds more funding in schools yields statistically
significant positive results for students.
Overall, the Committee recommendation provides
$50,918,030,000 for Federal K-12 education programs, including
the Individuals with Disabilities Education Act (IDEA), an
increase of $8,333,798,000 over the fiscal year 2022 enacted
level. The recommendation is a 20 percent increase over last
year.
In particular, the Committee recommends an additional
$3,000,000,000 over the fiscal year 2022 enacted level for
Title I Grants to Local Educational Agencies for a total of
$20,536,802,000. Title I serves an estimated 25 million
students in nearly 90 percent of school districts and nearly 60
percent of all public schools.
The Committee recommends $1,000,000,000 for the English
Language Acquisition program, which provides formula grants to
States to serve English Leaners (EL), an increase of
$168,600,000 over the fiscal year 2022 enacted level. Federal
data shows that significant achievement gaps exist between ELs
and their peers. At the same time, many States and school
districts have experienced rapid growth in their EL
populations. Providing increased resources to improve
educational quality for EL students is a top priority for the
Committee.
The Committee recommends $16,259,193,000 for IDEA Part B
Grants to States, which is $2,915,489,000 above the fiscal year
2022 enacted level. The Committee is concerned that the Federal
share of the excess cost of educating students with
disabilities has declined and notes the critical role this
increase will play in helping to reverse this trend and serve
as a significant step toward fully funding IDEA.
Early Childhood Education
The Committee includes nearly $20,000,000,000 for early
childhood education programs through the Child Care and
Development Block Grant (CCDBG), Head Start, and Preschool
Development Grants--an increase of $2,420,000,000 over the
fiscal year 2022 enacted level.
The Committee recognizes that child care and early learning
investments are essential for children and working families,
and includes a $1,000,000,000 increase for the CCDBG program.
This funding will provide critical support to families by
providing affordable, high quality child care to more children,
providing opportunities for more parents to remain in or return
to the workforce, and supporting the child care workforce,
which is primarily made up of women, and particularly women of
color.
The bill includes an increase of $1,360,000,000 for Head
Start, including a $596,000,000 cost-of-living adjustment for
the Head Start workforce, $262,000,000 in flexible, quality
improvement funding for program-specific needs, and
$500,000,000 to expand Head Start, Early Head Start, and Early
Head Start-Child Care Partnerships to approximately 30,000
additional infants and toddlers from low-income families.
The Committee further recommends $350,000,000, an increase
of $60,000,000, for Preschool Development Grants to build State
and local capacity to provide early childhood care and
education for children birth through five from low- and
moderate-income families.
Higher Education
In the aftermath of the COVID-19 pandemic, college
affordability and access are vital to our nation's recovery
efforts. Therefore, the Committee recommendation makes
necessary investments in programs supporting student financial
aid, student support services, and other programs supporting
institutions of higher education and their students.
The recommendation includes sufficient funding to support
an increase in the maximum Pell Grant by $500 over the fiscal
year 2022 enacted level, from $6,895 to $7,395. In addition,
the Committee recommendation provides $1,243,882,000 for
Federal Work Study, an increase of $33,882,000 over the fiscal
year 2022 enacted level. The Committee recommendation also
includes $920,000,000 for the Federal Supplemental Educational
Opportunity Grants, an increase of $25,000,000 over the fiscal
year 2022 enacted level.
The Committee recommendation includes $1,297,761,000 for
the TRIO programs, an increase of $160,761,000 over the fiscal
year 2022 enacted level. The recommendation also includes
$408,000,000 for the Gaining Early Awareness and Readiness for
Undergraduate Programs, which is $30,000,000 more than the
fiscal year 2022 enacted level.
In an effort to assist postsecondary institutions in
addressing barriers in completion and attainment, the Committee
recommendation includes a total of $1,110,117,000 for programs
that serve high proportions of students of color (Historically
Black Colleges and Universities, Hispanic-Serving Institutions,
Tribal Colleges and Universities, and other Minority Serving
Institutions), an increase of $225,000,001 over the fiscal year
2022 enacted level.
The Committee also includes robust funding to support
teacher preparation. The recommendation includes $30,000,000 in
funding for the Augustus F. Hawkins Centers of Excellence
program, an increase of $22,000,000 over the fiscal year 2022
enacted level, and the recommendation includes $132,092,000 for
the Teacher Quality Partnerships program, an increase of
$73,000,000 over the fiscal year 2022 enacted level.
Public Health
Public health can no longer only get attention during a
crisis. The Committee recognizes that State, local,
territorial, and Federal public health partners need a long-
term strategy and long-term investments, beginning at CDC. The
bill includes approximately $10,500,000,000 for CDC, an
increase of more than $2,000,000,000.
Half of the increase included in the bill is directed to
core capacities, as CDC's budget must be rebalanced between
disease- or condition-specific activities and fundamental
activities that support the nation's public health ecosystem.
Building on funding initially provided in fiscal year 2022, the
bill includes an increase of $550,000,000 for public health
infrastructure to turn the tide on the nation's public health
capacity by providing a stable source of disease-agnostic
funding so the nation's State, local, territorial, and Federal
public health agencies will be better equipped to coordinate
together to save lives.
This bill also includes core capacity increases of:
$45,000,000 for Public Health Workforce and Career Development
to invest in essential public health workers who protect our
communities and are empowered by science; $150,000,000 for
Public Health Data Modernization to advance the transformation
of the collection and utilization of public health data from
retrospective reporting to driving action in real time;
$10,000,000 to advance laboratory science and safety so CDC is
capable of meeting evolving health threats and maintaining the
highest standards; $10,000,000 for the National Center for
Health Statistics to initiate investments in the next
generation of surveys; $100,000,000 for Global Public Health
Protection to modernize and expand disease surveillance and
response capabilities to strengthen global health security; and
$50,000,000 for the Center for Forecasting and Outbreak
Analytics to improve preparedness and response.
Biomedical Research through NIH and ARPA-H
The Committee has increased NIH funding by nearly
$15,000,000,000, or 49 percent, over the past seven years,
under both Democratic and Republican leadership. The Committee
continues and accelerates this investment by providing
$47,459,000,000, an increase of $2,500,000,000 above the fiscal
year 2022 enacted level for NIH research and activities.
The Committee continues its ongoing support for key NIH
initiatives, such as the Cancer Moonshot, BRAIN Initiative, and
the All of Us Precision Medicine Initiative. The bill also
includes sufficient funding to provide an across-the-board
increase of at least 3.2 percent for NIH Institutes and
Centers. The Committee remains concerned that targeted funding
for specific research initiatives in recent years has slowed
the growth in other areas of basic research that may lead to
unforeseeable scientific breakthroughs.
The Committee also established the Advanced Projects
Research Agency for Health (ARPA-H) in fiscal year 2022.
Modeled after the Defense Advanced Research Project Agency
(DARPA), ARPA-H will invest in large high-risk, high-reward
research projects that have the potential to achieve
breakthroughs in the treatment of diseases such as cancer,
Alzheimer's disease, diabetes, amyotrophic lateral sclerosis
(ALS), and others that impact the lives of millions of
Americans and exacerbate existing health disparities. The
Committee provides $2,750,000,000 for ARPA-H in fiscal year
2023, an increase of $1,750,000,000 above the fiscal year 2022
enacted level, to accelerate these critical research projects.
Mental and Behavioral Health
The COVID-19 pandemic exacerbated existing mental health
and substance use disorder crises, with more people reporting
increased levels of anxiety, depression, suicidal ideation, and
substance use. In particular, more than a third of high school
students reported experiencing poor mental health during the
COVID-19 pandemic. Suicide continues to be a leading cause of
death, taking more than 45,000 lives in 2020, and is the second
leading cause of death among youth between the ages of 10 and
14. Drug overdose deaths have also continued to increase with
CDC estimating more than 107,000 drug overdose deaths in the
United States during 2021, an increase of nearly 15 percent
from 2020, according to provisional data.
The Committee recommendation includes $9,170,380,000 for
the Substance Use And Mental Health Services Administration
(SAMHSA), making a range of investments across the behavioral
health continuum to support prevention, screening, treatment,
and other services. The Committee includes a total increase of
$1,726,062,000 for mental health activities. This includes an
increase of $500,000,000 for the Mental Health Block Grant and
an increase of $85,000,000 for Certified Community Behavioral
Health Clinics. In addition, the Committee includes a
significant increase of $640,280,000 for the new three-digit
988 program, including the National Suicide Prevention Lifeline
and behavioral health crisis response infrastructure, which is
scheduled for rollout in July 2022. The bill also increases the
mental health crisis set-aside to ten percent and creates a new
set-aside for prevention and early intervention.
The Committee includes $60,000,000, an increase of
$50,000,000 over the fiscal year 2022 enacted level, for the
second year of the Mental Health Crisis Response Grant program,
to help communities continue to create mobile crisis response
teams that divert the response for mental health crises from
law enforcement to behavioral health teams.
The bill supports children's mental health with a
$68,113,000 increase to the National Child Traumatic Stress
Initiative, a $20,000,000 increase for Infant and Early
Childhood Mental Health, and an additional $100,000,000 for
Children's Mental Health services, including a new pilot
program to address the impact of violence in communities of
color.
The Committee includes a total increase of $871,452,000 for
substance use treatment activities. This includes an increase
of $500,000,000 for the Substance Use Prevention and Treatment
Block Grant and an increase of $250,000,000 for State Opioid
Response Grants. The bill creates a new set-aside within the
block grant to support recovery services. The Committee
recommendation also includes an increase of $30,215,000 for
substance use prevention services and activities.
The bill also includes a significant investment in
recruiting and training mental and behavioral health
professionals to expand access to quality mental health and
substance use disorder treatment services to areas and
populations most in need, including an increase of $62,000,000
for HRSA's Behavioral Health Workforce Education and Training
activities.
Maternal Health
To help eliminate race-based disparities and drive down the
rate of maternal mortality, the bill provides an increase of
$60,000,000 for CDC's Safe Motherhood and Infant Health
programs. This funding allows for the expansion of Maternal
Mortality Review Committees and Perinatal Quality
Collaboratives, and for increased support to current States and
territories, as well as increased support for other programs
including Sudden Unexplained Infant Death. The bill provides an
increase of $120,000,000 for HRSA's Maternal and Child Health
Services Block Grant, which includes investments in projects
such as an increase of $10,000,000 for State Maternal Health
Innovation Grants, an increase of $3,300,000 to expand the
Alliance for Innovation in Maternal Health Safety Bundles to
more States, and an increase of $3,000,000 to support and
expand availability of the Maternal Mental Health Hotline. The
bill also provides $30,000,000 to recruit and train midwives
and doulas and an increase of $5,000,000 for Screening and
Treatment for Maternal Depression and Related Disorders.
HIV Initiative
Advances in medications for the prevention and treatment of
HIV, improved diagnostic tests, and new outbreak detection
technology provide a unique opportunity to alter the trajectory
of HIV infection rates in the U.S. with a goal of eliminating
new HIV infections. This bill provides a total of $738,000,000,
which is an increase of $225,000,000 for the fourth year of the
Ending the HIV Epidemic Initiative, which began a new era of
moving the U.S. from HIV prevention to HIV epidemic control.
Firearm Injury and Mortality Prevention Research
Firearm injury and mortality is among the leading causes of
death for people aged 1-64 in the U.S. In 2019, there were
nearly 40,000 firearm-related deaths in the U.S. Addressing the
gaps in knowledge around this issue and identifying effective
prevention strategies are needed steps toward keeping people,
families, schools, and communities safe from firearm injury. In
fiscal year 2020, the Committee provided the first funding in
more than two decades to address the public health emergency of
firearm violence with a total of $25,000,000 to CDC and NIH.
This bill more than doubles the total funding to $60,000,000 to
support research to identify the most effective ways to prevent
firearm related injuries and deaths, and to broaden firearm
injury data collection. Building on these efforts to address
firearm injury and death, this bill also includes $100,000,000
for a new evidence-based community violence intervention
initiative at CDC, which aims to prevent intentional violence,
such as mass casualty violence or gang violence.
Employment and Training
The economy and the labor market have seen significant
gains since the economic recession resulting from the COVID-19
pandemic. The U.S. economy has added 6.5 million jobs over the
past year and the unemployment rate, which peaked at 14.7
percent two years ago, is now down to 3.6 percent. Despite the
strong labor market, however, economic opportunity remains hard
to reach for millions in communities around the country. The
unemployment rate for Black and Hispanic workers remains
considerably higher than that of the overall population, and
far too many women have been pushed out of the workforce or
forced to consider new employment over the last two years. We
must prioritize our workers and their wages as the nation
emerges from the COVID-19 pandemic.
As such, the Committee recommendation includes needed
investments in workforce and training systems. Specifically,
the recommendation includes $3,135,332,000 for Workforce
Innovation and Opportunity Act Grants to States, an increase of
$256,000,000 above the fiscal year 2022 enacted level and
$116,230,000 above the fiscal year 2023 budget request. In
addition, the recommendation includes $303,000,000 for
registered apprenticeships, an increase of $68,000,000 above
the fiscal year 2022 enacted level and the same as the fiscal
year 2023 budget request.
The recommendation also includes $100,000,000 for the
Strengthening Community Colleges Training Grant program, an
increase of $50,000,000 above the fiscal year 2022 enacted
level and equal to the fiscal year 2023 budget request. This
program helps community colleges build capacity for training
workers. The recommendation includes $50,000,000 for a new
grant program to support communities suffering dislocations
related to changes in fossil fuel and other energy industries.
The recommendation also includes $3,184,635,000 for
Unemployment Compensation State Operations, an increase of
$333,819,000 over the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request. This funding will
help support States in overcoming challenges associated with
administering unemployment insurance programs. Altogether,
these investments will continue to support families with the
economic consequences of COVID-19 and prepare workers for new
employment opportunities.
Worker Protection Agencies
The Committee recommends $2,179,524,000 for Department of
Labor agencies responsible for worker protection and worker
rights. This is an increase of $346,589,000 over the fiscal
year 2022 enacted level.
The Wage and Hour Division employs fewer investigators
today than it did 75 years ago, despite the workforce having
grown significantly in that time. To help make up for this lost
ground, hold bad-acting employers accountable, and defend
working people so they receive the pay they earned and are
legally entitled to, the Committee recommendation includes
$312,678,000, an increase of $61,678,000 over the fiscal year
2022 enacted level and an increase of $5,000,000 over the
fiscal year 2023 budget request.
The Occupational Safety and Health Administration (OSHA)
enforcement of safety and health laws is critical to preventing
workplace tragedies from occurring, which is why it is
concerning that, under current staffing levels, the agency
would need more than 150 years to inspect each workplace under
its jurisdiction. To restore OSHA's enforcement capacity, the
Committee includes $712,015,000, an increase of $100,000,000
over the fiscal year 2022 enacted level and $10,610,000 over
the fiscal year 2023 budget request for this critical worker
protection agency.
The Committee also recommends $319,424,000 for the National
Labor Relations Board, an increase of $45,200,000 over the
fiscal year 2022 enacted level and the same as the fiscal year
2022 budget request. This increase will restore the NLRB's
capacity to protect workers' rights to union representation and
collective bargaining.
POLICY HEARINGS
The Committee continued to fulfill its responsibility to
conduct oversight of programs under its jurisdiction by holding
nine subcommittee hearings--including four budget hearings and
three policy hearings, as well as subcommittee hearings to take
testimony from Members of Congress and public witnesses.
Social and Emotional Learning and Whole Child Approaches in K-12
Education
The Subcommittee held a hearing on ``Social and Emotional
Learning (SEL) and Whole Child Approaches in K-12 Education,''
during which the Subcommittee heard from a panel of national
experts on the robust evidence of effectiveness for whole child
interventions, including SEL. The Subcommittee focused on how
high-quality SEL programs that support students' social,
emotional, and cognitive development result in lasting positive
academic and life outcomes. In addition, the Subcommittee
explored how dedicated Federal resources for these approaches
are vital to expanding their reach nationwide.
Healthy Aging: Maximizing the Independence, Well-Being, and Health of
Older Adults
The Subcommittee held a hearing to discuss some of the top
health issues facing seniors, with a particular focus on the
importance of senior nutrition, elder justice, mental health,
and falls prevention programs. The Subcommittee recognizes that
the country's senior population is growing, and that the Labor,
Health and Human Services, Education, and Related Agencies bill
funds several key agencies, including the Administration for
Community Living (ACL), CDC, and SAMHSA, that provide direct
services to support seniors' independence, health, and overall
well-being. The Committee heard from four aging experts about
some of the most significant challenges to healthy aging, and
the need for specialized prevention, treatment, and support
services to support seniors' physical and mental well-being.
Tackling Teacher Shortages
The Subcommittee held a hearing on ``Tackling Teacher
Shortages,'' during which the Subcommittee heard from a panel
of national experts on the scope and severity of nationwide
teacher shortages. The Subcommittee discussed root causes of
teacher shortages and explored acute challenges with the
retention and recruitment of educators of color and special
educators. In addition, the Subcommittee identified strategies
to help rebuild educator pipelines and address shortages and
highlight needed investments in programs funded in this bill
that support educator pipelines and address challenges related
to recruitment and retention.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
Appropriation, fiscal year 2022....................... $10,481,739,000
Budget request, fiscal year 2023...................... 11,570,169,000
Committee Recommendation.............................. 11,763,847,000
Change from enacted level......................... +1,282,108,000
Change from budget request........................ +193,678,000
The Employment and Training Administration (ETA)
administers Federal job training grant programs and Trade
Adjustment Assistance and provides funding for the
administration and oversight of the State Unemployment
Insurance and Employment Service system.
TRAINING AND EMPLOYMENT SERVICES
Appropriation, fiscal year 2022....................... $3,912,338,000
Budget request, fiscal year 2023...................... 4,410,999,000
Committee Recommendation.............................. 4,597,632,000
Change from enacted level......................... +685,294,000
Change from budget request........................ +186,633,000
Training and Employment Services provides funding for
Federal job training programs authorized primarily by the
Workforce Innovation and Opportunity Act of 2014 (WIOA).
Adult Employment and Training Activities.--For Adult
Employment and Training Activities, the Committee recommends
$940,649,000, which is $70,000,000 more than the fiscal year
2022 enacted level and $40,662,000 more than the fiscal year
2023 budget request.
Youth Employment and Training Activities.--For Youth
Employment and Training Activities, the Committee recommends
$1,033,130,000, which is $100,000,000 more than the fiscal year
2022 enacted level and $69,293,000 more than the fiscal year
2023 budget request.
Dislocated Worker Employment and Training Activities.--For
Dislocated Worker Employment and Training Activities, the
Committee recommends $1,161,553,000, which is $86,000,000 more
than the fiscal year 2022 enacted level and $6,275,000 more
than the fiscal year 2023 budget request.
Dislocated Worker Assistance National Reserve.--The
Committee recommends $457,386,000 for the Dislocated Workers
National Reserve, an increase of $156,527,000 more than the
fiscal year 2022 enacted level and $70,000,000 below the fiscal
year 2023 budget request.
The Committee recommendation includes $100,000,000, an
increase of $50,000,000 over the fiscal year 2022 enacted level
and is the same as the fiscal year 2023 budget request, for
Strengthening Community College Training Grants to support a
new grant competition. This funding will continue to help
better align workforce development efforts with postsecondary
education and build off lessons learned from the Trade
Adjustment Assistance Community College and Career Training
Grant program. The Committee continues to direct the Department
to follow the program requirements as laid out in House Report
116-62, except that the 120 day requirement for the
solicitation shall not apply.
The Committee recommendation also includes $50,000,000 for
a new program designed to assist communities experiencing
dislocations occurring in fossil fuel and other energy related
industries. A part of the Interagency Working Group on Coal and
Power Plant Communities and Economic Revitalization, this
program builds upon the Obama Administration's POWER+
initiative and is intended to support the economic well-being
of workers and communities impacted by changes in the coal,
oil, gas, and other industries.
The Committee strongly encourages continued investment in
areas with high rates of unemployment and substance use
disorder impacted by the loss of employment in the coal
industry. This industry has experienced significant employment
reduction in the past decade and sustained investment to
transition workers to new industries is necessary to offset
challenging economic conditions.
The Committee is aware of the high, unmet demand for
cybersecurity and software development skills in both the
Department of Defense (DoD) and the private sector and
appreciates the Secretary's attention to this priority. Given
the high wages and job security associated with jobs in these
areas, combined with the benefits for national security and the
economy at large, the Committee directs the Secretary to
utilize appropriate discretionary or mandatory funds available
for the purpose of high skill job training to establish grants
for qualified training and educational institutions to help
increase training capacity to meet this demand. The Department
is also strongly encouraged to coordinate with partners within
the DoD to ensure the program is effectively targeted to meet
existing needs.
The Committee includes $5,000,000 for the Department of
Labor to establish an Automation Impacted Industries Pilot
Program to award competitive grants to industry or sector
partnerships to support demonstration and pilot projects
relating to the training needs of workers who are, or are
likely to become, dislocated workers as a result of automation.
Under this program, grantees may use the funds for one or more
of the following: 1) Providing training services, which may
include training services that prepare workers for in-demand
industry sectors or occupations; 2) providing assistance for
employers in developing a staff position for an individual who
will be responsible for supporting training services provided
under the grant; 3) purchasing equipment or technology
necessary for training services; 4) providing job search and
other transitional assistance to workers in industries with
high rates of job loss; 5) providing a training stipend to
workers for training services; 6) providing integrated
education and training.
The Committee provides $45,000,000 for the Workforce
Opportunity for Rural Communities program, to provide enhanced
worker training in the Appalachian, Delta, and Northern Border
regions.
The Committee encourages the Department to develop
demonstration and pilot programs that facilitate education and
training programs in the field of advanced manufacturing.
Eligible entities include local educational entities (e.g.,
technical college, community college, a manufacturing extension
center, or an entity that assists educationally underserved
communities) partnering with manufacturers that employ
individuals who have advanced manufacturing skills. These
programs should (1) develop skills and competencies of workers
in communities with expected growth in advanced manufacturing;
(2) provide education and training for available and
anticipated jobs in advanced manufacturing; (3) educate
individuals about career advancement opportunities within
advanced manufacturing; (4) strengthen community college
partnerships with manufacturing extension centers and advanced
manufacturing businesses in an effort to meet the needs of
businesses for adaptability in training of workers; and (5)
give priority to incumbent workers, dislocated workers, and
unemployed individuals.
The Committee recognizes that the environmental health
workforce is vital to protecting the health and safety of the
public. The Committee encourages the Secretary, in coordination
with Federal, State, local, and tribal government agencies, and
private-sector and nongovernmental entities, to develop model
standards and guidelines for credentialing environmental health
workers. The Committee further encourages the Secretary to
develop a comprehensive and coordinated plan for developing the
environmental health workforce to meet national needs. This
plan should include performance measures to more clearly
determine the extent to which these programs and activities are
meeting the Department's strategic goal of strengthening the
environmental health workforce; identify any gaps between
existing programs and activities and future environmental
health workforce needs; identify actions to address such
identified gaps; and identify any additional statutory
authority that is needed by the Department to implement such
identified actions. The Committee requests this plan no later
than 360 days after the date of enactment of this Act.
The Committee recognizes that there is a significant number
of immigrants that arrive in America, fluent in English and
holding degrees and credentials in health care from their home
countries. Because of the significant barriers of translating
these foreign certifications into required American
certifications, many immigrants are underemployed, resulting in
a lower quality of life and contributing to the shortage of
health care professionals. The Committee recommends that the
Secretary of Labor release guidance that identifies ways to
bridge the gap between unemployed immigrants and health care
professions.
The Committee supports efforts by organizations to advance
worker training for individuals who are survivors of abuse,
abandonment, or trauma. The Committee further supports worker
training projects that provide wraparound services to these
individuals and recognizes the value and need to support the
``whole'' worker, including access to new clothing, shoes, home
essentials, family hygiene items, relevant worker resources,
and life skill classes to foster healing and create long-term
goals.
Native Americans.--For the Indian and Native American
programs, the Committee recommends $63,800,000, which is
$6,800,000 more than the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request.
Migrant and Seasonal Farmworkers.--For the National
Farmworker Jobs program, the Committee recommends $105,000,000,
which is $9,604,000 more than the fiscal year 2022 enacted
level and $8,289,000 more than the fiscal year 2023 budget
request.
The Committee directs the Secretary to ensure that
additional funding made available in fiscal year 2023--above
the fiscal year 2022 enacted level--is available to all
eligible organizations.
YouthBuild.--For the YouthBuild program, the Committee
recommends $145,000,000, which is $45,966,000 more than the
fiscal year 2022 enacted level and the same as the fiscal year
2023 budget request.
Reintegration of Ex-Offenders.--The Committee recommends
$150,000,000 for training and reintegration activities for
individuals with criminal legal histories or who have been
justice system-involved, which is $47,921,000 more than the
fiscal year 2022 enacted level and the same as the fiscal year
2023 budget request. The Committee directs the Department to
ensure grantees establish formal partnerships with employers
and that program participants receive industry recognized
credentials and training in fields that prepare them for
successful reintegration, including ensuring participants
receive training and credentials in fields where their criminal
record is not a barrier to entry or continued employment. The
Committee also directs the Department to consider the needs of
communities that have recently experienced significant unrest.
The Committee includes a set-aside of $50,000,000 for
competitive grants to national and regional intermediaries. The
Committee encourages the Department to prioritize grants to
national intermediaries and community-based organizations with
recognized expertise and nationwide employer partners that will
address the inequities deepened by the pandemic by serving
populations with multiple barriers to employment and providing
wraparound services to the individuals served.
The Committee is aware that recent re-entry programs are an
excellent way to help address workforce challenges, including
those in the advanced manufacturing sector. The Committee
directs the Department to provide an update in the fiscal year
2024 Congressional Budget Justification on information from the
last three fiscal years on pathways and relationships built
with employers, including data on formerly incarcerated
individuals who have utilized the program, rates of increased
credentials, and placement in higher paying positions.
Workforce Data Quality Initiative.--The Committee
recommends $6,000,000 for the Workforce Data Quality
Initiative, which is the same as the fiscal year 2022 enacted
level and the fiscal year 2023 budget request. The Committee
supports the work of States in using these funds to create and
utilize data to align preschool through workforce systems.
Apprenticeship Grants.--The Committee recommends
$303,000,000 for the apprenticeship grants program, which is
$68,000,000 more than the fiscal year 2022 enacted level and
the same as the fiscal year 2023 budget request. The Committee
established this program in 2016 to expand work-based learning
programs in in-demand industries through registered
apprenticeships. Registered apprenticeships are a proven
strategy for meeting the needs of our nation's workforce and
industry simultaneously.
The Committee continues to invest in expanding
opportunities relating to Registered Apprenticeship programs
registered only under the National Apprenticeship Act, to be
available to the Secretary to carry out activities through
grants, cooperative agreements, contracts and other
arrangements with States and other appropriate entities. As
part of these opportunities, the Committee directs the
Secretary to continue funding for national and local
apprenticeship intermediaries, business and labor industry
partner intermediaries, and equity intermediaries. The
Committee also directs the Department to ensure that these
intermediaries are given opportunities to apply for competitive
grants, cooperative agreements, contracts, and other funding
opportunities. The Committee urges the Secretary to ensure that
States engage both business and labor as part of any State
funding opportunities associated with this program. In
addition, the Committee continues to support the funding and
development of industry or sector partnerships as a means to
expand work-based learning programs and registered
apprenticeships in in-demand industries.
The Committee directs the Secretary to submit a report to
the Committees on Appropriations providing details on entities
awarded funding, selection criteria used, and the funding
amount for each grant or contract awarded at the time such
awards are made. Not later than 90 days after enactment of this
Act, the Department shall provide the Committees on
Appropriations a detailed spend plan of anticipated uses of
funds made available, including administrative costs. The
Committee also directs the Department to provide quarterly
briefings on all spending activities under this program to the
Committee. The Committee strongly supports efforts to expand
Registered Apprenticeships to traditionally underrepresented
communities.
In addition, the Committee continues to note that
apprenticeships are an important path to the middle-class, with
those completing a program earning an average annual income of
$70,000. However, women are largely underrepresented in
apprenticeship programs, and women who do participate make far
less than men. Therefore, the Committee directs the Department
to accelerate efforts to recruit and retain women as part of
these programs and to ensure equal compensation.
The Committee recognizes that the creative economy was
severely impacted by COVID-19 and encourages the Department to
partner with the National Endowment for the Arts and the
National Endowment for the Humanities to explore the
feasibility and expansion of Registered Apprenticeship programs
for creative workers who previously received income through
creative, cultural, or artistic-based pursuits to produce
ideas, content, goods, and services, without regard to whether
such income is earned through employment as an independent
contractor or as an employee for an employer.
The Committee continues to be concerned about nationwide
shortages of qualified drinking water and wastewater operation
professionals, especially in rural areas, and urges the
Secretary to address these challenges through apprenticeship
opportunities consistent with the National Guideline Standards
of Apprenticeship for Water and Wastewater System Operations
Specialists.
The Committee notes that apprenticeship programs contribute
to higher wages and fewer injuries for workers in the energy
industry. The Committee also notes that as the United States
combats climate change, we need to expand the clean energy
workforce. However, we currently lack sufficient apprenticeship
programs in the clean energy sector. Therefore, the Committee
continues to encourage prioritization of apprenticeships in
clean energy and encourages the Department of Labor to
accelerate efforts to support apprenticeship programs that
increase the number of trained workers in the clean energy
sector with an emphasis in regions anticipating a loss in
fossil fuel industry jobs.
The Committee appreciates the Administration's actions to
ensure high-quality training opportunities by taking steps to
rescind the industry registered apprenticeship program. The
Committee strongly supports expansion of registered
apprenticeships, youth apprenticeships, and pre-apprenticeship
programs to create more job training opportunities--especially
in the face of shifting workforce needs and in-demand career
skills. In light of this need, the Committee encourages the
Secretary to identify key sectors, including advanced
manufacturing, with growing workforce demands that adapt well
within apprenticeship models and develop streamlined plans with
key stakeholders to execute apprenticeship programs.
The Committee supports efforts by organizations to advance
worker training for individuals who are survivors of abuse,
abandonment, or trauma. The Committee further supports worker
training projects that provide wraparound services to these
individuals and recognizes the value and need to support the
``whole'' worker, including access to new clothing, shoes, home
essentials, family hygiene items, relevant worker resources,
and life skill classes to foster healing and create long-term
goals.
National Youth Employment Program.--For the National Youth
Employment Program, the Committee recommends $75,000,000, which
is the same as the fiscal year 2023 budget request. This new
competitive grant program will provide funding for youth
employment programs, including summer and year-round
opportunities.
Veterans' Clean Energy Training Program.--For the Veterans'
Clean Energy Training Program, the Committee recommends
$10,000,000, which is the same as the fiscal year 2023 budget
request. This new competitive grant program will prepare
veterans and their spouses for careers in clean energy.
Civilian Climate Corps.--For the Civilian Climate Corps,
the Committee recommends $15,000,000, which is the same as the
fiscal year 2023 budget request. This new grant pilot will rely
on strong DOL partnerships with other Federal agencies to focus
on job training and paid community service for underrepresented
populations in clean energy and climate mitigation.
Community Project Funding.--Within the funds included in
this account, $132,114,000 shall be used for the projects, and
in the amounts, specified in the table titled ``Labor, HHS,
Education Incorporation of Community Project Funding Items'' at
the end of this report.
JOB CORPS
Appropriation, fiscal year 2022....................... $1,748,655,000
Budget request, fiscal year 2023...................... 1,778,964,000
Committee Recommendation.............................. 1,798,655,000
Change from enacted level......................... +50,000,000
Change from budget request........................ +19,691,000
Job Corps is the nation's largest residential employment
and workforce development program for youth, helping prepare
thousands of young people ages 16 through 24 for jobs in in-
demand occupations with good wages each year.
Operations.--For Job Corps Operations, the Committee
recommends $1,627,325,000, which is $24,000,000 more than the
fiscal year 2022 enacted level and $24,314,000 more than the
fiscal year 2023 budget request.
Construction, Rehabilitation, and Acquisition.--The
Committee recommends $133,000,000 for construction,
rehabilitation, and acquisition activities of Job Corps
centers, which is $20,000,000 more than the fiscal year 2022
enacted level and the same as the fiscal year 2023 budget
request.
Administration.--The Committee recommends $38,330,000 for
the administrative expenses of the Job Corps program, which is
$6,000,000 more than the fiscal year 2022 enacted level and
$4,623,000 below the fiscal year 2023 budget request.
For over 50 years, Job Corps has successfully educated and
trained millions of young adults for jobs in high demand
industries and trades. Job Corps has campuses across all 50
States and Puerto Rico and provides a safe living, learning and
disciplined residential setting that allows disconnected and
opportunity youth to gain the employment and skills that U.S.
employers seek. The Committee recommendation includes funding
for Job Corps to meet capacity and ensure a safe learning
environment for all students and staff, including to train
youth for employment in industry sectors facing critical
shortages of skilled workers, such as construction, healthcare,
manufacturing, transportation, and cyber technologies. Job
Corps centers are capable of serving approximately 50,000 out-
of-work and out-of-school youth each year, and the Committee
encourages the Department to use such funding accordingly.
The Committee continues to be concerned with the
administration of the Job Corps program, including the
underutilization of centers relative to on-board strength,
industry-standard training, and performance incentives.
As millions of disconnected youth struggle with housing,
food insecurity, and unemployment, the Committee supports the
full resumption of Job Corps operations, including the
reintegration of nonresidential students into normal classes,
similar to other schools and institutes of higher education
across the country.
The Committee has previously expressed concern regarding
the impact of the transition to fixed-price Job Corps contracts
on staff compensation. Currently, the Department exempts Job
Corps prime contracts from compliance with the McNamara-O'Hara
Service Contract Act. The Committee directs the Department to
provide a report within 90 days of enactment of this Act
explaining the rationale for this exemption and an estimate of
the costs of requiring all Job Corps contracts to comply with
this statute. The Committee further directs the Department to
estimate the costs of compliance if Job Corps academic and
trade instructors were classified as nonexempt for the purposes
of the Fair Standards Act.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriation, fiscal year 2022....................... $405,000,000
Budget request, fiscal year 2023...................... 405,000,000
Committee Recommendation.............................. 450,000,000
Change from enacted level......................... +45,000,000
Change from budget request........................ +45,000,000
The Community Service Employment for Older Americans
program provides grants to public and private non-profit
organizations that subsidize part-time work in community
service activities for unemployed persons aged 55 and older
whose family income is below 125 percent of the poverty level.
The Committee recommends $450,000,000 for the Community
Service Employment for Older Americans program, which is
$45,000,000 more than the fiscal year 2022 enacted level and
the fiscal year 2023 budget request.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriation, fiscal year 2022....................... $540,000,000
Budget request, fiscal year 2023...................... 494,400,000
Committee Recommendation.............................. 494,400,000
Change from enacted level......................... -45,600,000
Change from 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
Appropriation, fiscal year 2022....................... $3,711,331,000
Budget request, fiscal year 2023...................... 4,258,173,000
Committee Recommendation.............................. 4,213,960,000
Change from enacted level......................... +502,629,000
Change from budget request........................ -44,213,000
The total includes $4,124,894,000 from the Employment
Security Administration Account from the Unemployment Trust
Fund and $89,066,000 from the General Fund of the Treasury.
These funds are used to support the administration of Federal
and State unemployment compensation laws.
Unemployment Insurance Compensation.--For Unemployment
Insurance (UI) Compensation, the Committee recommends
$3,184,635,000, which is $333,819,000 more than the fiscal year
2022 enacted level and the same as the fiscal year 2023 budget
request. The recommendation provides additional resources for
States to increase staffing capacity and to accommodate
sustained increases in workload.
In addition, the recommendation provides contingency
funding for increased workloads that States may face in the
administration of UI. The Committee recommendation includes
bill language so that, during fiscal year 2023, for every
100,000 increase in the total average weekly insured
unemployment (AWIU) above 1,778,000, an additional $28,600,000
shall be made available to States from the Unemployment Trust
Fund.
In the event that additional funds are provided to States
under the AWIU contingency authority, the Department is
directed to provide notification to the Committees on
Appropriations of the current projected AWIU level for the
fiscal year, when funds were provided to States, and how much
additional funding was provided in total and to each State
within 15 days of funding being provided. In the event that
additional funds are provided on a quarterly basis, the
Department shall provide this information on a quarterly basis.
The Committee includes $117,000,000 for the Reemployment
Services and Eligibility Assessments program, and an additional
$258,000,000 is made available pursuant to the Bipartisan
Budget Act of 2018 (P.L. 115-123), which is $125,000,000 more
than the fiscal year 2022 enacted level and equal to the fiscal
year 2023 budget request.
UI Integrity Center of Excellence (UIICE).--The
recommendation provides $9,000,000 for the continued support of
UIICE.
Unemployment Compensation National Activities.--The
Committee recommends $118,000,000 for National Activities,
which is $100,000,000 more than the fiscal year 2022 enacted
level and $50,174,000 below the fiscal year 2023 budget
request. This increase in funding is intended to help modernize
information technology systems and support States in
administering the UI program.
The Committee supports ongoing efforts by the Department's
Employment and Training Administration to collaborate with
state workforce agencies to modernize unemployment insurance
management systems. The Committee continues to urge the
department to develop a comprehensive long-term strategy for
delivery of assistance to state workforce agencies, as outlined
in House report 117-96.
Employment Service.--The Committee recommends $723,862,000
for the Employment Service allotment to States, which is
$48,810,000 more than the fiscal year 2022 enacted level and
$25,000,000 more than the fiscal year 2023 budget request.
The Committee also recommends $25,000,000 for Employment
Service National Activities, which is the same as the fiscal
year 2022 enacted level and $2,682,000 more than the fiscal
year 2023 budget request.
The Employment Service offers vital services such as
referrals for job openings, career counseling, and job searches
for individuals seeking employment, including veterans and
people with disabilities. Since 1933, this Federal-State
partnership has facilitated the connection between employers in
need of workers and individuals seeking employment. Given the
nature of this exchange, the Department has historically
required that the Employment Service system rely on State
merit-staff employees to ensure that these services are
rendered in the public interest and not solely to meet private
interests. However, under the previous Administration, the
Department's issued a final rule that marked a dangerous
departure from this operation. As such, the recommendation
includes new bill language preventing the implementation of the
final rule, entitled ``Wagner-Peyser Act Staffing Flexibility''
(85 Fed. Reg. 592).
Foreign Labor Certification.--The Committee recommends
$94,810,000 for the Foreign Labor Certification (FLC) program,
which is $15,000,000 more than the fiscal year 2022 enacted
level and $3,721,000 below the fiscal year 2023 budget request.
The recommendation includes $68,528,000 for Federal
administration, an increase of $10,000,000 over the fiscal year
2022 enacted level and $1,721,000 below the fiscal year 2023
budget request, that is intended to be used to ensure effective
oversight and enforcement of employer regulations, and
$26,282,000 for grants to States, an increase of $5,000,000
over the fiscal year 2022 enacted level and $2,000,000 below
the fiscal year 2023 budget request.
Heat-Related Deaths.--The Committee recognizes that farm
workers ensure our nation's food supply at the risk of their
own health and safety, toiling under extreme temperatures and
other dangerous conditions. Agriculture had the highest average
rate of heat-related deaths of all industry sectors. More
specifically, agriculture had roughly three times the rate of
heat-related death compared to construction, which is the
industry with the second highest rate of heat-related death,
and 35 times the risk of heat related death compared to other
industry sectors. The Committee believes that no workers should
die of heat. Heat death and illness can be prevented by very
simple measures, such as access to drinking water, shade, and
rest breaks. The Committee urges the DOL to consider what
immediate steps they can take to prevent heat illness and death
while the OSHA rulemaking is in progress. In particular, the
Committee urges the DOL to consider what protections could be
put into place to protect workers at H-2A employers from heat
illness and death, such as requiring a heat illness prevention
plan as part of the H-2A labor certification process.
Workforce Information.--To better understand the growing
threat heat-related illness poses to climate-vulnerable
agricultural workers, the Committee encourages the Department
to assess heat-related illness prevention and response through
the National Agricultural Worker Survey. Specifically, the
Committee encourages the Employment and Training Administration
(ETA) to ensure workers' access to drinking vessels, potable
water, restrooms, and shade are addressed by the National
Agricultural Workers Survey. The Committee also directs ETA to
incorporate questions about the incidence and prevalence of
heat-related illness during agricultural employment and whether
workers have been training on the job about heat-related
illness. The Committee directs ETA to include a report to
Congress on the findings from these questions of the survey as
part of its annual report on the National Agricultural Worker
Survey.
Schedule A Occupational Classification.--The Committee is
aware that the Schedule A occupational classification list
currently includes only two broad occupational classifications
and a narrow subset of other applicants. The Committee
continues to encourage the Secretary to consider rulemaking to
improve the experience of employers and to effectively allocate
Department resources with the goal of protecting U.S. workers
from undue foreign competition through the labor certification
process.
One-Stop Career Centers/Labor Market Information.--The
Committee recommends $67,653,000 for One-Stop Career Centers
and Labor Market Information, which is $5,000,000 more than the
fiscal year 2022 enacted level and $18,000,000 below the fiscal
year 2023 budget request. The recommendation also includes
language authorizing the Secretary to transfer certain funding
to the Office of Disability Employment Policy for research and
demonstration projects.
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
Appropriation, fiscal year 2022....................... $164,415,000
Budget request, fiscal year 2023...................... 222,633,000
Committee Recommendation.............................. 209,200,000
Change from enacted level......................... +44,785,000
Change from budget request........................ -13,433,000
The recommendation includes $144,465,000 from the General
Fund of the Treasury and $64,735,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
The Committee includes new bill language ensuring Office of
Apprenticeship resources support Registered Apprenticeships and
adequate staffing in the Office of Apprenticeship and State
offices.
Prize Competition.--The Committee continues to encourage
the Department, in coordination with the Office of Science and
Technology Policy, to establish a prize competition consistent
with the requirements of section 24 of the Stevenson-Wydler
Technology Innovation Act of 1980, to support eligible programs
designed to prepare high school students to enter and succeed
in an in-demand industry sector or occupation.
National Guard Job ChalleNGe.--The Committee appreciates
the value and success of the National Guard's Youth ChalleNGe
Program, and the benefits the Department of Labor's
collaboration through Job ChalleNGe provides to the youth
served through the experience. The occupational skills
training, individualized career and academic counseling, work-
based learning opportunities, and leadership development
activities provided through the Job ChalleNGe are even more
vital in the aftermath of the economic fallout associated with
the pandemic. The Committee encourages the Department to build
upon its collaboration with Youth ChalleNGe programs and offer
youth occupational skills training, individualized career and
academic counseling, work-based learning opportunities, and
leadership development activities.
Gun Violence.--The Committee encourages the Department to
prioritize Workforce Innovation and Opportunity funding
opportunities, like the Young Adult Reentry Partnership and
YouthBuild, to support reintegration, transitional employment,
long-term impactful positions, union positions, and living
wages for systems-involved youth and older adults in cities
disproportionately impacted by daily gun violence.
Higher Education Workforce Development Initiative.--The
Committee encourages the Department of Labor to partner with
the Department of Education to explore the feasibility of
creating workforce development programs at 4-year higher
education institutions to align workforce development efforts
and post-secondary education and support expanded skills
instruction, apprenticeships, and other work-based learning
opportunities, including cooperative education and upskilling
and reskilling efforts in industries like manufacturing,
information technology, healthcare, and energy, among others.
The Committee encourages the Department to model the Higher
Education Workforce Development Innovation program similarly to
the Strengthening Community College Training Grants Program.
Electric Vehicle Mechanics.--The Committee recognizes the
growing need of high skilled mechanics and workforce
development in the automotive field to prepare for advances in
the electric vehicle industry. The Committee encourages the
Department of Labor and the Department of Education to explore
the feasibility of working with industry partners, labor
groups, and nonprofit experts to develop curriculum and
training programs to further career pathways for electric
vehicle mechanics. The collaboration should also develop
recommendations of advanced training programs for established
career mechanics to grow skilled labor outcomes and deepen
their skills and knowledge to meet the needs of the future.
Disaggregated Data by Race.--The Committee is aware that
few federal or federally funded workforce training programs
track outcomes by race. The Committee recommends careful
evaluation of disaggregated racial data in order to advance
racial equity and minimize racial disparities in workforce
training. The Committee requests a report from ETA within 120
days of enactment of this Act on efforts to evaluate
disaggregated racial data in federally-funded workforce
training programs.
Reducing Homelessness.--The Committee recognizes that
employment that pays a living wage and can support the cost of
housing is a key to reducing homelessness. The Office of
Workforce Investment (OWI) is responsible for a national
workforce investment system that provides workers with the
information, advice, job search assistance, supportive
services, and training for in-demand industries and occupations
needed to get and keep good jobs. The Committee urges OWI to
provide workforce boards with incentives and guidance to
promote coordination with local homelessness systems to ensure
that employment services are accessible and useful to people
who are homeless or have recently left homelessness.
Justice Involved Workers.--The Committee supports the
Department of Labor's intention to expand education, skills
training, and work experience programs to connect justice-
involved individuals with employment opportunities to obtain
and retain jobs. The Committee continues to recommend that
Federal workforce development funding under covered education
and training programs be available to eligible recipients with
a demonstrated capacity to develop and improve the availability
of employment and transitional job programs that support work-
based learning activities designed to increase reentry
employment as an equitable workforce approach. To increase
alignment of work experience opportunities across federal
programs, the committee also directs the Department to enter
into a cooperative agreement with national nonprofit
organizations that have an established partnership with the
SNAP Employment & Training program at the Department of
Agriculture.
Regional Councils and Councils of Governments.--The
Committee encourages the Department to list regional councils
and councils of governments as eligible entities in
competitions for Federal funding whenever local governments or
non-profit agencies are eligible entities. Furthermore, the
Committee encourages the Department to seek opportunities for
regional councils and councils of governments to serve as lead
applicants and grantees to encourage and expand greater
regional collaboration.
Employee Benefits Security Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $185,000,000
Budget request, fiscal year 2023...................... 233,867,000
Committee Recommendation.............................. 233,867,000
Change from enacted level......................... +48,367,000
Change from budget request........................ - - -
The Employee Benefits Security Administration (EBSA)
assures the security of retirement, health and other workplace-
related benefits of working Americans.
The Committee recommends $233,867,000 for EBSA, which is
$48,367,000 above the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request.
Mental Health Parity and Addiction Equity Act (MHPAEA)
Compliance.--The Committee has included resources for the
Employee Benefits Security Administration (EBSA) to fully
implement Section 203 of Division BB of the Consolidated
Appropriations Act, 2021. Section 203 requires that all group
health plans perform comparative analyses of the design and
application of nonquantitative treatment limitations (NQTLs) to
ensure those imposed on mental health and substance use
disorder benefits are not more restrictive than limitations for
medical and surgical benefits.
The Committee is encouraged that EBSA formed a MHPAEA NQTL
Task Force composed of experienced investigators, health policy
experts, technical experts from EBSA's regional and national
offices, and attorneys from the Office of the Solicitor of
Labor to assist in the implementation of the new provisions.
The Committee encourages EBSA to continue to enhance its MHPAEA
NQTL enforcement program by increasing the investigative
resources dedicated to NQTL review and analysis. To the extent
resources allow, the Committee also encourages EBSA to create
templates and tools for collecting and scoring the comparative
analyses and rendering decisions on compliance; enhance
coordination, standardization and MHPAEA-related decision-
making uniformity among regional offices; and conduct follow-up
investigations into group health plans whose comparative
analyses indicate likely noncompliance or areas in which
further examination is needed to determine compliance.
Pension Benefit Guaranty Corporation
Appropriation, fiscal year 2022....................... $472,955,000
Budget request, fiscal year 2023...................... 493,314,000
Committee Recommendation.............................. 493,314,000
Change from enacted level......................... +20,359,000
Change from budget request........................ - - -
Congress established the Pension Benefit Guaranty
Corporation to insure the defined-benefit pension plans of
working Americans.
Wage and Hour Division
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $251,000,000
Budget request, fiscal year 2023...................... 307,678,000
Committee Recommendation.............................. 312,678,000
Change from enacted level......................... +61,678,000
Change from budget request........................ +5,000,000
The Wage and Hour Division (WHD) enforces Federal minimum
wage, overtime pay, recordkeeping, and child labor requirements
of the Fair Labor Standards Act (FLSA). 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 recommends $312,678,000 for WHD, which is
$61,678,000 above the fiscal year 2022 enacted level and
$5,000,000 above the fiscal year 2023 budget request. The
increase will support additional investigators to combat wage
theft and protect workers. The Committee urges WHD to explore
and expand strategic enforcement approaches to the agency's
work to make the most of this increase.
Retaliation.--Because retaliation and the threat of
retaliation remain a critical challenge to workers' ability to
exercise their workplace rights, the Committee requests for WHD
to provide information regarding its volume of retaliation
complaints, the status of those complaints, and how WHD is
working effectively to protect workers from retaliation in the
fiscal year 2024 Congressional Budget Justification.
Accessibility.--The Committee notes the importance of
making sure all workers can access WHD's resources, including
workers of color, immigrant workers, workers in rural
communities or with limited access to transportation, and
workers with disabilities. The Committee encourages WHD to
undertake efforts to improve accessibility of WHD offices,
translate WHD documentation and signage into languages spoken
by 5 percent or more of the population in a given WHD region,
and translate WHD's online webpages, complaint forms, and
resources to match regional needs. In hiring investigators, the
Committee encourages WHD to focus on employing and retaining a
greater number of multilingual investigators. In addition, the
Committee encourages WHD to establish protocols that permit
workers to participate in investigations and hearings remotely
where appropriate.
Community-based Organizations and Partnerships.--The
Committee believes that community-based organizations are
critical in establishing necessary trust, connecting workers
with agencies, facilitating communication between agencies and
workers, and deploying enforcement resources strategically.
Working with community-based organizations helps agencies
cooperate with workers who might otherwise be difficult to
reach, including workers employed by small businesses, workers
with literacy challenges, workers with limited access to
broadband, and workers in high-hazard industries most
vulnerable to wage violations. Therefore, the Committee urges
WHD to increase its capacity to conduct outreach and
collaborate with community-based organizations.
U and T Visa Certification.--The Committee notes the
critical role WHD plays in completing U and T visa
certifications on behalf of victims of crime and victims of
trafficking in the workplace. Ensuring that all workers,
regardless of immigration status, can participate in WHD
investigations and exercise their workplace rights is critical
to the full and effective enforcement of Federal labor laws.
The Committee urges WHD to use resources provided in fiscal
year 2023 to ensure the efficient and timely processing and
certification of all certification requests.
Domestic Workers.--The Committee is concerned that domestic
workers are particularly vulnerable to workplace exploitation,
including wage theft, verbal abuse, trafficking, and sexual
assault. Domestic work commonly takes place in private homes,
where workers are often isolated and alone. This workforce is
predominantly female, and represents populations that are
already vulnerable, including immigrant women and women of
color. The Committee is concerned by the limited enforcement of
workplace rights for this population and the severe power
imbalance between domestic workers and their employers. In
response to these concerns, the Committee includes new bill
language directing the Secretary to use funds made available
under WHD to establish a national hotline to support domestic
workers. In addition, the Committee urges WHD to prioritize
investigations in sectors where workers are more vulnerable to
wage theft, including domestic work, long term care, and home
health care.
Misclassification.--The Committee is concerned that cases
of workers being misclassified as independent contractors have
been steadily rising in recent years, a development that
transfers costs of doing business to workers, denies them the
rights and protections of bedrock workplace protections, and
depletes federal coffers by limiting payroll taxes. The
Committee urges the WHD to use the full extent of its existing
powers to enforce laws related to employee classification and
to undertake such rulemaking action as may be necessary to
execute Congress's direction under 29 USC 202.
Warehouse Workers.--The Committee recognizes that temporary
warehouse workers have been the backbone of efforts to address
the supply chain issues that the United States experienced
during the COVID-19 pandemic. The Committee strongly supports
increased oversight to prevent wage theft from warehouse
workers and is encouraged by the WHD's initiative on Warehouse
and Logistics workers. The Committee requests a report within
90 days of enactment of this Act detailing the steps the WHD is
taking to address wage theft among warehouse workers, including
non-union temporary warehouse workers. In addition, the
Committee requests a progress report on the initiative on
Warehouse and Logistics workers, including steps to provide
education, outreach, enforcement to increase compliance and
reduce industry violations.
Office of Labor Management Standards
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $45,937,000
Budget request, fiscal year 2023...................... 49,951,000
Committee Recommendation.............................. 45,937,000
Change from enacted level......................... - - -
Change from budget request........................ -4,014,000
The Office of Labor Management Standards (OLMS) administers
the Labor-Management Reporting and Disclosure Act (LMRDA),
which establishes safeguards for union democracy and union
financial integrity, and requires public disclosure reporting
by unions, union officers, employees of unions, labor relations
consultants, employers, and surety companies.
The Committee recommends $44,937,000 for OLMS, which is the
same as the fiscal year 2022 enacted level and $4,014,000 below
the fiscal year 2023 budget request.
Persuader Reporting.--The Committee is concerned about
uneven compliance with rules regarding reporting of persuader
activity and urges the Department to review its rules and
policies on persuader reporting and take all appropriate
actions to strengthen its rules and enforcement to ensure
maximum compliance and reporting of persuader activity.
Further, the Committee urges the Department to consider
proposing a revision to its rules to require disclosure on the
LM-10 form as to whether the filer is a federal contractor,
whether the persuader activity relates to employees working on
or in connection with the federal contract, and with which
agency or agencies the employer contracts.
Office of Federal Contract Compliance Programs
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $108,476,000
Budget request, fiscal year 2023...................... 147,051,000
Committee Recommendation.............................. 147,051,000
Change from enacted level......................... +38,575,000
Change from budget request........................ - - -
The Office of Federal Contract Compliance Programs (OFCCP)
ensures equal employment opportunity in the Federal contracting
community through enforcement, regulatory work, outreach and
education to workers and their advocates.
OFCCP is responsible, per Executive Order 11246 (EO 11246),
for ensuring Federal contractors and subcontractors take
affirmative action to ensure that all individuals have an equal
opportunity for employment, without regard to race, color,
religion, sex, or national origin.
The Committee recommends $147,051,000 for OFCCP, which is
$38,575,000 above the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request. The Committee
supports OFCCP's efforts to make sure contractors and
subcontractors are adhering fully to EO 11246.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $120,129,000
Budget request, fiscal year 2023...................... 145,977,000
Committee Recommendation.............................. 145,977,000
Change from enacted level......................... +25,848,000
Change from budget request........................ - - -
The Office of Workers' Compensation Programs (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 recommendation includes $143,772,000 in
General Funds from the Treasury, which is $25,848,000 above the
fiscal year 2022 enacted level and the same as the fiscal year
2023 request, and $2,205,000 from the Special Fund established
by the Longshore and Harbor Workers' Compensation Act.
SPECIAL BENEFITS
Appropriation, fiscal year 2022....................... $244,000,000
Budget request, fiscal year 2023...................... 250,000,000
Committee Recommendation.............................. 250,000,000
Change from enacted level......................... +6,000,000
Change from budget request........................ - - -
These funds provide mandatory benefits under the Federal
Employees' Compensation Act.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriation, fiscal year 2022....................... $32,970,000
Budget request, fiscal year 2023...................... 36,031,000
Committee Recommendation.............................. 36,031,000
Change from enacted level......................... +3,061,000
Change from 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 recommends $36,031,000 for Special Benefits
for Disabled Coal Miners. This amount is in addition to the
$11,000,000 appropriated in fiscal year 2022 as an advance for
the first quarter of fiscal year 2023. The total program level
recommendation is $3,061,000 more than the fiscal year 2022
enacted level and the same as the fiscal year 2023 budget
request.
The Committee recommendation also provides $10,250,000 as
an advance appropriation for the first quarter of fiscal year
2024. These funds ensure uninterrupted payments to
beneficiaries.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS
COMPENSATION FUND
Appropriation, fiscal year 2022....................... $63,428,000
Budget request, fiscal year 2023...................... 64,564,000
Committee Recommendation.............................. 64,564,000
Change from enacted level......................... +1,136,000
Change from 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.
Beryllium Vendor Eligibility.--The Committee is concerned
that the Department of Labor's interpretation of what
constitutes a ``covered employee'' under the terms of the
Energy Employees Occupational Illness Compensation Program Act
(EEOICPA) mistakenly excludes some employees of beryllium
vendors and facilities and contravenes congressional intent
under EEOICPA. As such, the Committee encourages the Department
to examine making eligible all employees of beryllium vendors
named in EEOICPA for benefits under the Act regardless of
corporate structure, past reorganizations, or current ownership
as a subsidiary provided those actions were compliant with
applicable federal law. The Committee further directs the
Department to submit a report to the Committee no later than 90
days after the date of enactment of this Act that outlines the
number of beneficiaries and eligible employers covered under
the EEOICPA.
BLACK LUNG DISABILITY TRUST FUND
Appropriation, fiscal year 2022....................... $331,505,000
Budget request, fiscal year 2023...................... 394,896,000
Committee Recommendation.............................. 394,896,000
Change from enacted level......................... +63,391,000
Change from budget request........................ - - -
The Black Lung Disability Trust Fund, supported with
mandatory funding, 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.
Black Lung Benefits Claims Processing.--The Committee is
concerned with lengthy delays in the processing of Black Lung
Benefits Act claims, particularly where the mine operator's
ability to pay the claim is in question. Delays impede access
to necessary medical care while claims are pending. The
Committee supports efforts by the Secretary to resolve these
claims expediently to ensure miners can receive the benefits
and medical care they need. The Committee requests an update in
the fiscal year 2024 Congressional Budget Justification on the
Department's efforts to improve the speed and quality of its
black lung claims processing.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $612,015,000
Budget request, fiscal year 2023...................... 701,405,000
Committee Recommendation.............................. 712,015,000
Change from enacted level......................... +100,000,000
Change from budget request........................ +10,610,000
The Occupational Safety and Health Act of 1970 established
the Occupational Safety and Health Administration (OSHA) to
assure safe and healthy working conditions by setting and
enforcing standards and by providing training, outreach,
education and assistance.
Within the total for OSHA, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Safety and Health Standards.......................... $29,080,000
Federal Enforcement.................................. 285,508,000
Whistleblower Programs............................... 27,290,000
State Programs....................................... 121,075,000
Technical Support.................................... 27,007,000
Federal Compliance Assistance........................ 91,608,000
State Consultation Grants............................ 63,500,000
Training Grants...................................... 14,287,000
Safety and Health Statistics......................... 42,180,000
Executive Direction and Administration............... 10,480,000
------------------------------------------------------------------------
Compliance Safety and Health Officers (CSHOs).--The
Committee is concerned about the significant reduction in OSHA
Compliance Safety and Health Officers (CSHOs) in recent decades
relative to the number of workers they oversee. These CSHOs
enforce federal workplace standards across the country,
inspecting worksites and ensuring that employers comply with
worker safety and health regulations. That is why the Committee
is strongly supportive of OSHA's plans to use additional
resources to support and rebuild OSHA's enforcement program by
hiring additional CSHOs. The Committee encourages the agency to
focus on employing and retaining multilingual officers crucial
to thorough inspections of workplaces across the country.
Elimination of the Limiting OSHA Coverage to Small Farms
Rider.--The Committee continues to eliminate the existing
appropriations rider that prevents OSHA from conducting any
activities--including compliance assistance, investigations,
and enforcement activities--on small farms. Agriculture is
among the most dangerous industries in the United States.
However, OSHA is currently prohibited from investigating even
fatalities and serious injuries on small farms, as well as
responding to worker complaints. Agricultural exemptions in New
Deal worker protection laws, which set the precedent for the
OSHA small farms rider, were included as compromises to secure
the votes of Southern lawmakers who opposed expanding labor
rights for black farmworkers and sharecroppers. This is an
almost 40-year-old rider that continues to have a disparate
impact on racial and ethnic minorities and should not be
included in this Act. All farmworkers deserve to be protected
by the OSHA law, regardless of the size of their employer.
Penalties.--The Committee notes that OSHA penalties are
among the lowest of any Federal agency and believes they are
woefully inadequate in deterring workplace health and safety
violations by employers. For instance, despite widespread
reports that meatpacking facilities were becoming deadly COVID-
19 hotspots as early as March 2020, OSHA waited six months
before issuing two small financial penalties totaling $29,000
to a JBS plant and a Smithfield plant. For context, in 2019,
JBS's annual revenue was $51.7 billion and Smithfield's was $14
billion. To address these concerns, Committee urges OSHA to
adopt policies that encourage the use of maximum penalties or a
penalty multiplier for serious violations in large businesses.
Whistleblower Protection Program.--The Committee is
concerned about the increasing caseloads and unprecedented
length of time taken by OSHA to complete whistleblower
investigations. OSHA's whistleblower investigative staff
enforces protections for employees who suffer retaliation for
protected activity under more than 20 statutes, and the number
of statutes continues to increase. OSHA's already-overburdened
Whistleblower Protection Program staff has seen a consistent
increase in new complaints filed, including a large increase in
COVID-19 related complaints since the beginning of the
pandemic, which has resulted in a significant backlog of
pending investigations. The Office of Inspector General
concluded in August 2020 that when OSHA fails to respond in a
timely manner, it ``could leave workers to suffer emotionally
and financially'' and may lead to the erosion of evidence
needed for the case. To bolster the Whistleblower Protection
Program's capacity to conduct critical investigations in a
timely manner in industries across the country and bring the
agency closer to compliance with statutory requirements of more
than 20 statutes, the Committee increases resources for the
Whistleblower Protection program by $5,790,000 above the fiscal
year 2022 enacted level. This increase will support OSHA's
efforts to update its decades-old Whistleblower data base to
the current OSHA Information System for OSHA's main enforcement
program or to develop a new system.
Susan Harwood Training Grants.--The Susan Harwood Training
Grants to non-profit organizations reach workers in dangerous
industries with critical education and training on workplace
hazards and statutory protections. The latest statistics from
the Bureau of Labor Statistics show that workplace fatalities
are increasing for Black workers and that fatality rates are
higher among Hispanic and Black workers. The Committee supports
OSHA's efforts to provide funding to non-profit, community-
based groups, and other non-profit organizations with the
capability to reach workers in low-wage industries and workers
in dangerous industries. In addition, the Committee urges OSHA
to allow grantees to train on multiple hazards. Further, the
Committee encourages OSHA to ensure grants are awarded to train
workers employed in disaster recovery and rebuilding sectors.
U and T Visas.--The Committee strongly supports efforts by
OSHA to ensure all workers, regardless of immigration status,
can participate in OSHA investigations and exercise their
workplace rights. However, the Committee notes that OSHA does
not outline a process for U and T visa certification. The
Committee encourages OSHA to evaluate the merits of
establishing a policy on U and T visa certification requests
and consider assisting workers with U and T visa certification.
OSHA Noise Standard.--The Committee is aware that the
National Institute for Occupational Safety and Health (NIOSH)
estimates that 22 million U.S. workers are exposed to
potentially dangerous levels of noise in the workplace every
year and that hearing loss is the most commonly recorded
occupational illness in manufacturing, accounting for 1 in 9
recordable illnesses. The Committee is also aware that the OSHA
Noise Standard (20 CFR 1910.95) for employers was established
in 1983, but has not been updated since that time even as the
Department of Defense (DoD), NIOSH, and many other countries
have recommended or adopted more protective noise exposure
limits. Accordingly, to better protect the American workforce
and reduce the risk of noise-induced hearing loss, the
Committee urges OSHA to lower the current permissible exposure
level to 85 dBA TWA using a 3 dB exchange rate. Such a change
would substantially reduce the excess risk of developing
occupational noise-induced hearing loss over a working lifetime
and be consistent with current exposure limits specified by the
DoD and voluntarily adopted by many private employers.
OSHA Heat Standard.--The Committee recognizes that with
climate change, risks of heat-related illnesses continue to
grow, posing serious risks to workers and their families as
well as the nation's food supply and supply chains. Workers
exposed to extreme heat are disproportionately low-wage workers
and workers of color. The Committee is encouraged by the notice
of proposed rulemaking by the Department announced in October
2021. While the rulemaking is underway, the Committee is
pleased that OSHA's National Emphasis program will create, for
the first time, a nationwide enforcement mechanism to
proactively inspect workplaces for heat-related hazards and
prevent worker injuries, illnesses, and fatalities.
Children in Agriculture.--The Committee is concerned that
children working in agriculture are at risk from work injuries
that could result in death. The Committee requests a report
within 180 days of the date of enactment of this Act which
shall include an evaluation of data that reflects the status of
child labor and related safety and health hazards, such as the
health impact of pesticide use. The report shall include
information on work-related serious injuries to children under
18 employed in agriculture, as well as work-related deaths of
children under 18 employed in agriculture. The report shall
provide relevant details, including environmental hazards, such
as chemical or pesticide exposure; use of machinery or tools at
time of incident; work tasks performed at time of incident; and
other details relating to the incident. OSHA is encouraged to
collaborate with BLS and WHD.
Technology.--The Committee recognizes that technology is
increasingly incorporated into how we work. The Committee
encourages OSHA, in collaboration with NIOSH and stakeholders,
to examine the role of technology in improving safety. In
particular, OSHA should review efforts to make technology
innovation more accessible, to identify the most hazardous
situations for the American workforce, and to eliminate
barriers to the adoption of critical safety controls by
employers. The Committee requests a briefing with 120 days of
enactment of this Act on recommendations on these topics to
specifically focus on reducing fatalities.
Interagency Collaboration.--The Committee is concerned
about the implementation and renegotiation of the 1994
Memorandum of Understanding (MOU) between OSHA and the Food
Safety and Inspection Service (FSIS) towards establishing a
process for FSIS inspection personnel to be trained to
recognize and report serious workplace hazards. The Committee
requests a report within 90 days of enactment of this Act on
the implementation status of this renegotiated MOU that
includes the agencies' timeline and action plan for
implementation.
Asbestos.--The Committee is concerned that construction
workers continue to be exposed to asbestos at renovation,
rehabilitation, and restoration construction sites for both
private developments and public housing. The Committee
encourages OSHA, in collaboration with the Environmental
Protection Agency, to prioritize activities that proactively
prevent asbestos exposure, such as increased site visits. In
addition, the Committee encourages OSHA to work with employers
to ensure asbestos hazards, fact sheets, and safety protocols
are publicly listed in English and Spanish and to provide
trainings to employers and employees.
Arc-flash Personal Protective Equipment.--The Committee is
concerned with continued lack of compliance with OSHA's and
industry's standards for arc-flash (AR) clothing and associated
personal protective equipment (PPE) requirements that have been
in place for over two decades. More than 600,000 American
workers performing work on or near energized electrical
equipment are exposed to deadly arc-flash related injuries and
hazards on worksites across the country without the required
lifesaving protection. This results in many catastrophic
injuries and fatalities of American workers every year,
virtually all of which are preventable. The Committee
encourages OSHA to adopt an enforcement policy citing existing
standards such as NFPA 70E, and for requiring appropriate arc
flash protective clothing and PPE during all live electrical
work performed in the United States.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $383,816,000
Budget request, fiscal year 2023...................... 423,449,000
Committee Recommendation.............................. 403,816,000
Change from enacted level......................... +20,000,000
Change from budget request........................ -19,633,000
The Mine Safety and Health Administration (MSHA) enforces
the Federal Mine Safety and Health Act in underground and
surface coalmines and metal/non-metal mines.
Within the total for MSHA, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Mine Safety and Health Enforcement................... $279,509,000
Standards and Regulations Development................ 6,229,000
Assessments.......................................... 7,191,000
Educational Policy and Development................... 39,755,000
Technical Support.................................... 36,209,000
Program Evaluation and Information Resources......... 18,655,000
Program Administration............................... 16,268,000
------------------------------------------------------------------------
Coal, Metal, and Non-metal Mines.--MSHA is directed to
include in the fiscal year 2024 Congressional Budget
Justification and all future Congressional Budget
Justifications historical and budget year information on
enforcement activities and outcomes, distinguishing between
coal and metal/non-metal mines. To promote transparency in
agency spending on its enforcement activities, MSHA shall
continue to separately present annual spending on coal and
metal/non-metal mines as it has in past Congressional Budget
Justifications.
Resources and Activities.--The Committee notes significant
worker dislocations and mine closures because of economic
conditions throughout the mining industry, and in coal mining
in particular. The Committee reiterates its support for the
ongoing effort to bring MSHA enforcement into proportion by
redistributing resources and activities to the areas where mine
production is currently occurring and where MSHA identifies the
most significant safety hazards.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $687,952,000
Budget request, fiscal year 2023...................... 741,744,000
Committee Recommendation.............................. 726,334,000
Change from enacted level......................... +38,382,000
Change from budget request........................ -15,410,000
The Bureau of Labor Statistics (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.
The Committee recommendation includes $658,334,000 from the
General Fund of the Treasury and $68,000,000 from the
Employment Security Administration Account in the Unemployment
Trust Fund. The recommendation does not include funds for the
relocation of the BLS headquarters, which was fully funded in
fiscal year 2022.
Within the total for BLS, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Employment and Unemployment Statistics............... $261,454,000
Labor Market Information............................. 68,000,000
Prices and Cost of Living............................ 252,000,000
Compensation and Working Conditions.................. 92,976,000
Productivity and Technology.......................... 12,853,000
Executive Direction and Staff Services............... 39,051,000
------------------------------------------------------------------------
National Longitudinal Survey of Youth (NLSY).--The
Committee continues to recognize the importance of the National
Longitudinal Survey of Youth (NLSY), which has provided
valuable information about labor market trends for decades. The
increase includes sufficient resources to continue development
of a new NLSY cohort.
Preserving Existing Statistical Work and Staff.--When
implementing the NLSY and other new investments, the Committee
directs BLS not to reduce or eliminate existing statistical
work. Further, the Committee directs BLS not to reduce the
number of full-time equivalent positions beyond the apportioned
fiscal year 2022 full-time equivalent ceiling.
Nonprofit Sector Workforce.--The Committee recognizes the
importance of the nonprofit sector workforce as a critical
partner to government and a frontline service provider in
communities nationwide and encourages BLS to examine the value
in including nonprofit organizations as a distinct category of
employer in quarterly reports from its Quarterly Census of
Employment and Wages (QCEW).
Artificial Intelligence.--The Committee notes the continued
development of artificial intelligence and encourages BLS to
examine this trend's impact on the economy.
Public Safety Telecommunicators.--The Committee recognizes
that categorizations of a `public safety telecommunicator' as
an `office and administrative support occupation' is outdated
and does not reflect the nature of this life-saving work. The
Committee encourages BLS to update data collection practices to
be in line with modern changes to the public safety
telecommunications profession, classifying them as a
`protective service occupation' and collecting data
accordingly.
Military Spouses.--The Committee recognizes the need for
comprehensive data measuring employment among military spouses
over time. The Committee encourages BLS, in collaboration with
the Department of Defense, to assess the potential for
measuring labor market outcomes and characteristics of military
spouses with existing survey data and explore options for
modifying such surveys to capture this population.
BLS Data Collection Sources.--The Committee recognizes the
value and importance of real-time economic data for the purpose
of identifying economic trends and consumer sentiment. Further,
as the Department prepares future solicitations for economic
data and research, the Committee encourages the Department to
conduct robust market research to identify potential new market
entrants.
Office of Disability Employment Policy
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $40,500,000
Budget request, fiscal year 2023...................... 58,566,000
Committee Recommendation.............................. 58,566,000
Change from enacted level......................... +18,066,000
Change from budget request........................ - - -
The Office of Disability Employment Policy (ODEP) provides
policy guidance and leadership to eliminate employment barriers
to people with disabilities.
The Committee recommendation for ODEP is $58,566,000, which
is $18,066,000 above the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request. The Committee is
supportive of the budget proposal for ODEP to support the
planning and implementation of Equitable Transition Model (ETM)
projects that will develop strategies to enable low-income
youth with disabilities, including youth experiencing
homelessness, leaving foster care, or involved in the justice
system, to be more likely to transition to employment.
Departmental Management
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $367,697,000
Budget request, fiscal year 2023...................... 492,104,000
Committee Recommendation.............................. 498,917,000
Change from enacted level......................... +131,220,000
Change from budget request........................ +6,813,000
The Departmental Management appropriation provides funds
for the staff responsible for Departmental operations,
management, and policy development.
The Committee recommendation includes $498,609,000 from the
General Fund of the Treasury, $131,220,000 above the fiscal
year 2022 enacted level and $6,813,000 above the fiscal year
2023 budget request, and $308,000 from the Employment Security
Administration Account in the Unemployment Trust Fund.
Within the total for Departmental Management, the Committee
provides the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Program Direction and Support........................ $38,958,000
Departmental Evaluation.............................. 10,351,000
Legal Services....................................... 178,183,000
International Labor Affairs.......................... 138,965,000
Administration and Management........................ 36,630,000
Adjudication......................................... 42,836,000
Women's Bureau....................................... 35,361,000
Civil Rights Activities.............................. 11,591,000
Chief Financial Officer.............................. 6,042,000
------------------------------------------------------------------------
Office of the Solicitor (SOL).--The recommendation includes
$178,183,000 for SOL to bring enforcement actions on behalf of
DOL's agencies. The SOL is encouraged to increase staffing
levels to assist in the development of investigations,
negotiations, and litigations to ensure workers get the relief
they deserve.
Bureau of International Labor Affairs (ILAB).--Of the
$138,965,000 recommended for ILAB, the Committee directs the
Secretary to allocate not less than $40,500,000 in grants to
build the capacity of countries to enforce labor rights to
promote a more level playing field for workers in the U. S.
while maintaining critical funding for combatting child labor.
The Committee directs ILAB to use its fiscal year 2023 funding
increase to place additional labor attaches in strategic
countries, including, but not limited to, Honduras.
Flagship Reports on Child Labor and Forced Labor.--ILAB is
directed to continue its work on three key reports, including:
DOL's Findings on the Worst Forms of Child Labor; the List of
Goods Produced by Child Labor or Forced Labor; and, the List of
Products Produced by Forced or Indentured Child Labor. The
Committee includes the resources requested in the fiscal year
2023 budget request for staff and contract costs to fulfill a
new statutory mandate requiring the List of Goods Produced by
Child Labor or Forced Labor to include goods that are produced
with inputs that are produced with forced labor or child labor.
USMCA Implementation Act.--The Committee urges ILAB to use
USMCA Implementation Act funding to directly support workers'
rights and capacity to organize independent unions in Mexico.
These activities must be central to ILAB's monitoring,
enforcement, and capacity-building roles in USMCA
implementation. ILAB can also advance this critical work
through technical assistance that strengthens the capacity of
independent unions in USMCA priority sectors. Further, ILAB can
fund research and legal teams, including through academic
institutions, to develop sustainable programs that train and
support labor lawyers and researchers in priority sectors.
Finally, ILAB can support key USMCA objectives by funding
innovative supply chain monitoring and accountability
mechanisms, focused on ensuring the effective recognition of
workers' rights to organize and collective bargaining in USMCA
priority sectors. Such efforts to develop necessary research,
legal assistance and monitoring mechanisms will collectively
supplement and strengthen core ILAB program to directly educate
and train workers to build independent unions.
In the fiscal year 2024 Congressional Budget Justification,
ILAB is directed to include spending plans for resources
provided in the USMCA Implementation Act for fiscal years 2020
through 2024. Spending plans should include descriptions and
amounts for projects and staffing.
Child Labor in Cocoa.--The Committee is concerned about the
continued prevalence of child labor in the harvesting and
production of cocoa beans. Further, the Committee notes that
while the Child Labor Cocoa Coordinating Group (GLCCG) has
facilitated progress in the reduction of child labor in cocoa
production, substantial levels of children remain engaged in
child labor in the industry. The Committee is concerned about
the progress of the GLCCG in accordance with goals established
in the Harkin-Engel Protocol. The Committee encourages the
Department to report on indicators of progress being made by
high-risk countries to eliminate child labor and forced labor
in the cocoa sector, including progress being made to map all
cocoa farms. In addition, the Committee encourages the
Department to report on government and industry use of
available best practices for management, reporting, and
verification, and on the active and meaningful participation of
worker organizations in order to provide consumers with
assurance that cocoa products are produced without the use of
child labor and forced labor.
Women's Bureau.--Of the $35,361,000 appropriated to the
Women's Bureau, the Committee provides no less than $7,500,000
for the Women in Apprenticeship and Nontraditional Occupations
(WANTO) program, which is $5,000,000 above the fiscal year 2022
enacted level and the fiscal year 2023 budget request. This
program helps employers and labor unions recruit, train, and
retain women for nontraditional employment opportunities. These
resources are essential in helping women overcome traditional
barriers to entry and supporting women's full participation in
the labor force.
Operating Plan.--The Committee directs the Department to
submit its annual Operating Plan to the Committees on
Appropriations within the 45-day statutory deadline.
Advertising Spending.--The Committee understands that, as
the largest advertiser in the U.S., the Federal Government
should work to ensure fair access to its advertising contracts
for small disadvantaged businesses and businesses owned by
minorities and women. The Committee directs the Department to
include the following information in its fiscal year 2024
Congressional Budget Justification: Expenditures for fiscal
year 2022 and expected expenditures for fiscal years 2023 and
2024, respectively, for (1) all contracts for advertising
services; and, (2) contracts for the advertising services
of`(I) socially and economically disadvantaged small business
concerns (as defined in section 8(a)(4) of the Small Business
Act (15 U.S.C. 637(a)(4)); and (II) women- and minority-owned
businesses.
Nondisclosure Agreements.--The Committee recognizes that
harassment, including sexual harassment and assault, continue
to be pervasive in the workplace, and that the use of
predispute nondisclosure and nondisparagement clauses as
conditions of employment can perpetuate illegal conduct by
silencing survivors and shielding perpetrators. The Committee
directs the Department to include proposals in its fiscal year
2024 Congressional Budget Justification to eliminate the use of
grants and contracts to employers that use this practice.
National Equal Pay Enforcement Task Force.--The Committee
strongly urges the Secretary to establish a National Equal Pay
Enforcement Task Force (Task Force), consisting of
representatives from the Equal Employment Opportunity
Commission, the Department of Justice, the Department of Labor,
and the Office of Personnel Management. The mission of the Task
Force should be to improve compliance, public education, and
enforcement of equal pay laws. The agencies in the Task Force
should coordinate activities and limit potential gaps in
enforcement. The Committee further urges the Task Force to
investigate challenges related to pay inequity, advance
recommendations to address those challenges, and create action
plans to implement the recommendations. The Committee requests
an update in the fiscal year 2024 Congressional Budget
Justification on steps to establish the Task Force.
Employees.--The Committee directs the Department to provide
a report not later than 30 days after the conclusion of each
quarter detailing the number of full-time equivalent employees
and attrition by principal office and appropriations account.
Investments in Impoverished Areas.--The Committee supports
targeted investments in impoverished areas, particularly in
persistent poverty counties and in other high poverty census
tracts. To understand how programs funded through the
Department are serving these particular areas, the Committee
directs the Department to submit a report to the Committees on
Appropriations on the percentage of funds allocated by all
competitive grant programs in fiscal years 2020, 2021 and 2022
to serve individuals living in persistent poverty counties, as
defined as a county that has had 20 percent or more of its
population living in poverty over the past 30 years, as
measured by the 1990 and 2000 decennial censuses and the most
recent Small Area Income and Poverty estimates, or any
territory or possession of the United States, and high-poverty
areas, as defined as any census tract with a poverty rate of at
least 20 percent as measured by the 2014-2018 5-year data
series available from the American Community Survey of the
Census Bureau. The Department shall report this information to
the Committees within 90 days of such data being available and
provide a briefing to the Committees not later than 180 days of
enactment of this Act on how the Department is carrying out
this directive. In the case of any competitive program for
which at least 10 percent of the funds allocated were not
allocated to persistent poverty counties or for which the
percentage allocated to high-poverty areas in fiscal year 2021
or 2022 was less than the average percentage of Federal
assistance allocated to high-poverty areas awarded under the
program in fiscal years 2017, 2018, and 2019, such report and
briefing shall explain why such a benchmark is unable to be
met.
Study on the Health Impact of Pesticide Use on Children in
Agriculture.--The Committee includes $1,000,000 for the
Department to contract with the National Academies of Sciences,
Engineering, and Medicine (NASEM) to study the impact of
pesticide exposure on children working in agriculture.
Pesticides have a detrimental effect on human health, with
children among the particularly vulnerable, and low levels of
pesticide exposure can affect children's neurological and
behavioral development. The Committee encourages NASEM to
review other environmental hazard-related exposures on children
in agriculture as well.
Evidence-based Policymaking Act.--The Committee is
supportive of efforts by the Department to consider evidence of
effectiveness in grant competitions and requests an update in
the fiscal year 2024 Congressional Budget Justification on
implementation of the Foundations for Evidence-based
Policymaking Act (P.L. 115-435) and implementation plans for
the coming year. The Committee encourages the Secretary to
develop guidance to ensure relevant participants and grantees
are involved in the Department-wide process of prioritizing
evidence needs, including participating in Department led
evaluations. Consistent with program statutes, the Committee
encourages the Secretary to ensure that evidence of
effectiveness is a consideration in grant opportunities.
Organizational Priority Goals.--The Committee directs the
Department to comply with title 31 of the United States Code,
including the development of organizational priority goals and
outcomes such as performance outcome measures, output measures,
efficiency measures, and customer service measures. The
Committee further directs the Department to include an update
on the progress of these efforts in the fiscal year 2024
Congressional Budget Justification.
Streamlining Service Delivery and Improving Customer
Service.--The Committee continues to support efforts to improve
customer service in accordance with Executive Order 13571--
Streamlining Service Delivery and Improving Customer Service.
The Committee directs the Secretary to develop standards to
improve customer service and incorporate the standards into the
performance plans required under 31 U.S.C. 1115. The Committee
further directs the Department to include an update on the
progress of these efforts in the fiscal year 2024 Congressional
Budget Justification.
Use of Force.--The Committee supports vigorous action to
improve training for all Federal, State, and local law
enforcement officers on racial profiling, implicit bias,
procedural justice, the use of force, and the duty for officers
to intervene when witnessing the use of excessive force against
civilians. The Committee therefore directs the Secretary to
work with the Attorney General and the Federal Law Enforcement
Training Centers to implement improved, mandatory training on
these topics for all federal law enforcement officers, along
with the development of related standards that can be applied
in hiring and performance assessments. These training
requirements and standards should be based on the related
provisions in H.R. 1280, as passed by the House of
Representatives in March 2021.
The Committee directs the Department's Division of
Protective Operations, to the extent it has not already done
so, to submit its use of force data to the Federal Bureau of
Investigation's National Use of Force Data Collection database.
The Committee requests a briefing within 90 days of enactment
of this Act on current efforts to tabulate and submit use of
force data to the FBI.
Inter-agency Collaboration.--The Committee identifies a
need for more inter-agency collaboration between the
Department--including WHD and OSHA--, Equal Employment
Opportunity Commission, and the National Labor Relations Board
to enforce labor and civil rights laws fully and effectively.
The Committee encourages the agencies to review and evaluate
current enforcement efforts, rescind harmful regulations and
sub-regulatory guidance, and ensure each agency is using all
the tools and policies at their disposal to protect workers.
This includes robust coordinated outreach and education to
rebuild trust in government enforcement, especially in
communities of color.
Critical Minerals.--The Committee recognizes the importance
of critical minerals for use in the United States. In response
to this growing need, as part of the Consolidated
Appropriations, Act of 2021 (P.L. 116-260), Congress authorized
in section 7002 a workforce assessment and workforce
development program in the Department of Labor to address
mineral security. The Committee requests an update on these
efforts in the fiscal year 2024 Congressional Budget
Justification.
Residential Contractor Certification Program.--The
Committee encourages the Department to develop a system,
similar to Energy Star, to help consumers make informed
decisions when hiring a residential contractor to perform work.
The Department should work with labor unions and other
stakeholders in developing such a system. The Committee
requests a briefing within 90 days of enactment of this Act on
the Department's plans to develop this system.
VETERANS EMPLOYMENT AND TRAINING
Appropriation, fiscal year 2022....................... $325,341,000
Budget request, fiscal year 2023...................... 330,968,000
Committee Recommendation.............................. 338,841,000
Change from enacted level......................... +13,500,000
Change from budget request........................ +7,873,000
The recommendation includes $70,500,000 from the General
Fund of the Treasury and $268,341,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
The Veterans Employment and Training (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.
Within the total for VETS, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
State Administration Grants.......................... $183,000,000
Transition Assistance Program........................ 32,379,000
Federal Administration............................... 49,548,000
Veterans Employment and Training Institute........... 3,414,000
Homeless Veterans Reintegration Program.............. 70,500,000
------------------------------------------------------------------------
The Committee recommendation includes $32,379,000 for the
Transition Assistance Program, which is the same as the fiscal
year 2022 enacted level and $1,000,000 more than the fiscal
year 2023 budget request. This funding will enhance the quality
of employment support services for transitioning service
members and allow VETS to develop and implement a course
curriculum to help military spouses overcome the challenges
they face related to employment and career development.
The Committee includes $70,500,000 for the Homeless
Veterans Reintegration Program, which is $10,000,000 more than
the fiscal year 2022 enacted level and $8,000,000 more than the
fiscal year 2023 budget request. Funds will be used to further
support the needs of veterans experiencing homelessness.
The Committee includes $500,000, which is the same as the
fiscal year 2022 enacted level and the fiscal year 2023 budget
request, to support the HIRE Vets Medallion Program authorized
by the Honoring Investments in Recruiting and Employing
American Military Veterans Act of 2017.
The Committee recommendation includes $300,000 within
Federal Administration, which is the same as the fiscal year
2022 enacted level and the fiscal year 2023 budget request, to
continue the operation of the Disabled Veteran Program (DVP),
which was initiated by the Committee in fiscal year 2020. The
DVP addresses the high unemployment and low labor force
participation rate of veterans with service-connected and non-
service-connected disabilities. The DVP helps increase
employment and advancement opportunities for veterans with
disabilities by working with Federal, State, and private
partners to promote the hiring of veterans with disabilities,
improve coordination of available employment services and
supports, and to identify and share employment best practices
for hiring, retaining, and advancing veterans with disabilities
in the workforce.
Equity and Access for Homeless Veterans.--The Committee
continues to direct the Department to include an update on
racial equity and access to programs at the Department
providing services to homeless veterans in its fiscal year 2024
Congressional Budget Justification. The update shall also track
departmental expenditures within the Homeless Veteran Programs,
specifically with regard to minority, female, and LGBTQ
populations. Where available, the Department shall disaggregate
data by ethnicity, age, gender identity, and discharge status.
INFORMATION TECHNOLOGY MODERNIZATION
Appropriation, fiscal year 2022....................... $28,269,000
Budget request, fiscal year 2023...................... 47,969,000
Committee Recommendation.............................. 38,269,000
Change from enacted level......................... +10,000,000
Change from budget request........................ -9,700,000
Information Technology (IT) Modernization provides a
dedicated source of funding for Department-wide IT
modernization projects together with funding through the
Department's Working Capital Fund.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2022....................... $90,847,000
Budget request, fiscal year 2023...................... 107,865,000
Committee Recommendation.............................. 99,028,000
Change from enacted level......................... +8,181,000
Change from budget request........................ -8,837,000
The Office of Inspector General (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 recommendation includes $93,187,000 from the General
Fund of the Treasury, which is $8,000,000 more than the fiscal
year 2022 enacted level, and $5,841,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
Pandemic Unemployment Assistance.--The PUA program was
designed to ensure that critical emergency assistance was
delivered immediately, so it would be available to unemployed
workers when it was most needed. It is important to ensure that
resources for such critical emergency assistance during
simultaneous public health crisis and financial crisis should
be targeted to individuals and families who are eligible for
benefits. The Committee supports the Inspector General's
oversight activities and efforts to investigate any illegal
schemes to defraud the PUA program.
General Provisions
Sec. 101. The Committee continues a provision to prohibit
the use of Job Corps funds for the salary of an individual at a
rate in excess of Executive Level II.
(TRANSFER OF FUNDS)
Sec. 102. The Committee continues a provision regarding
transfer authority.
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 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
surplus property and apprenticeship programs.
Sec. 109. The Committee modifies a provision relating to
the Secretary's security detail.
Sec. 110. The Committee continues a provision relating to
the Treasure Island Job Corps Center.
Sec. 111. The Committee continues a provision relating to
Job Corps.
Sec. 112. The Committee includes a new provision relating
to the Wagner-Peyser Act Staffing Flexibility regulation.
Sec. 113. The Committee includes a new provision relating
to regulations pertaining to industry recognized apprenticeship
programs.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Appropriation, fiscal year 2022....................... $8,891,772,000
Budget request, fiscal year 2023...................... 8,782,614,000
Committee Recommendation.............................. 9,574,521,000
Change from enacted level......................... +682,749,000
Change from budget request........................ +791,907,000
The Health Resources and Services Administration (HRSA)
supports programs that provide health services to
disadvantaged, medically underserved, and special populations;
decrease infant mortality rates; assist in the education of
health professionals; and provide technical assistance
regarding the utilization of health resources and facilities.
The Committee recommendation for HRSA includes
$9,295,951,000 in discretionary budget authority, $256,370,000
in mandatory funding and $15,200,000 in trust fund
appropriations for the Vaccine Injury Compensation Program
Trust Fund, and $7,000,000 for the Countermeasures Injury
Compensation Program.
PRIMARY HEALTH CARE
Appropriation, fiscal year 2022....................... $1,748,772,000
Budget request, fiscal year 2023...................... 1,839,022,000
Committee Recommendation.............................. 1,946,772,000
Change from enacted level......................... +198,000,000
Change from budget request........................ +107,750,000
Health Centers
The Committee recommends $1,945,772,000 for the Health
Centers program, $198,000,000 above the fiscal year 2022
enacted level and $107,750,000 above the fiscal year 2023
budget request. Health Centers deliver affordable, accessible,
quality, and cost-effective primary health care to millions of
people across the country regardless of their ability to pay.
Programs supported by this funding include community health
centers, migrant health centers, health care for the homeless,
and public housing health service grants.
The Committee includes bill language providing up to
$120,000,000 for the Federal Tort Claims Act program, the same
as the fiscal year 2022 enacted level and the fiscal year 2023
budget request.
Alcee L. Hastings Program for Advanced Cancer Screening in
Underserved Communities.--The Committee appreciates the work
and leadership of HRSA to implement the Alcee L. Hastings
Program for Advanced Cancer Screening in Underserved
Communities and provides $15,000,000 for this activity, an
increase of $10,000,000 above the fiscal year 2022 enacted
level. This program is imperative to redressing disparities in
cancer screening in medically underserved communities. In
continuing to implement this program, the Committee encourages
HRSA to support approaches that leverage the use of community
health workers and navigators providing health services at the
individual health center and, where appropriate, health center-
controlled network level with training, oversight, and clinical
workflow support from NCI-designated comprehensive cancer
centers. Also, given the immense data supporting the disparate
impact of lung cancer on medically underserved populations and
the effectiveness of screening for this condition, the
Committee strongly encourages HRSA to prioritize programs
targeting lung cancer, such as screening and smoking cessation
counseling.
Early Childhood Development.--The Committee provides
$42,500,000 within the total for HRSA-funded Health Centers to
hire or contract for early childhood development specialists to
better integrate early developmental promotion services, as
described in the fiscal year 2023 budget request. The Committee
encourages HRSA to create a service expansion grant opportunity
for health centers, with training and technical assistance to
be provided by the Maternal and Child Health Bureau, which has
a long-standing commitment to improving the health and
wellbeing of young children and their families.
Ending the HIV Epidemic (EHE) Initiative.--The Committee
provides $172,000,000 within the Health Centers program for the
EHE Initiative, $49,750,000 above the fiscal year 2022 enacted
level and the same as the fiscal year 2023 budget request. This
initiative provides funding to Health Centers in high-need
jurisdictions to increase the use of pre-exposure prophylaxis
(PrEP) among people at high risk for HIV transmission.
Health Care for the Homeless.--The Committee supports the
activities of the Health Care for the Homeless program, which
provides funding to community-based health centers to provide
low- or no-cost health care to underserved populations using a
trauma-informed, harm reduction approach. Services provided by
such health centers include primary care, mental health
treatment, substance use treatment, medical respite care, case
management, and enrollment/benefits assistance.
Health Center Controlled Networks (HCCNs).--These networks
are the foundation of health information technology (HIT)
services for the nation's community health centers. Health
centers function as the largest primary care network in the
country, caring for 30 million patients. HCCNs are voluntary
associations of community health centers that band together to
invest in HIT tools, optimize the use of these technologies,
digitally connect to health care and community partners, and
more. The HIT infrastructure requires robust Federal investment
to support the demand caused by the COVID-19 pandemic's
resulting shift in how health care is provided. The Committee
encourages HRSA to provide robust support for these networks
and requests as part of the fiscal year 2024 Congressional
Budget Justification an update on the status of the network HIT
infrastructure.
Integrating High-Quality Contraceptive Care.--The Committee
is aware that while most primary care physicians provide
women's health services, many are not able to provide patients
with a broad range of contraceptive care options, including
long-acting reversible contraceptive methods that require
specialized training and skill development. The Committee
includes $25,000,000 within the total for Health Centers to
support grants for training and quality improvement efforts to
make available patient-centered contraceptive care within
health center primary care settings. Grantees may use funds to
support training and quality improvement to implement best
practices in contraceptive care, including reproductive health
screening, patient-centered contraceptive counseling, and
access to the full range of FDA-approved, cleared, or granted
contraceptive products that are determined by an individual's
medical provider to be medically appropriate. These activities
would improve health equity, strengthen maternal health and
prenatal care, and empower patients to decide if and when they
want to become pregnant.
School-Based Health Centers (SBHCs) and Health Center
School-Based Service Sites.--Recognizing the critical role of
Health Centers as part of our Nation's health care safety net,
and that Health Centers providing services at sites located at
schools within the communities they serve are currently one of
the most effective sources of mental health care for children
and adolescents, the Committee includes $50,000,000, an
increase of $20,000,000 above the fiscal year 2022 enacted
level, for awards to Health Centers operating school-based
service sites to increase their capacity to meet the increasing
demand for health services, including mental health services.
The Committee also includes $50,000,000 to make grants to fund
the School-Based Health Center Program and expand services at
SBHCs pursuant to 42 USC 280h-5. SBHCs provide a convenient
access point to high-quality, comprehensive primary health
care, mental health services, preventive care, social services,
and youth development to primarily children and adolescents
from low-income families.
HRSA Strategy to Address Intimate Partner Violence and
Project Catalyst.--The Committee includes no less than
$2,000,000 within the total for Health Centers for the HRSA
Strategy to Address Intimate Partner Violence, the same as the
fiscal year 2022 enacted level.
Native Hawaiian Health Care Program.--The Committee
provides $23,000,000 within the total for Health Centers for
the Native Hawaiian Health Care Program, $1,000,000 above the
fiscal year 2022 enacted level and the fiscal year 2023 budget
request. The Native Hawaiian Health Care Systems help improve
the health status of Native Hawaiians by making health
education, health promotion, disease prevention, and Native
Hawaiian traditional healing services available.
Of the total amount appropriated for the Native Hawaiian
Health Care Program, not less than $10,000,000 shall be
provided to Papa Ola Lokahi for administrative purposes
authorized under 42 U.S.C. 11706, including expanded research
and surveillance related to the health status of Native
Hawaiians and strengthening the capacity of the Native Hawaiian
Health Care Systems to provide comprehensive health education
and promotion, disease prevention services, traditional healing
practices, and primary health services to Native Hawaiians.
Vaccination and Screening for Hepatitis B.--The Committee
encourages HRSA to urge health center grantees to adopt the
necessary practices and policies to comply with the November
2021 Advisory Committee on Immunization Practices (ACIP)
recommendation that all adults between 19 and 59 be vaccinated
for hepatitis B. To implement this policy, the Committee
further encourages HRSA to ensure that Health Centers screen
all individuals for hepatitis B, offer to immunize all non-
infected patients in the 19-59 age cohort, and navigate
infected individuals into care. The Committee urges that this
recommendation be implemented as early as possible in fiscal
year 2023.
Free Clinics Medical Malpractice
The Committee includes $1,000,000 for carrying out
responsibilities under the Federal Tort Claims Act, the same as
the fiscal year 2022 enacted level and the fiscal year 2023
budget request. The program provides medical malpractice
coverage to individuals involved in the operation of free
clinics to expand access to health care services to low-income
individuals in medically underserved areas.
HEALTH WORKFORCE
Appropriation, fiscal year 2022....................... $1,295,742,000
Budget request, fiscal year 2023...................... 1,619,884,000
Committee Recommendation.............................. 1,543,566,000
Change from enacted level......................... +247,824,000
Change from budget request........................ -76,318,000
The Bureau of Health Workforce strengthens the health care
workforce by providing grants, scholarships, and loan repayment
programs to help communities recruit and retain health care
providers where they are most needed.
The Committee bill strikes language prohibiting HRSA funds
from being used to support section 340G-1 of the Public Health
Service Act (PHS Act), which authorizes demonstration projects
to train or employ alternative dental health care providers,
including dental therapists. Dental therapists are licensed
providers who play a similar role in dentistry to that of
physician assistants in medicine, and work under the
supervision of a dentist to provide routine dental care like
exams and fillings. Ending this prohibition on funding will
give States flexibility to expand the oral health workforce and
improve access to dental care, particularly in rural and
underserved communities.
Impact of the COVID-19 Pandemic on the Health Workforce.--
The Committee looks forward to receiving the report requested
in House Report 117-96 on the impact of the COVID-19 public
health emergency on the nursing workforce and encourages HRSA
to continue to analyze and make information available about the
impact of the pandemic on the broader health care workforce and
strategies to mitigate and address these impacts.
Registered Nursing Shortages.--The Committee is concerned
about current and projected shortages of registered nurses in
the U.S. as discussed in the HRSA publication Supply and Demand
Projections of the Nursing Workforce 2014-2030. The Committee
encourages HRSA to prioritize investments to increase the
supply of registered nurses particularly in states with the
greatest projected shortages.
Report and Analysis of Technology's Role in the Health Care
Workforce.--The Committee recognizes the important role that
HHS and its operating divisions continue to provide to support
and protect the public health workforce during the COVID-19
pandemic. The Committee directs HRSA to submit a report to the
Committee within 18 months of enactment of this Act on the
challenges associated with hiring, recruiting, and retaining
the Federal, State, local, Tribal and territorial public health
workforce. This study should include a specific analysis of how
technology, especially hands-free technology, could help to
protect clinicians' physical safety and ease the burden of
patient care, thereby increasing retention of the public health
workforce.
Grant-Based Program to Include Disability Clinical Care
Competency Training.--The Committee strongly encourages HRSA to
consider implementation of 42 U.S.C. 293, to develop a grant-
based program in collaboration with the National Council on
Disability, professional societies, licensing and accreditation
entities, health professions schools, experts in minority
health and cultural competency, and public health and
disability groups, and community-based organizations to expand
upon the National Initiative In Developmental Medicine: Draft
Curriculum, which targets a patient population of adults with
intellectual and developmental disabilities, to include
disability clinical care competency training inclusive of all
disability patient subpopulations (e.g. deaf, blind, mobility
disabilities, etc.).
Addressing Workforce Shortages.--The Committee supports
HRSA's efforts to develop the workforce needed to care for a
rapidly aging U.S. population. The Committee encourages HRSA to
address the skilled care workforce needs of seniors through
existing workforce education and training programs.
National Health Service Corps (NHSC)
The Committee includes $155,600,000, an increase of
$34,000,000 above the fiscal year 2022 enacted level, for NHSC
to support competitive awards to health care providers
dedicated to working in underserved communities in urban,
rural, and tribal areas. Within this total, the Committee
includes an increase of $10,000,000 for loan repayment for
mental and behavioral health providers, including peer support
specialists, that serve in crisis centers, as described in the
fiscal year 2023 budget request. The Committee also includes
$15,600,000, the same as the fiscal year 2022 enacted level,
within the total to support NHSC awards to participating
individuals that provide health services in IHS facilities,
Tribally-Operated Health Programs, and Urban Indian Health
Programs.
Behavioral Health Demonstration Program.--The Committee
notes that racial and ethnic minority communities continue to
face acute challenges accessing behavioral health services due
to the lack of providers who speak their language or understand
their culture. The Committee includes $10,000,000 within NHSC
for a pilot program to evaluate the benefit to patient access
and practitioner recruitment and retention of increasing loan
repayment of upwards of $15,000 above the maximum amount for
qualified behavioral health providers serving in Federally
Qualified Health Centers (FQHCs), preferably at which at least
20 percent of patients are best served in a language other than
English. The Committee notes that if the qualified behavioral
health provider is fluent in a language other than English or
is determined by the health center to have achieved fluency in
a language other than English during the provider's period of
obligated service, the provider shall be paid $15,000 above the
maximum amount. The Committee also directs HRSA to include an
assessment of program utilization and impact in the annual NHSC
report to Congress.
Maternity Care Target Areas (MCTAs).--The Committee
includes $5,000,000, $4,000,000 above the fiscal year 2022
enacted level and the same as the fiscal year 2023 budget
request, within NHSC to implement requirements contained in the
Improving Access to Maternity Care Act, including establishing
criteria for and identifying MCTAs and collecting and
publishing data on the availability and need for maternity care
health services in Health Professional Shortage Areas (HPSAs).
NHSC Loan Repayment Application Process.--The Committee is
concerned that HPSA designations may not arrive in time for
provider to apply for loan forgiveness through the NHSC loan
repayment program, and therefore must wait for the loan
forgiveness application to reopen. Given the loan repayment
program is a critical component to attract providers--
particularly those in critically needed fields like behavioral
health--the Committee is concerned that the timeline for HPSA
designation process and the timeline for NHSC loan repayment
are inconsistent and could deter providers from participating
in the NHSC. The Committee requests a report within 90 days of
enactment of this Act assessing the coordination of the two
processes, and any improvements that could be made to ensure
all providers working in a HPSA are eligible for the NHSC
student loan repayment program as soon as they are hired or the
HPSA is designated during the calendar year.
Rural Demonstration Program.--The Committee notes that
rural communities continue to face acute workforce challenges,
with approximately five percent of incoming medical students
coming from rural areas and only one-third of NHSC placements
in rural communities. The Committee includes $10,000,000 within
NHSC to conduct a pilot program to evaluate the benefit to
patient access and practitioner recruitment and retention of
extending loan repayment for 5 years and $200,000 for providers
serving in a rural HPSA. The Committee directs HRSA to submit a
report to the Committee within a year of enactment of this Act
on program utilization and impact.
Health Professions Training for Diversity
The Committee supports programs that improve the diversity
of the health care workforce. HRSA's diversity pipeline
programs, including the Health Careers Opportunity Program,
Centers for Excellence, Faculty Loan Repayment, Nursing
Workforce Diversity, and Scholarships for Disadvantaged
Students, help advance patient care and ensure opportunity for
all health care providers.
Centers of Excellence (COEs).--The Committee includes
$30,422,000 for COEs, $6,000,000 above the fiscal year 2022
enacted level. This program provides grants to health
professions schools and other institutions to serve as resource
and education centers for the recruitment, training, and
retention of underrepresented minority students and faculty.
Health Careers Opportunity Program (HCOP).--The Committee
includes $18,500,000 for HCOP, $3,050,000 above the fiscal year
2022 enacted level and the same as the fiscal year 2023 budget
request. The Committee notes that HCOPs assist students from
minority and economically disadvantaged backgrounds to navigate
careers in the health professions. The Committee encourages
HRSA to continue its improvement of the diversity and
distribution of needed health care professionals through the
National HCOP Academies.
Faculty Loan Repayment.--The Committee includes $1,500,000
for Faculty Loan Repayment, $274,000 above the fiscal year 2022
enacted level. This program provides loan repayment to health
profession graduates from disadvantaged backgrounds who serve
as faculty at eligible health professions academic
institutions.
Scholarships for Disadvantaged Students (SDS).--The
Committee includes $56,014,000 for SDS, $3,000,000 above the
fiscal year 2022 enacted level and $4,044,000 above the fiscal
year 2023 budget request. This program provides grants to
health professions and nursing schools to provide scholarships
to students from disadvantaged background who have financial
need.
Set-Aside for Midwifery Training.--Within the total for
SDS, the Committee includes $5,000,000, $1,500,000 above the
fiscal year 2022 enacted level, to increase the number of
grants awarded for the purpose of educating midwives to address
the national shortage of maternity care providers, and
specifically the lack of adequate diversity in the maternity
care workforce.
Primary Care Training and Enhancement
The Committee includes $54,924,000, an increase of
$6,000,000 above the fiscal year 2022 level and $1,000,000
above the fiscal year 2023 budget request, for Primary Care
Training and Enhancement programs, which support training and
direct financial assistance for future primary care clinicians,
teachers, and researchers. The Committee includes funding to
support the proposal in the fiscal year 2023 budget request to
make grants to support mental health training for primary care
professionals.
Eating Disorders Screening, Brief Intervention, Referral,
and Treatment (SBIRT).--The COVID-19 pandemic worsened eating
disorders across the Nation, with one study reporting a
significant increase in eating disorder caseloads in children's
hospitals. Despite the medical and psychiatric acuity
associated with eating disorders, many patients remain
undetected and untreated, as only 20 percent of surveyed
medical residency programs offer elective training in eating
disorders and only six percent require such training. Within
the total for Primary Care Training and Enhancement, the
Committee provides up to $1,000,000, in coordination with
SAMHSA's Center of Excellence for Eating Disorders, to provide
trainings for primary care health professionals to screen,
briefly intervene, and refer patients to treatment for the
severe mental illness of eating disorders, as authorized under
section 13006 of the 21st Century Cures Act.
Oral Health Training
The Committee includes $42,173,000 for Oral Health
Training, $1,500,000 above the fiscal year 2022 enacted level
and the fiscal year 2023 budget request. The Committee directs
that this increased funding be allocated to General Dentistry
Programs, Pediatric Dentistry Programs, and State Oral Health
Workforce Improvement Grants. The Committee directs HRSA to
provide continuation funding for section 748 post-doctoral
training grants initially awarded in fiscal year 2020 and
dental faculty loan repayment program (DFLRP) grants initially
awarded in fiscal years 2021 and 2022. The Committee also
directs HRSA to initiate a new DFLRP grant cycle with a
preference for pediatric dentistry faculty supervising dental
students or residents and providing clinical services in dental
clinics located in dental schools, hospitals, and community-
based affiliated sites.
Action for Dental Health.--With the enactment of the Action
for Dental Health Act of 2018, the Committee encourages HRSA to
expand oral health grants for innovative programs under PHS Act
Section 340G to include Action for Dental Health activities.
The Action for Dental Health program helps reduce barriers to
dental care through oral health education, prevention, and the
establishment of dental homes for underserved populations.
Interdisciplinary Community-Based Linkages
Area Health Education Centers (AHEC).--The Committee
includes $48,000,000 for the AHEC program, an increase of
$3,000,000 above the fiscal year 2022 level and $4,750,000
above the fiscal year 2023 budget request. This program links
university health science centers with community health service
delivery systems to provide education and training networks.
Patient Safety Telesimulation Programs.--The Committee
encourages HRSA to support the development and implementation
of patient safety telesimulation programs. Allowable use of
these funds may include increasing virtual content delivery
capacity at modeling simulation centers, establishing
partnerships with medical schools in providing telesimulation
programs, developing telesimulation content and devices,
developing appropriate governance on data and data management,
and outfitting HPSA locations with necessary telesimulation
hardware and software assets.
Geriatrics Workforce Enhancement Program (GWEP).--The
Committee includes $48,245,000 for the GWEP program, $3,000,000
above the fiscal year 2022 level and $1,708,000 above the
fiscal year 2023 budget request. This program supports training
to integrate geriatrics into primary care delivery and develops
academic-primary care-community based partnerships to address
gaps in health care for older adults.
Mental and Behavioral Health Programs.--The Committee
includes $44,053,000 for Mental and Behavioral Health Programs,
an increase of $5,000,000 above the fiscal year 2022 level.
Adolescent Addiction Medicine and Addiction Psychiatry
Workforce.--The Committee remains concerned by the lack of
pediatric and adolescent addiction medicine and addiction
psychiatry expertise. Currently, there are insufficient
opportunities to effectively train a robust mental health and
substance use disorder (SUD) workforce. Only 75 of the Nation's
179 accredited medical schools offer addiction medicine
fellowships, and only one program focuses on fellowship
opportunities for pediatric and adolescent addiction medicine
and addiction psychiatry. The Committee strongly encourages
HRSA to include an adequate number of funding awards to
fellowship programs focused on increasing the number of board
certified pediatric and adolescent addiction medicine and
addiction psychiatry subspecialists.
Graduate Psychology Education (GPE).--Within the total for
Mental and Behavioral Health Programs, the Committee
recommendation includes $25,000,000, $5,000,000 above the
fiscal year 2022 enacted level, for the interprofessional 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. The
Committee recognizes the severe impact of COVID-19 on
Americans' mental and behavioral health and urges HRSA to
strengthen investments in the training of health service
psychologists to help meet these demands.
Behavioral Health Workforce Education and Training
(BHWET).--The Committee includes $185,000,000 for the BHWET
Program, $62,000,000 above the fiscal year 2022 enacted level.
This program establishes and expands internships or field
placement programs in behavioral health, serving populations in
rural and medically underserved areas.
The Committee is concerned that increased gun violence and
the pandemic's exacerbation of health disparities has unveiled
an immediate and desperate need for behavioral health
professionals, including social workers, psychologists,
counselors, occupational therapists, and psychiatrists.
Neuropsychiatrists and advanced practice behavioral nurses are
specially trained to diagnose mood disorders or biochemical
imbalances. A HRSA report, however, found that there will be a
shortage of 250,000 mental health professionals by 2025. The
Committee supports increased funding for BHWET to increase the
quality and supply of behavioral health professionals and
access to behavioral health services, in particular for
children, adolescents, and transitional-aged youth at risk for
behavioral health disorders. The Committee encourages HRSA to
continue to collect data and analyze the scope of the shortage
of behavioral health professionals and barriers to careers in
behavioral health.
Behavioral Health Integration Into Community-Based
Settings.--The Committee includes $10,000,000, the same as the
fiscal year 2023 budget request, to provide grants to
community-based organizations and local health departments to
integrate navigators and community health workers trained in
Mental Health First Aid or similar trainings into non-
traditional community settings. This effort will be carried out
in partnership with the Maternal and Child Health Bureau and
will help to address the behavioral health needs of families in
underserved communities.
Community Improvement Program.--The Committee includes
$10,000,000, the same as the fiscal year 2023 budget request,
to develop and expand community-based experiential training
through internships and field placements for behavioral health
and behavioral health-related professionals to prepare them to
work with and support individuals who are involved, or at risk
of being involved, in the criminal justice system.
Crisis Workforce Development.--The Committee includes
$15,000,000 for grants to support crisis workforce development.
Crisis service models present opportunities for cost savings
and more effective use of the behavioral health workforce by
stabilizing individuals experiencing behavioral health crises
in less intensive settings.
Mental and Substance Use Disorder Workforce Training
Demonstration.--The Committee includes $34,700,000 for this
activity, $3,000,000 above the fiscal year 2022 enacted level
and $700,000 above the fiscal year 2023 budget request. This
program makes grants to institutions, including but not limited
to medical schools and FQHCs, to support training for medical
residents and fellows in psychiatry and addiction medicine, as
well as nurse practitioners, physician assistants, and others,
to provide SUD treatment in underserved communities.
Peer Support Specialists in the Opioid Use Disorder
Workforce.--Within the total for BHWET, the Committee includes
$14,000,000, the same as the fiscal year 2022 enacted level, to
fund training, internships, and national certification for
mental health and SUD peer support specialists to create an
advanced peer workforce prepared to work in clinical settings.
Social Workers.--While the Committee is aware that the
behavioral health workforce is seeing shortages in all
professions, the Committee encourages HRSA to ensure that
social workers are receiving equitable treatment from the
program given their multifaceted roles in health care settings.
Additionally, the Committee encourages HRSA to ensure that
program awardees are actively working to recruit a diverse
field of behavioral health professionals.
Substance Use Disorder Treatment and Recovery (STAR) Loan
Repayment Program.--The Committee includes $28,000,000 for this
program, $4,000,000 above the fiscal year 2022 enacted level
and the same as fiscal year 2023 budget request. An estimated
21 million Americans needed treatment for SUD in 2017, but only
4 million received any form of treatment for SUD. The Bureau of
Labor Statistics data has cited tremendous workforce shortages
in the SUD treatment profession. Without strategic investments
in the SUD workforce, this gap will not close and more lives
will be lost. This program addresses shortages in the SUD
workforce by providing for the repayment of education loans for
individuals working in a full-time SUD treatment job that
involves direct patient care in either a Mental Health
Professional Shortage Area or a county where the overdose death
rate exceeds the national average.
National Center for Health Workforce Analysis (NCHWA)
The Committee includes $6,663,000, $1,000,000 above the
fiscal year 2022 enacted level and the fiscal year 2023 budget
request, for the NCHWA. This program collects and analyzes
health workforce data to provide information on health
workforce supply and demand.
Public Health and Preventive Medicine Training Programs
The Committee includes $18,000,000 for Public Health and
Preventive Medicine Training Grant Programs, $1,000,000 above
the fiscal year 2022 enacted level and the same as the fiscal
year 2023 budget request. Within this total, the Committee
provides an increase of $500,000 for the Preventive Medicine
Residency Training Program and an increase of $500,000 for
Public Health Training Centers.
Nursing Workforce Development
The Committee recommends $324,472,000 for Nursing Workforce
Development programs authorized under title VIII of the PHS
Act, $44,000,000 above the fiscal year 2022 enacted level and
$29,500,000 above the fiscal year 2023 budget request.
Expanding Access to Nursing Education.--The Committee
remains concerned about workforce shortages among health care
professionals, including the nursing workforce. According to
the American Hospital Association, nursing vacancies increased
by nearly 30 percent between 2019 and 2020, with an additional
500,000 nurses expected to retire or leave the profession by
the end of this year. Recent studies suggest that an additional
1.2 million nurses will be required in the U.S. by 2030 to meet
anticipated demand, with States like California, Texas, and
Florida projected among those with the greatest need. The
Committee also recognizes that nursing schools across the U.S.
are struggling to expand capacity to meet this rising demand
for care. Significant shortages of faculty, classroom space,
and clinical training sites are commonly identified as factors
in nursing schools turning away qualified applicants in many
areas of the country. The Committee supports efforts to expand
access to educational opportunities at accredited nursing
schools to qualified applicants, including low-income and
minority students, to meet this growing demand for nursing
professionals.
Experiential Learning Opportunities.--The Committee is
aware that mental health is one of the most in-demand skills in
nursing, but many nurse education training programs do not
expose students to mental health care settings. The Committee
encourages HRSA to give priority to experiential learning
opportunities grantees that are partnering with behavioral and
mental health hospitals to increase the pipeline of nurses into
this field.
Advanced Nursing Education.--The Committee includes
$105,581,000 for Advanced Nursing Education, $26,000,000 above
the fiscal year 2022 enacted level and the same as the fiscal
year 2023 budget request. This program supports traineeships
and faculty and curriculum development to increase the number
of qualified nurses in the primary care workforce.
Maternal and Perinatal Nursing Workforce Program.--Within
the total for Advanced Nursing Education, the Committee
includes $20,000,000 to increase and diversify the number of
certified nurse midwives, with a focus on practitioners working
in rural and underserved communities, as described in the
fiscal year 2023 budget request. These funds will support
grants to accredited nurse midwifery programs or other eligible
entities to award scholarships to students and registered
nurses to cover the total cost of tuition for the duration of
the nurse midwifery program, as well as the planning/
development of new midwife training programs.
Nursing Education, Practice, Quality, and Retention
(NEPQR).--The Committee includes $56,413,000 for NEPQR,
$2,000,000 above the fiscal year 2022 enacted level and
$7,500,000 above the fiscal year 2023 budget request. This
program supports academic, service, and continuing education
projects to enhance nursing education, improve the quality of
care, increase nurse retention, and strengthen the nursing
workforce.
Nurse Practitioner Optional Fellowship Program.--The
Committee provides $6,000,000, the same as the fiscal year 2022
enacted level, for grants to establish or expand community-
based nurse practitioner residency and fellowship training
programs for practicing postgraduate nurse practitioners in
primary care or behavioral health, as described in House Report
117-96.
Nursing Workforce Diversity.--The Committee includes
$26,343,000 for Nursing Workforce Diversity, $3,000,000 above
the fiscal year 2022 enacted level and the fiscal year 2023
budget request. This program increases nursing education
opportunities for individuals from disadvantaged backgrounds by
providing student stipends, scholarships, and preparation and
retention activities.
Nurse Corps Scholarship and Loan Repayment.--The Committee
includes $101,635,000 for Nurse Corps, $13,000,000 above the
fiscal year 2022 enacted level and the fiscal year 2023 budget
request. This program supports scholarships and loan repayment
assistance for nurses and nursing students committed to working
in communities with inadequate access to care.
Nursing Faculty Loan Program.--The Committee includes
$28,500,000 for the Nursing Faculty Loan Program, the same as
the fiscal year 2022 enacted level and the fiscal year 2023
budget request. This program supports schools of nursing to
provide loans to students enrolled in advanced nursing
education programs who are committed to becoming nurse faculty.
Children's Hospitals Graduate Medical Education (CHGME)
The Committee includes $385,000,000 for the CHGME payment
program, $10,000,000 above the fiscal year 2022 enacted level
and $35,000,000 above the fiscal year 2023 budget request. This
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.
Medical Student Education
The Committee includes $60,000,000, $5,000,000 above the
fiscal year 2022 enacted level, to support colleges of medicine
at public universities located in the top quartile of States
projected to have a primary care provider shortage. The
Committee directs HRSA to give priority to applications from
academic institutions located in States with the greatest
number of Federally-recognized Tribes. The Committee also
directs HRSA to give priority to applications from public
universities with a demonstrated public-private partnership.
Pediatric Subspecialty Loan Repayment Program
The Committee includes $15,000,000, an increase of
$10,000,000 above the fiscal year 2022 enacted level, for the
Pediatric Subspecialty Loan Repayment Program authorized in
section 775 of the PHS Act. The Committee recognizes that there
are significant shortages of pediatric subspecialists, child
psychiatrists, and other child mental health providers in
underserved areas. The Committee also understands that high
graduate debt load is a significant barrier to providers
choosing to complete additional training to enable them to
provide specialized care for children with special medical and
mental health care needs.
Public Health Loan Repayment Program
The Committee includes $25,000,000 to establish the Public
Health Loan Repayment Program. Funds will support loan
repayment for public health professionals who agree to serve
three years in a local, State, or tribal health department.
This investment in the public health workforce will contribute
to our Nation's preparedness to address current and future
public health emergencies.
Preventing Burnout in the Health Workforce Program
The Committee includes $25,000,000 for activities
authorized in the Dr. Lorna Breen Health Care Provider
Protection Act (P.L. 117-105) to provide comprehensive and
evidence-based support to prevent suicide, burnout, and mental
and behavioral health conditions among health care providers.
National Practitioner Data Bank (NPDB)
The Committee includes $18,814,000 for the NPDB, the same
as the fiscal year 2022 enacted level and the fiscal year 2023
budget request. The NPDB is a workforce tool that collects and
discloses information to authorized entities on past adverse
actions of health care practitioners, providers, and suppliers
to reduce fraud and abuse and improve health care quality.
MATERNAL AND CHILD HEALTH
Appropriation, fiscal year 2022....................... $1,044,470,000
Budget request, fiscal year 2023...................... 1,272,930,000
Committee Recommendation.............................. 1,201,296,000
Change from enacted level......................... +156,826,000
Change from budget request........................ -71,634,000
The mission of the Maternal and Child Health Bureau (MCHB)
is to improve the physical and mental health, safety, and well-
being of the Nation's women, infants, children, adolescents,
and their families.
Maternal and Child Health (MCH) Block Grant
The Committee recommends $872,700,000 for the MCH Block
Grant, $125,000,000 above the fiscal year 2022 enacted level.
States use the MCH Block Grant to improve access to care for
mothers, children, and their families; reduce infant mortality;
provide pre-and post-natal care; support screening and health
assessments for children; and provide systems of care for
children with special health care needs.
MCH Block Grant Special Projects of Regional and National Significance
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 2023
Budget Activity Committee
------------------------------------------------------------------------
Set-aside for Oral Health............................ $5,250,000
Set-aside for Epilepsy............................... 3,642,000
Set-aside for Sickle Cell Disease.................... 7,000,000
Set-aside for Fetal Alcohol Syndrome................. 1,000,000
------------------------------------------------------------------------
Addressing Emerging Issues and Social Determinants of
Maternal Health.--The Committee includes $10,000,000 to create
an innovation fund for community-based organizations to support
reducing maternal mortality and adverse maternal outcomes, as
described in the fiscal year 2023 budget request. Projects may
include expanding access to maternal mental health and SUD
services, providing resources to address social determinants of
maternal health, developing digital tools to enhance maternal
health care, and technology-enabled collaborative learning and
capacity building models for pregnant and postpartum women.
Alliance for Innovation in Maternal Health Safety
Bundles.--The Committee includes $15,300,000, an increase of
$3,300,000 above the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request, to support
continued implementation of the Alliance for Innovation on
Maternal Health program's maternal safety bundles to all U.S.
States, the District of Columbia, and U.S. territories, as well
as tribal entities. Maternal safety bundles are a set of
targeted and evidence-based best practices that, when
implemented, improve patient outcomes and reduce maternal
mortality and severe maternal morbidity.
Behavioral Health Integration Into Community-Based
Settings.--The Committee includes $40,000,000, the same as the
fiscal year 2023 budget request, to provide grants to engage
and train community partners in underserved communities to link
mothers and children with resources to address their mental and
behavioral health needs, as well as children's social and
emotional development. This effort will be carried out in
partnership with the Behavioral Health Workforce Education and
Training program.
Bias Recognition in Clinical Skills Testing.--The Committee
includes $1,000,000, the same as the fiscal year 2023 budget
request, to support a National Academies of Sciences,
Engineering, and Medicine (NASEM) study authorized under
Subtitle D, Sec. 133 of the fiscal year 2022 Consolidated
Appropriations Act (P.L. 117-103) to make recommendations for
incorporating bias recognition in clinical skills testing for
accredited schools of allopathic medicine and osteopathic
medicine.
Bias Training for Health Care Professionals.--The Committee
includes $2,000,000 to make grant awards to train health care
providers on identifying and avoiding implicit bias, as
described in the fiscal year 2023 budget request.
Congenital Syphilis (CS).--The Committee is concerned with
the rise in CS. A recent report by CDC cited data showing a 300
percent increase in CS over the past five years. Those born
with CS can have skeletal and facial deformities, deafness,
blindness, be still born, or die shortly after birth. These
conditions and deaths are completely preventable with expanded
prenatal screening and appropriate treatment. The Committee
urges HRSA to expand efforts to increase multiple prenatal
screening and testing for CS throughout pregnancies to detect
and treat CS at the earlier possible stage. Assuring that
providers are trained on the recommended treatment of syphilis
in pregnant women is a critical component of eliminating CS.
Early Childhood Development Expert Grants.--The Committee
includes $10,000,000, $5,000,000 above the fiscal year 2022
enacted level, to support the placement of early childhood
development experts in pediatric settings with a high
percentage of Medicaid and Children's Health Insurance Program
patients. Funds will support additional State-level awards and
related technical assistance with nationwide reach.
Group Prenatal and Postpartum Care Programs.--The Committee
recognizes the important role of group prenatal and postpartum
care (GPC/PC) programs, such as Centering Pregnancy, can have
on improving prenatal care and providing support for expecting
mothers. GPC/PC programs provide the opportunity for expectant
mothers to learn more about pregnancy, a network of social
support, educational tools, and ultimately work towards
lowering rates of infant and maternal mortality. The Committee
includes $2,000,000 within SPRANS for grants to establish new
or support existing GPC/PC programs.
Growing and Diversifying the Doula Workforce Program.--The
Committee includes $10,000,000 to provide grants to community-
based organizations to develop and/or expand programs to
recruit doula candidates, support their training/certification,
and then employ them as doulas to support improved birth
outcomes in the community, as described in the fiscal year 2023
budget request.
Hereditary Hemorrhagic Telangiectasia (HHT) Centers of
Excellence.--The Committee includes $2,000,000 for HHT Centers
of Excellence. This funding supports coordination and expansion
of care for HHT patients and participation in a prospective,
longitudinal registry of HHT patients to better understand this
rare disease and accelerate the development of new diagnostic
and treatment options.
Infant-Toddler Court Teams.--The Committee includes
$18,000,000 for research-based Infant-Toddler Court Teams to
change child welfare practices to improve well-being for
infants, toddlers, and their families. The Committee directs
HRSA to allocate the funding increase of $5,000,000 above the
fiscal year 2022 enacted level to existing court team grantees.
Maternal Mental Health Hotline.--The Committee includes
$7,000,000, an increase of $3,000,000 above the fiscal year
2022 level and the same as the fiscal year 2023 budget request,
to support the maternal mental health hotline. The COVID-19
pandemic has exacerbated maternal mental health conditions,
with pregnant and new mothers experiencing anxiety and
depression at a three to four times higher rate than prior to
the pandemic. The hotline should provide 24 hours a day voice
and text support that is culturally and linguistically
appropriate. Funds provided should also be used to raise public
awareness about maternal mental health issues and the hotline.
Minority-Serving Institutions.--The Committee includes
$5,000,000 to establish a research network to support minority-
serving institutions to study health disparities in maternal
health outcomes, as described in the fiscal year 2022 budget
request.
Oral Health and Primary Care Integration.--The Committee
includes $5,250,000 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 encourages the Chief Dental Officer to continue to
provide leadership in the design, monitoring, oversight, and
implementation of the demonstration projects.
Pregnancy Medical Home Demonstration.--The Committee
includes $10,000,000 to support a demonstration providing
incentives to maternal health care providers to provide
integral health care services to pregnant women and new
mothers, with the goal of reducing adverse maternal health
outcomes and maternal deaths, as described in the fiscal year
2023 budget request. The Integrated Services for Pregnant and
Postpartum Women Program will award grants to establish or
operate programs to deliver integrated health care services to
pregnant and postpartum women to optimize maternal and infant
health outcomes.
Regional Pediatric Pandemic Network.--The Committee
provides $18,000,000, the same as the fiscal year 2022 enacted
level, to continue support for coordination among the Nation's
pediatric hospitals and their communities in preparing for and
coordinating timely research-informed responses to future
pandemics.
State Maternal Health Innovation Grants.--The Committee
includes $39,000,000, $10,000,000 above the fiscal year 2022
enacted level, for State Maternal Health Innovation Grants to
establish demonstrations to implement evidence-based
interventions to address critical gaps in maternity care
service delivery and reduce maternal mortality. The
demonstrations should be representative of the demographic and
geographic composition of communities most affected by maternal
mortality.
Fetal, Infant, and Child Death Review (FIDCR).--The
Committee includes no less than $3,100,000, an increase of
$1,000,000 above the fiscal year 2022 enacted level, for the
FIDCR program to expand support and technical assistance to
States and tribal communities and improve the availability of
data on sudden unexpected infant deaths.
Uterine Fibroids Public Health Information Dissemination.--
The Committee encourages HRSA to work with partners to advance
awareness of uterine fibroids and promote evidence-based care
for women with fibroids. These efforts may include specific
information on minority women, who have an elevated risk to
develop uterine fibroids, and the range of available options
for the treatment of symptomatic uterine fibroids, including
non-hysterectomy drugs and devices approved under the Federal
Food, Drug, and Cosmetic Act in these awareness efforts. The
Committee encourages HRSA to work with health care-related
specialty societies and health systems, as appropriate, to
promote awareness of evidence-based care for women with
fibroids.
Maternal and Child Health Programs
Sickle Cell Anemia Demonstration Program
The Committee includes $8,205,000 for this program, an
increase of $1,000,000 above the fiscal year 2022 enacted level
and the fiscal year 2023 budget request. The Committee
recognizes the importance of the program in supporting the
comprehensive sickle cell disease (SCD) centers in the
provision of coordinated, comprehensive, culturally competent,
and family-centered care to people with SCD. The Committee
affirms the goals of the program to improve care delivery and
access to high quality care for people with SCD, with a focus
on increasing access to SCD specialists; increase the number of
providers with SCD expertise and knowledge of SCD treatment
methods; and enable access to the latest treatment options
following evidence-based guidelines.
With the start of new five-year grant awards in fiscal year
2022, the Committee requests an update in the fiscal year 2024
Congressional Justification on how the program is supporting
the growth of comprehensive sickle cell disease centers that
provide the latest treatment options following evidence-based
guidelines and have mechanisms to identify and serve patients
with SCD who are not currently being cared for by SCD
specialists.
Autism and Other Developmental Disorders
The Committee recommends $57,344,000 for Autism and Other
Developmental Disorders, $3,000,000 above the fiscal year 2022
enacted level. 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.
Leadership Education in Neurodevelopmental and Related
Disabilities (LEND).--The Committee provides $38,245,000,
$1,000,000 above the fiscal year 2022 enacted level, for the
LEND program to allow the existing 60 LEND sites to maintain
their capacity to train interdisciplinary professionals to
screen, diagnose, and provide evidence-based interventions to
individuals with autism spectrum disorder and other
developmental disabilities.
Heritable Disorders
The Committee provides $21,883,000 for the Heritable
Disorders program, $2,000,000 above the fiscal year 2022
enacted level. This program assists States to improve and
expand their newborn screening programs and to promote parent
and provider education. HRSA also supports the work of the
Advisory Committee on Heritable Disorders in Newborns and
Children, which provides states with a Recommended Uniform
Screening Panel (RUSP) to help ensure every infant is screened
for conditions that have a recognized treatment. With new
funding provided in fiscal year 2023, the Heritable Disorders
program can continue to enhance, improve, expand and provide
technical assistance to State public health newborn screening
systems as four new disorders have been added to the RUSP in
the last six years, and can continue developing and
disseminating national, regional, and State education and
training resources for parents, families, providers, and
patient support groups.
Severe Combined Immune Deficiency (SCID).--Within the total
amount for Heritable Disorders, the Committee provides
$4,000,000, the same as the fiscal year 2022 enacted level, to
support wider implementation, education, and awareness of
newborn screening and follow-up for SCID and other newborn
screening disorders.
Healthy Start
The Committee recommends $145,000,000 for the Healthy Start
program, $13,160,000 above the fiscal year 2022 enacted level
and the fiscal year 2023 budget request. The program provides
grants to communities with high rates of infant mortality to
support primary and preventive health care services for mothers
and their infants.
The primary purpose of Healthy Start is to reduce maternal
and infant mortality and to generally improve maternal and
infant health. Grants are awarded to nonprofits, State and
local health departments, and community health centers in
eligible communities with high rates of infant mortality and
other adverse birth outcomes to develop a package of innovative
health and social services for pregnant women and infants, and
evaluate those services. Funding is provided to both increase
funding to existing grantees so they can increase the number of
individuals served and to support new, additional awards to
community-based organizations for targeted initiatives to
reduce disparities in maternal and infant health outcomes. The
Committee requests an update in the fiscal year 2024
Congressional Justification on existing evaluations of Healthy
Start's effectiveness.
Maternal Mortality.--The Committee continues to provide no
less than $15,000,000, the same as the fiscal year 2022 enacted
level and the fiscal year 2023 budget request, for Healthy
Start grantees to support nurse practitioners, certified nurse
midwives, physician assistants, and other maternal-child
advance practice health professionals within all program sites
nationwide.
Early Hearing Detection and Intervention (EHDI)
The Committee includes $18,818,000 for the EHDI program, an
increase of $1,000,000 above the fiscal year 2022 enacted level
and the fiscal year 2023 budget request. This program awards
grants to 53 States and territories to support Statewide
systems of newborn hearing screening and early intervention
programs.
The Committee recognizes the requirement under the PHS Act
for EHDI funds to support prompt evaluation and diagnosis of
children referred from screening programs and appropriate
educational, audiological, medical, and communication (or
language acquisition) interventions (including family support),
for children identified as deaf or hard-of-hearing. The
Committee encourages HRSA to provide the most accurate,
comprehensive, up-to-date, and evidence-based information to
children identified as deaf or hard-of-hearing and their
families. The Committee also encourages HRSA to work with
partners to advance awareness about the wide range of
modalities available for children who are deaf and hard of
hearing, including but not limited to auditory-oral therapy,
auditory-verbal therapy, Signed Exact English (SEE), American
Sign Language (ASL), Total Communication (TC), and Cued Speech;
as well as a full range of assistive hearing technologies, such
as hearing aids and cochlear implants.
Emergency Medical Services for Children
The Committee includes $25,000,000 for Emergency Medical
Services for Children, an increase of $2,666,000 above the
fiscal year 2022 enacted level. Funding is available to every
State emergency medical services office to improve the quality
of emergency care for children and to support research on and
dissemination of best practices.
Screening and Treatment for Maternal Depression and Related Disorders
State Grants
The Committee provides $11,500,000 for the Screening and
Treatment of Maternal Depression and Related Behavioral
Disorders Program (MDRBD), an increase of $5,000,000 above the
fiscal year 2022 enacted level and $1,500,000 above the fiscal
year 2023 budget request. Suicide and overdose, driven by
maternal mental health conditions (MMH), are the leading cause
of maternal mortality in the first year following pregnancy.
MMH conditions impact one in five pregnant or postpartum
individuals, including as many as one in three pregnant and
postpartum Black individuals. However, 75 percent of those
impacted by MMH conditions go untreated. The COVID-19 pandemic
has exacerbated the number of individuals experiencing MMH
conditions, with pregnant and new mothers experiencing anxiety
and depression at a three to four times higher rate than prior
to the pandemic. MDRBD trains health care providers to screen,
assess, and treat for MMH conditions and provide specialized
psychiatric consultation to assist the providers. The Committee
directs HRSA to make grants to establish new State programs and
improve or maintain existing State programs, prioritizing
States with high rates of adverse maternal health outcomes.
Grants shall include culturally and linguistically appropriate
approaches to assist in the reduction of maternal health
inequities. The Committee recognizes the high need amongst
States and directs MDRBD to provide technical assistance to
non-grantee States.
Pediatric Mental Health Access
The Committee includes $14,000,000 for Pediatric Mental
Health Access, an increase of $3,000,000 above the fiscal year
2022 enacted level and $4,000,000 above the fiscal year 2023
budget request. This program supports expanded access to
behavioral health services in pediatric primary care by
supporting the development of pediatric mental health care
telehealth access programs.
Poison Control Centers
The Committee includes $26,846,000 for Poison Control
Centers, an increase of $1,000,000 above the fiscal year 2022
enacted level and $2,000,000 above the fiscal year 2023 budget
request. The Poison Control Centers program supports a national
network of centers that prevent and treat poison exposures by
providing cost effective, quality health care advice to the
public and health care providers. The Committee encourages
Poison Control Centers to partner with institutions of higher
education in border communities to be better equipped to combat
public health outbreaks exacerbated by the flow of people and
goods across international borders.
RYAN WHITE HIV/AIDS PROGRAM
Appropriation, fiscal year 2022....................... $2,494,776,000
Budget request, fiscal year 2023...................... 2,654,781,000
Committee Recommendation.............................. 2,694,776,000
Change from enacted level......................... +200,000,000
Change from budget request........................ +39,995,000
The Ryan White Human Immunodeficiency Virus/Acquired
Immunodeficiency Syndrome (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:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Emergency Assistance................................. $691,045,000
Comprehensive Care Programs.......................... 1,385,517,000
AIDS Drug Assistance Program..................... 900,313,000
Early Intervention Program........................... 211,861,000
Children, Youth, Women, and Families................. 79,114,000
AIDS Dental Services................................. 13,826,000
Education and Training Centers....................... 35,413,000
Special Projects of National Significance............ 28,000,000
Ending the HIV Epidemic Initiative................... 250,000,000
------------------------------------------------------------------------
Ending the HIV Epidemic (EHE) Initiative.--The Committee
includes $250,000,000 within the Ryan White HIV/AIDS Program
for the EHE Initiative, an increase of $125,000,000 above the
fiscal year 2022 enacted level. Funds are distributed to high-
need jurisdictions to increase linkage, engagement, and
retention in care with the goal of increasing viral suppression
among people living with HIV.
HEALTH SYSTEMS
Appropriation, fiscal year 2022....................... $96,009,000
Budget request, fiscal year 2023...................... 94,009,000
Committee Recommendation.............................. 99,009,000
Change from enacted level......................... +3,000,000
Change from budget request........................ +5,000,000
The Health Systems Bureau supports national activities that
enhance health care delivery in the U.S., including maintaining
a national system to allocate and distribute donor organs to
individuals awaiting transplant; building an inventory of cord
blood units; and maintaining a national system for the
recruitment of bone marrow donors.
Organ Transplantation
The Committee includes $31,049,000 for the Organ
Transplantation program, $1,000,000 above the fiscal year 2022
enacted level and $2,000,000 above the fiscal year 2023 budget
request.
Maximizing Deceased Donor Organ Recovery, Acceptance, and
Utilization.--The Committee supports regulatory and enforcement
efforts to minimize excessive and frivolous expenses reimbursed
to Organ Procurement Organizations (OPOs) and the Organ
Procurement Transplantation Network (OPTN) by Medicare,
including as related to organ acquisition costs and the
waitlisting of patients, and to ensure all potential conflicts
of interest of OPO and OPTN executive and board leadership are
publicly disclosed. The Committee encourages HHS to make all
efforts to promote competition for the Organ Procurement
Transplantation Network (OPTN) contract, including the NASEM
recommendation that HRSA separate the information technology
functions of the OPTN contract. The Committee supports this
recommendation as it will both increase the likelihood of full
and open competition for all components of the OPTN contract
activities and likely lead to significant improvements in the
OPTN's IT functionality, which is also a goal HRSA highlights
in their request for information published on April 8, 2022.
Living Organ Donation Reimbursement Program.--The Committee
includes $8,000,000, an increase of $1,000,000 above the fiscal
year 2022 enacted level, for the Living Organ Donation
Reimbursement Program. The Committee supports significant
expansion of income eligibility for the program to allow as
many donors as possible to qualify and to ensure that financial
reimbursement and monetary exchange take place outside of the
organ donor-organ recipient relationship to the greatest extent
possible.
Reducing Organ Discards.--The Committee expresses its
support for the procurement and transplantation of moderate-to-
high Kidney Donor Profile Index (KDPI) kidneys at risk of
discard to alleviate the organ shortage. The Committee requests
a report within 180 days of enactment of this Act regarding the
OPTN proposal to remove donor service areas from allocation and
the impact of this policy on organ discards.
National Cord Blood Inventory (NCBI)
The Committee includes $19,266,000 for the NCBI, an
increase of $1,000,000 above the fiscal year 2022 level. The
NCBI program supports cord blood banks to build a genetically
and ethnically diverse inventory of the highest quality cord
blood units for transplantation. To further strengthen
communication and collaboration between HRSA and cord blood
banks, the Committee directs HRSA to host quarterly stakeholder
calls open to all cord blood banks contracting with NCBI. These
calls should serve as a forum for the agency to solicit
feedback from the cord blood banks and ensure that the program
is implemented in accordance with Congressional intent. Such
feedback should be incorporated into contracts between the
agency and the cord blood banks to increase the programs reach
and achieve program goals.
C.W. Bill Young Cell Transplantation
The Committee includes $33,009,000 for the C.W. Bill Young
Cell Transplantation program, an increase of $1,000,000 above
the fiscal year 2022 level. This program supports coordinating
the procurement of bone marrow and umbilical cord blood units
for transplantation.
The Committee continues to support cell transplantation
using bone marrow, peripheral blood stem cells, and cord blood.
The Committee appreciates HRSA's efforts to increase the
diversity of the volunteer registry and supports efforts to
significantly reduce barriers to transplant for patients. This
includes increasing targeted donor recruitment efforts,
intervening with community referring physicians upon patient
diagnosis to accelerate the path to transplant, and propelling
innovation to improve outcomes and establish new treatment
options to ensure a matched donor for all searching patients,
regardless of their racial/ethnic background, socioeconomic
status, age, ancestry, or any other individually defining
characteristic. The highest priority should be given to
providing immediate and free testing of patients' cellular
markers to quickly determine if a there is an available matched
a donor. Eliminating these barriers would allow therapies for
patients to be delivered on time and to provide equal and
successful outcomes for all.
Hansen's Disease Program
The Committee includes $13,706,000 for the Hansen's Disease
Program, $122,000 for Hansen's Disease Buildings and
Facilities, and $1,857,000 for Payments to Hawaii for Treatment
of Hansen's Disease. These funding levels are the same as the
fiscal year 2022 enacted levels and the amounts requested in
the fiscal year 2023 budget request. The programs support
inpatient, outpatient, long-term care, as well as training and
research in Baton Rouge, Louisiana; 11 outpatient clinic sites
in the continental U.S. and Puerto Rico; facility-related
expenses for the buildings of the Gillis W. Long Hansen's
Disease Center; and medical care and treatment of persons with
Hansen's disease in hospital and clinic facilities at
Kalaupapa, Molokai, and Honolulu, Hawaii.
RURAL HEALTH
Appropriation, fiscal year 2022....................... $331,062,000
Budget request, fiscal year 2023...................... 373,709,000
Committee Recommendation.............................. 375,675,000
Change from enacted level......................... +44,613,000
Change from budget request........................ +1,966,000
The Federal Office of Rural Health Policy's 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; and for the
outreach and treatment of coal miners and others with
occupation-related respiratory and pulmonary impairments.
Rural Health Outreach Programs
The Committee includes $90,975,000 for Rural Health
Outreach Programs, an increase of $5,000,000 above the fiscal
year 2022 enacted level and $975,000 above the fiscal year 2023
budget request. This program supports projects that demonstrate
new and innovative modes of outreach in rural areas, such as
integration and coordination of health services.
Rural Maternity and Obstetrics Management Strategies
(RMOMS).--The Committee recommendation includes no less than
$8,000,000 for RMOMS, an increase of $2,000,000 above the
fiscal year 2022 enacted level. RMOMS supports grants to
improve access to and continuity of maternal and obstetrics
care in rural communities by increasing the delivery of and
access to preconception, pregnancy, labor and delivery, and
postpartum services, as well as developing sustainable
financing models for the provision of maternal and obstetrics
care.
Rural Health Research and Policy Development
The Committee includes $11,076,000 for Rural Health
Research and Policy Development, the same as the fiscal year
2022 enacted level and the fiscal year 2023 budget request.
Funding supports the Federal Office of Rural Health Policy's
activities to analyze, advise the Secretary, and provide
information to the public regarding issues that affect the
availability, access to, and quality of health care in rural
areas.
Rural Health Research Centers.--In the next competition for
Rural Health Research Centers, the Committee strongly
encourages the Federal Office of Rural Health Policy to
prioritize States that have not previously hosted such a
center. The Committee supports centers in areas that have a
demonstrated collaborative partnership with research and
education in the pharmacological and physician space. Further,
the Committee strongly encourages the Office to explore
establishing a center which encompasses research related to
biomedical and cancer research, opioid abuse, delivery of rural
healthcare, and training for rurally focused residency
programs.
Rural Health Flexibility Grants
The Committee includes $68,500,000 for Rural Health
Flexibility Grants, $6,223,000 above the fiscal year 2022
enacted level and $10,991,000 above the fiscal year 2023 budget
request. These programs support States to assist small and
critical access rural hospitals to remain economically viable
and to provide high-quality care. Within this total, the
Committee includes no less than $5,000,000 for the Rural
Emergency Hospitals Technical Assistance Program and no less
than $20,942,000 for the Small Rural Hospital Improvement
Program.
State Offices of Rural Health
The Committee includes $12,500,000 for State Offices of
Rural Health, the same as the fiscal year 2022 enacted level
and the fiscal year 2023 budget request. HRSA supports the
establishment and operation of State offices of rural health to
strengthen rural health care delivery system.
Black Lung Clinics
The Committee includes $12,190,000 for Black Lung Clinics,
an increase of $345,000 above the fiscal year 2022 enacted
level and the same as the fiscal year 2023 budget request. This
program funds clinics that treat respiratory and pulmonary
diseases of active and retired coal miners, steel mill workers,
agricultural workers, and others with occupationally-related
respiratory and pulmonary impairments.
Radiation Exposure Screening and Education Program (RESEP)
The Committee includes $2,734,000 for the RESEP program, an
increase of $845,000 above the fiscal year 2022 enacted level
and the same as the fiscal year 2023 budget request. This
program provides grants for the education, prevention, and
early detection of radiogenic cancers and diseases resulting
from exposure to uranium during mining and milling at nuclear
test sites.
Rural Health Residency Program
The Committee includes $12,700,000 for the Rural Health
Residency Program, an increase of $2,200,000 above the fiscal
year 2022 enacted level and the same as the fiscal year 2023
budget request. This program funds physician residency training
programs that support physician workforce expansion in rural
areas.
The Committee commends the Federal Office of Rural Health
Policy for their efforts to expand the physician workforce in
rural areas and supports continuation and expansion of the
program to develop new rural residency programs, or Rural
Training Programs.
Rural Communities Overdose Response Program (RCORP)
The Committee includes $160,000,000, an increase of
$25,000,000 above the fiscal year 2022 enacted level, for the
RCORP program, and allows for the expanded focus on behavioral
health care, including SUD, needs in rural communities. The
Committee is particularly interested in programs that address
health equity and reach rural populations that have
historically suffered poorer behavioral health outcomes
relative to their counterparts. Within the funding provided,
the agreement includes $10,000,000 to continue the Rural
Centers of Excellence (COE) program in order to collaboratively
identify, implement, and evaluate innovative SUD and broader
behavioral health approaches to build the evidence-base for
effective prevention, treatment, and recovery programs in rural
communities across the U.S.; and through the addition of a
fourth coordinating COE, track, synthesize, and disseminate
national and State-level SUD policies and research, including
any effective interventions and outcomes identified.
Rural Health Clinic Behavioral Health Initiative
The Committee includes $5,000,000 to support expanded
access to behavioral health services at rural health clinics,
as described in the fiscal year 2023 budget request.
FAMILY PLANNING
Appropriation, fiscal year 2022....................... $286,479,000
Budget request, fiscal year 2023...................... 400,000,000
Committee Recommendation.............................. 500,000,000
Change from enacted level......................... +213,521,000
Change from budget request........................ +100,000,000
The Family Planning program administers Title X of the PHS
Act. This program supports preventive and primary health care
services at health centers nationwide by increasing access to
affordable contraceptive education, services, and supplies; STD
prevention, screening, and treatment; cervical and breast
cancer screenings; first-line infertility services; and other
community and health care services. The Title X program is a
vital component of the health care safety net and is essential
to addressing health inequities.
The Committee directs the Secretary to ensure that grantees
certify that they: (1) provide medically accurate and complete
counseling, including referral as requested, on all matters;
(2) shall not condition the receipt of Title X-supported
services on patients remaining sexually abstinent until
marriage; and (3) will not make any appointments or referrals
for patients that are contrary to the patient's wishes. The
bill requires that all recipients of funds under this heading
offer services consistent with the best available evidence-
based standards, including the Quality Family Planning
guidelines from the CDC and the Office of Population Affairs
(OPA).
Recommendations for Quality Family Planning Services.--The
Committee directs the Secretary to continue the process of
revising ``Providing Quality Family Planning Services,''
evidence-based recommendations that were last updated in 2017,
and to ensure the robust participation of both the CDC's
Division of Reproductive Health and OPA in this effort.
Revisions should incorporate new evidence and support
comprehensive reproductive and sexual health needs of all
people. The Committee requests a briefing on the status of this
process no later than 180 days of enactment of this Act.
Estimated Need for Services.--The Committee requests the
Secretary conduct a study, within 270 days of enactment of this
Act, determining the current estimated need for Title X
services, updating the 2016 study published in the American
Journal of Public Health. The Committee requests that, as in
the previous work, the CDC's Division of Reproductive Health
and OPA collaborate on this effort.
HRSA-Wide Activities and Program Support
Appropriation, fiscal year 2022....................... $1,259,484,000
Budget request, fiscal year 2023...................... 230,709,000
Committee Recommendation.............................. 934,857,000
Change from enacted level......................... -324,627,000
Change from budget request........................ +704,148,000
This account supports telehealth programs, operation of the
340B drug pricing program, community projects, and the cost of
Federal staff and related activities to coordinate, direct, and
manage the programs of HRSA.
HRSA Chief Dental Officer.--The Committee is disturbed to
learn that despite its directive to have HRSA ensure that the
Chief Dental Officer (CDO) is functioning at an executive level
with resources and staff to lead oral health programs and
initiatives across HRSA, no such authority has been delegated.
The Committee urges HRSA to hire a CDO and restore the position
with executive level authority and resources to oversee and
lead dental programs and initiatives across the agency. The CDO
is also expected to serve as the agency representative on oral
health issues to international, national, State, and/or local
government agencies, universities, and oral health stakeholder
organizations. The Committee requests an update as part of the
fiscal year 2024 Congressional Justification on how the CDO is
serving as the agency representative with executive level
authority on oral health issues to international, national,
State and/or local government agencies, universities, and oral
health stakeholder organizations.
Oral Health Literacy.--The Committee includes $300,000 to
continue the development of an oral health awareness and
education campaign across relevant HRSA divisions, including
the Health Centers Program, Oral Health Workforce, Maternal and
Child Health, Ryan White HIV/AIDS Program, and Rural Health.
The Committee directs HRSA to identify oral health literacy
strategies that are evidence-based and focused on oral health
care prevention and education, including prevention of oral
disease such as early childhood and other caries, periodontal
disease, and oral cancer. The Committee encourages HRSA to
ensure that the Chief Dental Officer plays a key role in the
design, monitoring, oversight, and implementation of this
project.
Targeted Investments in Impoverished Areas.--The Committee
supports targeted investments in impoverished areas,
particularly in persistent poverty counties and in other high-
poverty census tracts. For purposes of this Act, the term
``high-poverty area'' means any census tract with a poverty
rate of at least 20 percent as measured by the 2016-2020 5-year
data series available from the American Community Survey of the
Census Bureau and the term ``persistent poverty counties''
means any county that has had 20 percent or more of its
population living in poverty over the past 30 years, as
measured by the 1993 Small Area Income and Poverty Estimates,
the 2000 decennial census, and the most recent Small Area
Income and Poverty Estimates, or any territory or possession of
the U.S. The Committee directs HRSA to develop and implement
measures to increase the share of investments in high-poverty
census tracts with a poverty rate of at least 20 percent as
measured by the 2016-2020 5-year data series available from the
American Community Survey of the Census Bureau, and any other
impoverished areas the Department determines to be appropriate
areas to target. The Committee directs HRSA to submit a report
to the Committee within 180 days of enactment of this Act that
includes the amount of funds that were targeted to such areas;
the percent change from fiscal year 2022 in the amount of funds
that were targeted toward such areas; and, to the extent
practicable, an assessment of the economic impact of the
program on the areas, including data on the categories of
individuals impacted by the targeting of funds to such areas
under the program, disaggregated by household income, race,
gender, age, national origin, disability status, and whether
the individuals live in an urban area, suburban area, or rural
area.
Office of Pharmacy Affairs (OPA)
The Committee includes $13,238,000 for OPA, $2,000,000
above the fiscal year 2022 enacted level. OPA administers the
340B drug pricing program, which was designed to help safety
net providers maintain, improve, and expand patient access to
health care services. The 340B program has lowered the cost of
outpatient drugs to health clinics and nonprofit and public
hospitals that serve a disproportionate share of low-income and
rural patients. These entities provide additional services and
benefits to their communities with the savings realized.
The Committee recognizes that the 340B program is a
critical lifeline to safety net providers, including FQHCs,
FQHC Look-Alikes, children's hospitals, Ryan White HIV/AIDS
clinics, and other safety-net hospitals and providers. These
covered entities are model stewards of the program and reinvest
340B savings to reach more patients and provide more
comprehensive services.
The Committee is concerned by the fact that the number of
pharmaceutical manufacturers that are violating the 340B
statute has dramatically increased, threatening the ability of
safety-net providers to care for patients in need. The
Committee is pleased that HRSA has continued to take steps to
enforce the statute and take action against companies that
curtail the use of 340B drugs in contract pharmacies, refer
violations of the statute by manufacturers to the HHS Office of
Inspector General, and appeal litigation in these matters. The
Committee encourages HRSA to continue to use its authority and
any available measures, including the imposition of civil
penalties, where appropriate, to hold those drug manufacturers
in violation of the law directly accountable. The Committee
urges HRSA to continue to take actions to safeguard covered
entities' lawful access to discounted drugs.
Telehealth
The Committee includes $37,050,000 for Telehealth, an
increase of $2,000,000 above the fiscal year 2022 enacted
level. Funds support the Office for the Advancement of
Telehealth, which promotes the effective use of technologies to
improve access to health services for people who are isolated
from health care and to provide distance education for health
professionals.
Provider Bridge.--The Committee includes $500,000 within
the total for Telehealth for the Provider Bridge program. With
funds appropriated in the Coronavirus License Portability Grant
Program, HRSA established the Provider Bridge Program to
empower medical professionals to safely and efficiently deliver
urgently-needed care to communities during public health
emergencies. To date, over 400 entities and 85,000 healthcare
professionals have leveraged this national tool connecting
health care professionals with State agencies and health care
entities to quickly verify credentials and professional
background information. Specifically, the platform provides a
directory of State and Federal COVID-19 resources, allows
health care professionals to submit professional background
information, produces official and verified digital documents
of licensure and credentialing information, and provides access
to a database of information for volunteer clinicians willing
to provide care.
Telehealth Centers of Excellence.--The Committee supports
the continued development of Telehealth Centers of Excellence
to continue to validate technologies and reimbursement
mechanisms, establish training protocols, and develop
comprehensive templates for States to integrate telehealth into
their state health provider networks.
Rural Telehealth Initiative.--The Committee supports the
Memorandum of Understanding entered into on August 31, 2020,
establishing a Rural Telehealth Initiative among HHS, the
Federal Communications Commission, and the Department of
Agriculture. Together, this important initiative can leverage
expertise of each respective agency and improve collaboration
amongst entities tasked with addressing rural telehealth
access. This initiative recognizes the unique problems facing
rural Americans that need access to critical care services
through telehealth platforms. The Committee encourages agencies
involved in this initiative to prioritize opportunities to
continue the expansion of telehealth services, close the
digital divide, and not leave rural communities behind.
Community Project Funding
Within the funds included in this account, $726,569,000
shall be used for the projects, and in the amounts, specified
in the table titled ``Labor, HHS, Education Incorporation of
Community Project Funding Items'' at the end of this report.
The Committee includes $6,000,000 within this total for agency
administrative expenses.
VACCINE INJURY COMPENSATION PROGRAM
Appropriation, fiscal year 2022....................... $13,200,000
Budget request, fiscal year 2023...................... 26,200,000
Committee Recommendation.............................. 15,200,000
Change from enacted level......................... +2,000,000
Change from budget request........................ -11,000,000
The Committee includes $15,200,000 for administrative costs
associated with the Vaccine Injury Compensation Program, an
increase of $2,000,000 above the fiscal year 2022 enacted
level. This program provides compensation for individuals with
vaccine-associated injuries or deaths.
COVID-19 Vaccine Liability.--The FDA has approved one
COVID-19 vaccine for children 5 and older and granted emergency
use authorization for a second COVID-19 vaccine for children 12
and older. The ACIP recommends that every eligible person
receive the COVID-19 vaccine, including children aged 5 and
older. Under the National Childhood Vaccine Injury Act (NCVIA),
this recommendation requires the Secretary to add the COVID-19
vaccine to the VICP within two years. As the public anticipates
the transition of COVID-19 vaccine injury compensation claims
from the Countermeasure Injury Compensation Program (CICP) to
the VICP, the Committee requests a report within 60 days of
enactment of this Act regarding HHS's transition plan for
COVID-19 vaccine injury compensation claims. This report should
include a specific timeline for the rulemaking process to add
COVID-19 vaccines to the Vaccine Injury Table, as well as a
plan for how pending claims already filed with the
Countermeasure Injury Compensation program will be handled. The
plan should also include any anticipated resources needed to
facilitate this transition and quickly process pending claims
as well as how HHS will inform current and potential
petitioners of their options.
COVERED COUNTERMEASURES PROCESS FUND
Appropriation, fiscal year 2022....................... $5,000,000
Budget request, fiscal year 2023...................... 15,000,000
Committee Recommendation.............................. 7,000,000
Change from enacted level......................... +2,000,000
Change from budget request........................ -8,000,000
The Committee includes $7,000,000 for administrative costs
associated with the Countermeasures Injury Compensation Program
(CICP), an increase of $2,000,000 above the fiscal year 2022
enacted level. The CICP provides benefits to individuals who
are seriously injured as a result of a vaccination, medication,
device, or other item recommended to diagnose, prevent or treat
a declared pandemic, epidemic or security threat.
Centers for Disease Control and Prevention
Appropriation, fiscal year 2022....................... $8,457,204,000
Budget request, fiscal year 2023...................... 10,730,159,000
Committee Recommendation.............................. 10,499,354,000
Change from enacted level......................... +2,042,150,000
Change from budget request........................ -230,805,000
The Committee recommendation for the Centers for Disease
Control and Prevention (CDC) program level includes
$9,540,696,000 in discretionary budget authority, $55,358,000
in mandatory funds under the terms of the Energy Employees
Occupational Illness Compensation Program Act, and $903,300,000
in transfers from the Prevention and Public Health (PPH) Fund.
CDC's mission is to protect America from health, safety,
and security threats, which it accomplishes by supporting core
public health functions at State, local, and tribal health
departments, detecting and responding to new and emerging
health threats, promoting health and safety, and providing
leadership in the public health workforce.
IMMUNIZATION AND RESPIRATORY DISEASES
Appropriation, fiscal year 2022....................... $868,155,000
Budget request, fiscal year 2023...................... 1,250,930,000
Committee Recommendation.............................. 1,083,155,000
Change from enacted level......................... +215,000,000
Change from budget request........................ -167,775,000
The Committee recommendation includes $663,805,000 in
discretionary budget authority and $419,350,000 in transfers
from the PPH Fund.
Immunization cooperative agreements are awarded to State
and local public health departments for planning, developing,
and conducting childhood, adolescent, and adult immunization
programs, including enhancement of the vaccine delivery
infrastructure. CDC directly maintains a stockpile of vaccines,
supports consolidated purchase of vaccines for State and local
health agencies, and conducts surveillance, investigations, and
research into the safety and efficacy of new and presently used
vaccines.
Within the total for Immunization and Respiratory Diseases,
the Committee recommends the following amounts:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Immunization Program................................. $825,797,000
Acute Flaccid Myelitis............................... 6,000,000
Influenza Planning and Response...................... 251,358,000
------------------------------------------------------------------------
Cost Estimates.--The Committee urges that the report on
estimated funding needs of the Section 317 Immunization Program
be updated and submitted not later than February 1, 2023. The
updated report should include an estimate of optimum State and
local operations funding, as well as a discussion of the role
of the 317 Program, as coverage for vaccination under public
and private resources continues to evolve. It should also
include specific information on the estimated cost to fully
address evidence-based public health strategies that could be
funded through CDC to improve coverage for human papillomavirus
(HPV) and influenza.
Immunization Program.--The Committee includes an increase
of $175,000,000 to enhance immunization efforts, including
increasing awardee base awards with a focus on expanding and
sustaining critical immunization program infrastructure.
Immunization Rates.--The Committee is concerned about the
marked decline in routine vaccines as a result of the pandemic.
The Committee encourages CDC to continue surveillance and
laboratory efforts, and to promote HPV vaccination in support
of the Administration's Cancer Moonshot Initiative. In
addition, the Committee requests information in the fiscal year
2024 Congressional Budget Justification on how the Advisory
Committee on Immunization Practices (ACIP) can support both
routine and emergency reviews in real time to ensure timely
access to immunizations. Furthermore, the Committee recognizes
that office-based physicians are trusted sources of health care
information and delivery, and encourages CDC to consider their
role in vaccination efforts.
Improving Immunization Information System Infrastructure
and Data.--The Committee encourages CDC to engage with States
and local jurisdictions to assess gaps and greatest areas of
need to work toward all Immunization Information Systems (IIS)
adopting and adhering to national standards to support the
capture of data for all vaccinations administered across the
life course, and have secure bi-directional information sharing
capabilities both inter- and intra-State and with other IIS,
health information exchanges, health data systems and entities,
including data repositories to achieve interoperability levels
needed to capture reliable, complete, real-time vaccine
administration data.
Influenza Planning and Response.--The Committee includes an
increase of $40,000,000 to enhance CDC's influenza activities,
including expanding vaccine effectiveness monitoring and
evaluation, and increasing influenza vaccine acceptance by
removing barriers to vaccination and promoting vaccination
coverage.
Influenza Vaccine.--The Committee encourages CDC to
consider including vaccines produced through recombinant DNA
technology in addition to traditionally-produced vaccines in
future solicitations to facilitate the competitive process for
all vaccine manufacturers.
HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND
TUBERCULOSIS PREVENTION
Appropriation, fiscal year 2022....................... $1,345,056,000
Budget request, fiscal year 2023...................... 1,470,556,000
Committee Recommendation.............................. 1,463,556,000
Change from enacted level......................... +118,500,000
Change from budget request........................ -7,000,000
CDC provides national leadership and support for prevention
research and the development, implementation, and evaluation of
evidence-based HIV, viral hepatitis, sexually transmitted
diseases (STD), and tuberculosis (TB) prevention programs
serving persons affected by, or at risk for, these infections.
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 2023
Budget Activity Committee
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research............ $1,046,712,000
HIV Initiative................................... 245,000,000
School Health-HIV................................ 46,081,000
Viral Hepatitis...................................... 54,500,000
Sexually Transmitted Infections...................... 179,310,000
Tuberculosis......................................... 140,034,000
Infectious Diseases and the Opioid Epidemic.......... 43,000,000
------------------------------------------------------------------------
Access to PrEP.--The Committee notes the importance of
expanding HIV pre-exposure prophylaxis (PrEP) nationally to
improve access to medications and essential support services,
community and provider outreach, to make progress towards
ending the HIV epidemic.
Ending the HIV Epidemic Initiative.--The Committee includes
an increase of $50,000,000 for the fourth year of the Ending
the HIV Epidemic initiative. The Committee commends CDC for
including dedicated funding within this initiative for sexually
transmitted infection clinics. The Committee notes the
important role that self-testing has played in the response to
the COVID-19 pandemic and encourages CDC to explore
opportunities to facilitate access to HIV self-testing.
Hepatitis.--The Committee includes an increase of
$13,500,000 to enhance efforts to eliminate the public health
threat of viral hepatitis. The Committee is aware of the
November 2021 ACIP recommendation that all adults between ages
19 and 59 be vaccinated for hepatitis B, and urges CDC to take
any associated action as early as possible. In addition, the
Committee urges CDC to expand the viral hepatitis disease
tracking and surveillance capabilities of States to permit an
effective targeting of resources and evaluation of program
effectiveness. Furthermore, the Committee encourages CDC to
expand outreach and communications efforts and related
initiatives to promote hepatitis C screening during pregnancy
with the goal of ensuring that every pregnant individual gets
tested for hepatitis C during each pregnancy.
Infectious Diseases and the Opioid Epidemic.--The Committee
includes an increase of $25,000,000 to expand activities to
target the infectious disease consequences of the public health
crisis involving injection drug use, including expanding the
implementation of and access to high quality syringe services
programs nationwide.
School Health.--The Committee includes an increase of
$10,000,000 to bolster school capacity for evidence-based
sexual health education, and access to sexual health services
and safe and supportive environments.
Sexually Transmitted Infections.--The Committee includes an
increase of $15,000,000 to address the high rates of sexually
transmitted infections (STIs). The Committee directs CDC to
utilize a portion of the increase to move the grant year
forward by one month to provide for a more efficient
expenditure of funds and improve grantee activities, with the
intention that the grant year will be moved forward by one
month each year for the next three years, contingent on the
availability of funds. In addition, the Committee encourages
CDC to maximize the impact of available resources, prevent the
largest number of infections, and increase health equity by
allocating funding to States and local jurisdictions using data
driven methods incorporating burden of disease provided that a
portion of these funds be used to ensure that no grantee
receives less than the amount received in fiscal year 2022.
Furthermore, the Committee encourages CDC to work with other
agencies, as appropriate, to develop innovative approaches
including the use of telehealth platforms and at home specimen
collection to increase screening, treatment, and education to
curb the spread of STIs in vulnerable populations.
Tuberculosis.--The Committee includes an increase of
$5,000,000 to enable CDC, along with State and local entities,
to provide TB screening, identification, treatment and
prevention services, and to support the TB Trials Consortium.
The Committee is concerned that the COVID-19 pandemic caused
significant impacts on individuals with TB and on State and
local TB programs, including delays in care for people with TB
and postponement of identification and treatment of individuals
with latent TB infection, stalling efforts to eliminate TB in
the U.S.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriation, fiscal year 2022....................... $693,272,000
Budget request, fiscal year 2023...................... 703,272,000
Committee Recommendation.............................. 799,272,000
Change from enacted level......................... +106,000,000
Change from budget request........................ +96,000,000
The Committee recommendation includes $747,272,000 in
discretionary appropriations and $52,000,000 in transfers from
the PPH Fund.
Programs funded under Emerging and Zoonotic Infectious
Diseases (EZID) 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:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Antibiotic Resistance Initiative..................... $202,000,000
Vector-borne Diseases................................ 87,103,000
Prion Disease........................................ 7,500,000
Chronic Fatigue Syndrome............................. 5,400,000
Emerging Infectious Diseases......................... 214,997,000
Harmful Algal Blooms................................. 3,500,000
Food Safety.......................................... 80,000,000
National Healthcare Safety Network................... 31,000,000
Quarantine........................................... 65,772,000
Advanced Molecular Detection......................... 50,000,000
Epidemiology and Laboratory Capacity................. 40,000,000
Healthcare-Associated Infections..................... 12,000,000
------------------------------------------------------------------------
Advanced Molecular Detection.--The Committee includes an
increase of $15,000,000 and recognizes the value of the
Advanced Molecular Detection program through its crosscutting
and collaborative work that introduces and helps establish
biotechnology-focused innovation to public health programs
across CDC and in State and local health departments.
Antibiotic Resistance.--The Committee includes an increase
of $20,000,000 to enhance capacity to combat the growing threat
of antibiotic resistant bacteria. The Committee recognizes the
importance of addressing the problem of antibiotic-resistant
bacteria through a One Health approach and by tracking
resistance through local, regional, national, and global
surveillance. In addition, the Committee urges CDC to develop
improved data collection and surveillance of Clostridioides
Difficle (C diff.), including working with State and local
partners as part of the Nationally Notifiable Diseases
Surveillance System. The Committee urges CDC to assist State
and local partners in increasing awareness of antibiotic
stewardship as it relates to C diff. The Committee requests an
update in the fiscal year 2024 Congressional Budget
Justification on these activities.
Emerging Infectious Diseases.--The Committee includes an
increase of $20,000,000 for emerging infectious disease work,
including laboratory capacity and wastewater surveillance. The
Committee commends CDC for implementing the National Wastewater
Surveillance System (NWSS) with partners at health laboratories
and academic institutions to better track COVID-19. The
Committee encourages CDC to support staff sharing arrangements
among multiple local health departments implementing NWSS and
efforts to stand up systems in rural settings that do not have
access to centralized wastewater treatment services. The
Committee requests information in the fiscal year 2024
Congressional Budget Justification on best practices in
developing wastewater surveillance programs in rural settings,
and strategies to increase participation in the NWSS among
State and local governments, institutions of higher education,
and correctional facilities.
Food Safety.--The Committee includes an increase of
$12,000,000 to help address the critical unmet needs in the
nation's food safety system, in part through programs that
enhance State and local public health capacity to support vital
national surveillance, improve foodborne outbreak detection and
investigations, enhance food safety prevention efforts, and
maintain vigilance for emerging threats to our nation's food
supply.
Harmful Algal Blooms.--The Committee includes an increase
of $1,000,000 to support monitoring and health reporting
concerns related to harmful algal blooms (HABs). The Committee
urges CDC to continue work on affected waters, with a focus on
freshwater and the related dangers to drinking water supplies.
CDC has a unique role in better understanding the intersection
of public health and environmental impacts of HABs using a One
Health approach to: (1) increase outreach efforts to States and
local public health officials to use these monitoring and
reporting systems; and (2) work with a variety of agencies that
currently collaborate on HABs. The scope of future research may
expand to include improving laboratory methods for HAB-related
toxins in biological specimens and clinical diagnostic methods
to identify HAB-related symptoms and illnesses, optimizing
emergency response capacities, and identifying and addressing
the impacts of harmful algal toxins to humans. There is an
important nexus between freshwater and health through drinking
water and recreation, and CDC is urged to expand their work
regionally to understand HABs impact on our nation's largest
fresh bodies of water. In addition, CDC is urged to work with
other agencies 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.
Live Animal Imports.--The Committee notes the importance
that live cargo inspections maintain standards of animal
welfare and occur in the shortest practicable period. In
addition, the Committee recognizes CDC's efforts to eliminate
canine rabies in the U.S. and encourages CDC to provide a clear
framework for those seeking to bring canines into the U.S.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.--The
Committee commends CDC for its recent progress in myalgic
encephalomyelitis/chronic fatigue syndrome (ME/CFS) medical
education and in its participation in the Interagency Working
Group for ME/CFS.
Mycotic Diseases.--The Committee provides an increase of
$2,000,000 in Emerging Infectious Diseases for mycotic
diseases, including, but not limited to, surveillance and
prevention, building capacity in the State and local health
departments, cooperative agreements, education of the public
and healthcare providers, and laboratory support. The Committee
requests an update in the fiscal year 2024 Congressional Budget
Justification on how this funding is being utilized.
National Healthcare Safety Network.--The Committee includes
an increase of $10,000,000 and recognizes the value of this
system for healthcare quality measurement and improvement. The
Committee supports the modernization of the system's
infrastructure resulting in increased timeliness and accuracy,
reduced burden on healthcare facilities, and the ability to
collect urgent data.
Prion.--The Committee includes an increase of $1,000,000 to
advance efforts on human prion diseases, rapidly progressive
and fatal neurodegenerative diseases that occur in both humans
and animals, and recognizes the critical work of the National
Prion Disease Pathology Surveillance Center.
Quarantine.--The Committee includes an increase of
$15,000,000 to enhance programs to protect the U.S. from
infectious diseases, including expanded coverage at the most
heavily trafficked airports and land border crossings and
increased capacity for health screenings.
Vector-Borne Diseases.--The Committee includes an increase
of $12,000,000 for enhanced vector-borne disease activities,
including Lyme Disease and tickborne diseases. The Committee
includes funding to support training and the development of
communities of practice in vector-borne disease prevention and
control for the regions of the U.S. that account for the
largest burden of vector-borne disease. The Committee urges CDC
to increase provider and public awareness of Lyme and known
tickborne diseases (TBD) in differential diagnoses, to practice
shared decision making, to be aware of the existence of two
sets of differing Lyme Disease Clinical Guidelines, and to
encourage the public to take preventive measures. The Committee
requests an update in the fiscal year 2024 Congressional Budget
Justification on the use of advanced and emerging technologies
for the development of improved diagnostics, including a
timeline on when improved diagnostics may become commercially
available for Lyme disease. In addition, the Committee notes
that the pandemic response necessitated the disruption of
mosquito control and abatement efforts by many State and local
health departments and notes the importance of continuing
mosquito prevention efforts. The Committee is aware of the
ongoing challenges faced by the U.S. territories in the
Caribbean and the Pacific regarding control and management of
vector-borne diseases. The Committee urges CDC to support the
training and research needs of the U.S. territories and
encourages the use of the Mosquito Abatement for Safety and
Health Program to provide grants and technical assistance to
States and political subdivisions to prevent and control
mosquito-borne diseases. In addition, the Committee requests
CDC, in consultation with other appropriate agencies, to
provide information in the fiscal year 2024 Congressional
Budget Justification on the ecological structure and
epidemiological factors that must be known and monitored to
estimate the mosquito-borne infectious disease outbreak risk.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriation, fiscal year 2022....................... $1,338,664,000
Budget request, fiscal year 2023...................... 1,612,264,000
Committee Recommendation.............................. 1,601,914,000
Change from enacted level......................... +263,250,000
Change from budget request........................ -10,350,000
The Committee recommendation includes $1,346,964,000 in
discretionary appropriations and $254,950,000 in transfers from
the PPH Fund.
Programs supported within Chronic Disease Prevention and
Health Promotion provide national leadership and support for
State, tribal, and community efforts to promote health and
well-being through the prevention and control of chronic
diseases.
Within the total provided, the Committee recommends the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Tobacco.............................................. $251,500,000
Nutrition, Physical Activity, and Obesity............ 58,420,000
High Obesity Rate Counties....................... 16,500,000
School Health........................................ 27,400,000
Glaucoma............................................. 4,000,000
Vision and Eye Health................................ 2,500,000
Alzheimer's Disease.................................. 35,500,000
Inflammatory Bowel Diseases.......................... 1,000,000
Interstitial Cystitis................................ 1,100,000
Excessive Alcohol Use................................ 6,000,000
Chronic Kidney Disease............................... 8,500,000
Chronic Disease Education and Awareness.............. 6,000,000
Prevention Research Centers.......................... 29,961,000
Heart Disease and Stroke............................. 147,105,000
Diabetes............................................. 156,129,000
National Diabetes Prevention Program................. 38,300,000
Breast and Cervical Cancer........................... 244,500,000
WISEWOMAN........................................ 37,620,000
Breast Cancer Awareness for Young Women.............. 8,960,000
Cancer Registries.................................... 56,440,000
Colorectal Cancer.................................... 45,294,000
Comprehensive Cancer................................. 26,425,000
Johanna's Law........................................ 12,500,000
Ovarian Cancer....................................... 14,500,000
Prostate Cancer...................................... 15,205,000
Skin Cancer.......................................... 5,000,000
Cancer Survivorship Resource Center.................. 725,000
Oral Health.......................................... 20,750,000
Safe Motherhood/Infant Health........................ 143,000,000
Arthritis............................................ 11,000,000
Epilepsy............................................. 13,000,000
National Lupus Registry.............................. 10,500,000
Racial and Ethnic Approaches to Community Health..... 75,950,000
Good Health and Wellness in Indian Country....... 26,500,000
Social Determinants of Health........................ 100,000,000
Million Hearts....................................... 10,000,000
National Early Child Care Collaboratives............. 5,000,000
Hospitals Promoting Breastfeeding.................... 9,750,000
------------------------------------------------------------------------
Alzheimer's Disease.--The Committee includes an increase of
$5,000,000 to support provisions enacted in the Building Our
Largest Dementia (BOLD) Infrastructure for Alzheimer's Act
(P.L. 115-406), including the implementation of the Road Map
Series, expanding the number of Centers of Excellence, and
building a robust Alzheimer's and other dementias public health
infrastructure across the country.
Breast and Cervical Cancer.--The Committee includes an
increase of $10,000,000 to increase the provision of critical,
lifesaving breast cancer screening and diagnostic services to
uninsured and underinsured women, supporting the Cancer
Moonshot goal to increase the percentage of women served by the
National Breast and Cervical Cancer Early Detection Program
(NBCCEDP) who have rarely or never been screened. In addition,
the Committee is concerned with the public health impact from
triple-negative breast cancer, named as such because it tests
negative for estrogen receptors, progesterone receptors, and
excess HER2 protein and thus does not respond to treatments
developed for these subtypes. The Committee supports efforts to
increase awareness of triple negative breast cancer and
incorporate diagnoses strategies in existing breast cancer
screening, diagnosis and linkage to care health programs.
Furthermore, the Committee encourages recipients to implement
navigator programs to help patients overcome barriers and have
the resources they need. The Committee requests information in
the fiscal year 2024 Congressional Budget Justification
outlining current activities to support navigation services.
Cancer.--The Committee includes a total increase of
$32,250,000 for cancer prevention and control activities in
this account. The Committee supports the Administration's
inclusion of CDC in the Cancer Moonshot initiative, recognizing
the importance of public health efforts in cancer prevention,
screening, early detection, and reducing disparities in quality
of care. In addition to the programs discussed separately under
this account, the Committee includes: an increase of $3,000,000
to expand awareness and prevention efforts for Breast Cancer
Awareness for Young Women; an increase of $5,000,000 to enhance
the work of the National Program of Cancer Registries; an
increase of $2,000,000 for colorectal cancer; an increase of
$6,000,000 for the National Comprehensive Cancer Control
Program; an increase of $2,000,000 for Johanna's Law that
raises awareness of the five main types of gynecological
cancer; an increase of $2,000,000 to advance ovarian cancer
prevention, early detection, risk assessment, and access to the
standard of care; an increase of $1,000,000 for skin cancer;
and an increase of $250,000 for the Cancer Survivorship
Resource Center.
Chronic Disease Education and Awareness.--The Committee
includes an increase of $3,000,000 to expand public health
education and awareness activities that help to improve
surveillance, diagnosis, and proper treatment for chronic
diseases. This competitive grant program expands and advances
CDC's work with stakeholders on education, outreach, and public
awareness activities for a variety of chronic diseases for
which there is a clear disparity in public and professional
awareness that are not already specified under CDC in this
report. As this program matures, CDC is urged to identify and
facilitate opportunities for coordination and best practices
among grantees to benefit from shared goals and if appropriate,
with smaller partners and rare disease organizations that
receive funding through other chronic disease programs.
Chronic Kidney Disease.--The Committee includes an increase
of $5,000,000 to accelerate activities to increase awareness,
diagnosis, and treatment of chronic kidney disease (CKD) and to
fund partnerships to support community-based activities that
enhance health systems' capacity to identify, risk-stratify,
and manage individuals with CKD. The Committee urges CDC to
support activities addressing inherited kidney diseases, such
as polycystic kidney disease (PKD) and encourages CDC to
continue to discuss the availability and feasibility of any
potential data sources for surveillance of PKD.
Diabetes.--The Committee includes an increase of $5,000,000
to prevent diabetes and its complications, and to reduce
inequities through prevention strategies, translational
research, and education. In addition, the Committee includes an
increase of $5,000,000 for the Diabetes Prevention Program to
expand efforts of this public-private partnership that provides
diabetes prevention for people with prediabetes. The Committee
supports the dissemination of community-based prevention and
control programs and encourages flexibility to organizations
serving low-income populations to address barriers these
populations face in achieving weight loss outcomes.
Early Child Care Collaboratives.--The Committee includes an
increase of $1,000,000 to enable training of early care and
education providers in the implementation of healthy eating and
physical activity best practices, including strategies for
engaging families. Funds will also support technical assistance
for integration of healthy eating and physical activity best
practices into existing State and local professional
development systems' early care and education settings, and
health initiatives. The Committee also encourages the program
to serve a mix of rural, suburban and urban areas, including
areas with high childhood obesity rates.
Eating Disorders.--The Committee encourages CDC to assist
States in collecting data by including standard questions on
unhealthy weight control practices for eating disorders,
including binge eating, through the Youth Risk Behavior
Surveillance System and the Behavioral Risk Factor Surveillance
System.
Epilepsy.--The Committee includes an increase of $2,500,000
for epilepsy. The Committee commends CDC for its ongoing
leadership of this successful program and its effective
community collaborations, and encourages further efforts to
eliminate stigma, improve awareness and education, and better
connect people with the epilepsies to health and community
services.
Excessive Alcohol Use Prevention.--The Committee includes
an increase of $1,000,000 to expand alcohol epidemiology
capacity through improved data collection on excessive drinking
and related harms in more States, and monitoring identifying
strategies to reduce youth exposure to alcohol and alcohol
marketing.
Farm-to-School.--The Committee includes $2,000,000 within
Nutrition, Physical Activity, and Obesity to continue research
and education activities related to farm to school programs
that result in promoting healthy eating habits for students.
Food Allergies.--The Committee includes $2,000,000 for a
school-based effort to address food allergies and reduce
potentially fatal anaphylactic reactions.
Glaucoma.--The Committee requests information in the fiscal
year 2024 Congressional Budget Justification on efforts to
reach African American and Hispanic communities through the
glaucoma program.
Heart Disease and Stroke.--The Committee includes a total
increase of $15,500,000 to address cardiovascular diseases. The
Committee includes an increase of $2,000,000 to support,
strengthen, and expand evidence-based initiatives at the State,
local, tribal, and territorial level. The Committee recognizes
the vital importance of addressing cardiovascular disease among
women, particularly women of color, and further recognizes that
the resulting costs to the health care system of unrecognized
cardiovasular disease in women can be substantially reduced
with appropriate public awareness and prevention efforts. The
Committee includes an increase of $7,500,000 for the WISEWOMAN
program to be expanded to additional States, growing the number
of low-income, uninsured and underinsured women who are
assessed and connected to resources. The Committee also
includes an increase of $6,000,000 for the Million Hearts
initiative to increase education and outreach about the
importance of healthy behaviors, regular heart screenings, and
prevention measures.
High Obesity Rate Counties.--The Committee continues to
support the rural extension and outreach service grants for
rural counties with an obesity prevalence of over 40 percent.
CDC is encouraged to give preference to projects in States
where at least 10 percent of counties meet the requirements of
the program.
Inflammatory Bowel Diseases.--The Committee commends the
ongoing work of CDC to better understand the incidence and
prevalence of Crohn's disease and ulcerative colitis, as well
as disparities in patterns of care and health outcomes for this
patient population through the Incidence, Prevalence, and
Treatment Patterns of IBD in the United States (INPUT) study.
The Committee is concerned about new information from the INPUT
Study indicating that social determinants of health contribute
to disparities in diagnosis and patterns of care and encourages
CDC to continue supporting the INPUT study to better understand
these disparities in children and in adults related to race,
socioeconomic status and other factors, and to identify
potential interventions to reduce disparities in care and
outcomes. The Committee also encourages CDC to develop a
strategic framework for the next iteration of the INPUT study
and to produce a concept plan for an education and awareness
campaign focused on communicating these messages to healthcare
providers, patients, and caregivers.
Interstitial Cystitis.--The Committee requests an update in
the fiscal year 2024 Congressional Budget Justification on
education, outreach, and public awareness activities related to
interstitial cystitis.
Lupus.--The Committee includes an increase of $1,000,000
for activities to advance public health knowledge about lupus,
which will lead to improved care for those living with the
disease.
Multiple Myeloma.--The Committee is concerned about the
burden of multiple myeloma on patients and their caregivers.
The Committee encourages CDC to increase outreach and education
of myeloma among high-risk individuals especially among African
Americans, Hispanics, and other communities of color.
Nutrition, Physical Activity and Obesity.--The Committee
supports CDC's efforts to promote healthy behaviors at every
stage of life by encouraging regular physical activity, good
nutrition, and preventing adult and childhood obesity.
Oral Health.--The Committee includes an increase of
$1,000,000 to expand support to State and territorial health
departments in their efforts to reduce oral disease and improve
oral health through effective interventions.
Prevention Research Centers.--The Committee includes an
increase of $3,000,000 to expand the national network
conducting prevention research and translating research results
into policy and public health practice that address local
health needs.
Prostate Cancer.--The Committee includes an increase of
$1,000,000 to bolster public awareness of prostate cancer
risks, screening, and treatment, and improve surveillance of
this disease. The Committee encourages CDC to increase outreach
and education among high-risk men, especially African-American
men. In addition, the Committee encourages CDC to consider an
interactive simulation decision aid for men at risk of prostate
cancer, and to establish a resource center with educational
materials to assist in decision-making for men, their partners,
and providers.
Racial and Ethnic Approaches to Community Health (REACH).--
The Committee includes a total increase of $10,000,000 to
continue scaling this program to all States and territories,
and to support grantees in building capacity for collaboration
and disseminating evidence-based strategies in communities.
REACH is a vital initiative to help eliminate healthcare
disparities in minority communities. The Committee's
recommended level includes an increase of $4,000,000 for Good
Health and Wellness in Indian Country.
Safe Motherhood and Infant Health.--The Committee includes
a total increase of $60,000,000 for this portfolio of programs
to improve the health of pregnant and postpartum individuals
and their babies, including to reduce disparities in maternal
and infant health outcomes. The total funding allows for the
expansion of Maternal Mortality Review Committees (MMRCs) and
Perinatal Quality Collaboratives (PQCs) to additional States
and territories and for increased support to current States and
territories, as well as increased support for other programs
including Sudden Unexplained Infant Death (SUID). The Committee
supports CDC's efforts to provide technical assistance to
existing State MMRCs to build stronger data systems, improve
data collection to ensure the accuracy and completeness, and
create consistency in data collection. The Committee encourages
CDC to establish data collection guidelines and to provide
technical assistance to State MMRCs regarding the unique
concerns of rural and underserved communities. The Committee
encourages CDC to work with States to include and report data
from birth centers in the Maternity Practices in Infant
Nutrition and Care Survey and the Levels of Care Assessment
Tool. In addition, the Committee encourages CDC to collect and
report PQC data by race and ethnicity to mitigate inequities in
overuse of cesarean sections. The Committee also encourages
PQCs, whenever feasible, to include all care settings
(hospital, birth center, home) and midwives with all nationally
recognized credentials (certified nurse-midwives, certified
professional midwives, certified midwives) for shared learning
and teaching in this quality improvement work. The Committee
also encourages CDC to increase awareness through PQCs of newer
options and technologies for postpartum hemorrhage management.
In addition, the Committee urges CDC to facilitate improved
data collection and analysis, including the expansion of the
SUID and Sudden Death in the Young Case Registry, to improve
SUID prevention strategies. Furthermore, the Committee supports
the CDC's past efforts to promote the engagement of fathers and
partners in addressing maternal mortality and severe morbidity.
The Committee encourages CDC to continue these efforts and to
consider opportunities to build on the PRAMS for Dads pilot
projects by expanding such pilot projects into additional
States.
School Health.--The Committee includes an increase of
$10,000,000 to expand the number of States in the Healthy
Schools program.
Social Determinants of Health.--The Committee includes an
increase of $92,000,000 to award competitive grants to State,
local, territorial, or tribal jurisdictions to support the
development of Social Determinants of Health Accelerator Plans,
the implementation of those plans, and to improve the health of
Medicaid beneficiaries. Such plans should include a description
of the health and social outcome objectives of the Social
Determinants Accelerator Plan; identify target populations that
would benefit from implementation of the plan including
Medicaid-eligible individuals; and identify non-governmental,
private, or public health organizations and community
organizations that would participate in the development of the
plan. Grantees may use a portion of grant funding to convene
government entities, public and private stakeholders, and to
engage qualified research experts in developing Accelerator
Plans.
Tobacco.--The Committee includes an increase of $10,000,000
so that CDC, States and territories can continue efforts to
more robustly respond to the public health threat caused by
youth use of e-cigarettes and other tobacco products, to reduce
tobacco use among disparate populations and in areas and
regions with high tobacco prevalence and mortality, and to
expand the highly successful and cost-effective Tips from
Former Smokers media campaign.
In addition, the Committee encourages CDC, in consultation
with the Food and Drug Administration (FDA), Director of the
Center for Tobacco Products, and any other relevant agency, to
develop an additional question on National Youth Tobacco Survey
to assess youth consumption of premium cigars. For purposes of
this section, the term premium cigar shall be the definition
agreed upon by DOJ, FDA and industry in the case of Cigar
ssociation of America vs. FDA.
Vision and Eye Health.--The Committee includes an increase
of $1,000,000 to initiate efforts to reinstate national-level
surveillance of vision impairment and eye disease.
BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES AND HEALTH
Appropriation, fiscal year 2022....................... $177,060,000
Budget request, fiscal year 2023...................... 195,310,000
Committee Recommendation.............................. 225,060,000
Change from enacted level......................... +48,000,000
Change from budget request........................ +29,750,000
This account supports efforts to conduct research on and
address the causes of birth defects and developmental
disabilities, as well as reduce the complications of blood
disorders and improve the health of people with disabilities.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Birth Defects........................................ $19,000,000
Fetal Death.......................................... 1,900,000
Fetal Alcohol Syndrome............................... 12,000,000
Folic Acid........................................... 3,150,000
Infant Health........................................ 8,650,000
Autism............................................... 33,100,000
Disability & Health.................................. 49,000,000
Tourette Syndrome.................................... 2,500,000
Early Hearing Detection and Intervention............. 10,760,000
Muscular Dystrophy................................... 7,500,000
Attention Deficit Hyperactivity Disorder............. 1,900,000
Fragile X............................................ 2,000,000
Spina Bifida......................................... 7,500,000
Congenital Heart..................................... 8,250,000
Public Health Approach to Blood Disorders............ 10,900,000
Hemophilia Activities................................ 3,500,000
Hemophilia Treatment Centers......................... 5,100,000
Thalassemia.......................................... 2,100,000
Neonatal Abstinence Syndrome......................... 3,250,000
Surveillance for Emerging Threats to Mothers and 33,000,000
Babies..............................................
------------------------------------------------------------------------
Autism.--The Committee includes an increase of $10,000,000
to expand the Autism and Developmental Disabilities Monitoring
(ADDM) Network and to re-establish surveillance of cerebral
palsy at two ADDM sites.
Blood Disorders.--The Committee includes an increase of
$3,500,000 for sickle cell data collection and analysis. The
Committee encourages CDC to provide technical assistance to
additional States with a higher prevalence of sickle cell
disease, so that they can successfully participate in this
grant program to better identify affected individuals in their
states and better meet their needs.
Congenital Heart Defects.--The Committee includes an
increase of $1,000,000 to advance congenital heart disease-
related public health research and surveillance initiatives.
Early Hearing Detection and Intervention.--The Committee is
aware of the significant racial and ethnic disparities in care
facing children with hearing loss, and the effect unaddressed
congenital hearing loss has on communication skills,
psychosocial development, educational progress, and language
development. The Committee encourages CDC to expand their work
to improve surveillance of early hearing detection and
intervention systems to ensure access to timely identification
of congenital and acquired hearing loss and develop materials
to enhance connection to follow up services among racial and
ethnic minorities, and other medically underserved populations.
Fetal Alcohol Spectrum Disorders.--The Committee includes
an increase of $1,000,000 to expand efforts related to fetal
alcohol spectrum disorders.
Fetal Death.--The Committee includes an increase of
$1,000,000 to expand research, surveillance and data collection
activities related to stillbirth and stillbirth risk factors
and to develop, make available, and evaluate evidence-based
awareness and educational activities on stillbirth prevention.
Fragile X and Fragile X-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. To
help this effort, the Committee urges CDC to support additional
strategies to promote earlier identification of children with
FX. The Committee also urges CDC to work to ensure underserved
populations at risk of FX conditions are being properly
diagnosed and are aware of medical services available.
Improving the Health of People with Intellectual
Disabilities.--The Committee includes an increase of
$10,000,000 for the expanded provision of year-round,
grassroots activities in communities to create opportunities
for health screenings and access to quality healthcare, and
health and wellness programming for people with intellectual
disabilities. These efforts enhance the lives of individuals
while eliminating stigmas and stereotypes.
Muscular Dystrophy.--The Committee includes an increase of
$1,000,000 to enhance Muscular Dystrophy research and disease
surveillance initiatives, including the Duchenne Muscular
Dystrophy Care Considerations. The Committee looks forward to
CDC's report describing how the Muscular Dystrophy Program
funding is allocated, including evaluation of the impact of the
Care Considerations as well as differences in care and outcomes
between Certified Duchenne Care Centers and non-certified
centers with the MD-STARnet network. Finally, the Committee
encourages CDC to work with stakeholders to extract and
evaluate the utility of common data elements in electronic
health records to improve care, understand disease outcomes,
and model disease progression.
Spina Bifida.--The Committee requests an update in the
fiscal year 2024 Congressional Budget Justification on efforts
to address the transitional and adult care needs of the
growing, aging spina bifida community.
Surveillance for Emerging Threats to Mothers and Babies
Network (SET-NET).--The Committee includes an increase of
$20,000,000 to increase efforts and expand the reach of SET-NET
to detect and respond to emerging threats to mothers and
babies.
Tourette Syndrome.--The Committee includes an increase of
$500,000 to enhance efforts focused on Tourette Syndrome.
PUBLIC HEALTH SCIENTIFIC SERVICES
Appropriation, fiscal year 2022....................... $651,997,000
Budget request, fiscal year 2023...................... 798,537,000
Committee Recommendation.............................. 867,497,000
Change from enacted level......................... +215,500,000
Change from budget request........................ +68,960,000
This account supports programs that provide leadership and
training for the public health workforce, support
infrastructure to modernize public health surveillance, promote
and facilitate science standards and policies, and improve
access to information on disease outbreaks and other threats.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Health Statistics.................................... $190,397,000
Surveillance, Epidemiology, and Informatics.......... 298,100,000
Advancing Laboratory Science......................... 23,000,000
Public Health Data Modernization..................... 250,000,000
Public Health Workforce.............................. 106,000,000
------------------------------------------------------------------------
Advancing Laboratory Science.--The Committee includes an
increase of $10,000,000 to strengthen CDC's laboratory science
and safety, as CDC scientists and laboratories must be capable
and prepared to meet evolving health threats, and maintain the
highest standards of laboratory quality and safety oversight.
The Committee is concerned about the suspension of parasitic
lab services which clinicians and patients rely upon and urges
prompt resumption of all services.
Familial Hypercholesterolemia.--The Committee includes
$100,000 to support public health efforts focused on this
inherited genetic disorder to improve diagnosis and care
delivery and prevent heart disease.
National Center for Health Statistics (NCHS).--The
Committee includes an increase of $10,000,000 for NCHS, a
component of our nation's public health infrastructure, to
monitor the health of our Nation and to make much-needed
investments in the next generation of surveys and products.
National Neurological Conditions Surveillance System.--The
Committee includes $5,000,000 within Surveillance,
Epidemiology, and Informatics to continue efforts on the two
initial conditions.
Primary Immunodeficiencies.--The Committee includes
$3,500,000, an increase of $500,000, for education, awareness,
and genetic sequencing surveillance related to primary
immunodeficiencies. This program has proven effective in
identifying undiagnosed patients and linking them to centers of
care.
Public Health Data Modernization Initiative.--The Committee
includes an increase of $150,000,000 for the Data Modernization
Initiative (DMI) to build upon current work to create modern,
integrated, and real-time public health surveillance with CDC,
State, territorial, local and tribal partners. The Committee
acknowledges the need for sustained funding for this public
health infrastructure to continue to move from siloed and
brittle public health data systems to connected, resilient,
adaptable, and sustainable systems to achieve real change.
Essential to this significant effort are core data standards
and support to recruit and retain the data science workforce.
This is a massive undertaking by CDC, and it will only be
successful with the commitment to improvement by the entire
agency, and active engagement with partners. The Committee
reiterates that the NCHS is to be fully integrated in the DMI.
Public Health Workforce.--The Committee includes an
increase of $45,000,000 to aid in the rebuilding of the public
health workforce. The Committee recognizes that a robust and
well-trained public health workforce is critical to maintaining
a highly effective public health infrastructure.
ENVIRONMENTAL HEALTH
Appropriation, fiscal year 2022....................... $228,350,000
Budget request, fiscal year 2023...................... 401,850,000
Committee Recommendation.............................. 328,850,000
Change from enacted level......................... +100,500,000
Change from budget request........................ -73,000,000
The Committee recommendation includes $311,850,000 in
discretionary appropriations and $17,000,000 in transfers from
the PPH Fund.
Programs supported within Environmental Health conduct
surveillance and data collection to detect and address emerging
pathogens and environmental toxins that pose significant
challenges to public health, as well as determine whether and
at what level of exposure these substances are harmful to
humans.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Environmental Health Laboratory....................... $71,750,000
Newborn Screening Quality Assurance Program....... 22,000,000
Newborn Screening /Severe Combined 1,250,000
Immunodeficiency Diseases........................
Environmental Health Activities....................... 23,000,000
Safe Water............................................ 8,600,000
Amyotrophic Lateral Sclerosis (ALS) Registry.......... 10,000,000
Climate and Health.................................... 75,000,000
Trevor's Law.......................................... 2,000,000
Environmental and Health Outcome Tracking Network..... 34,000,000
Asthma................................................ 33,500,000
Childhood Lead Poisoning.............................. 66,000,000
Lead Exposure Registry................................ 5,000,000
------------------------------------------------------------------------
Amyotrophic Lateral Sclerosis (ALS) Registry.--The
Committee recognizes that the National ALS Registry is a unique
scientific resource in the fight to understand and prevent ALS.
The Committee urges CDC to continue its investment in research
that will lead to interventions to reduce the incidence of ALS
and encourages CDC to further examine the potential risks of
ALS through State and local environmental reports where there
is an increased prevalence of ALS to further understand the
disease's etiology.
Asthma.--The Committee includes an increase of $3,000,000
for the National Asthma Control Program to increase the number
of States carrying out programmatic activities. In addition,
the Committee recognizes that States receiving funding under
CDC's National Asthma Control Program utilize the EXHALE
strategy to better control asthma and reduce asthma-related
hospitalizations, emergency department visits, and healthcare
costs. The Committee requests a report within one year of the
date of enactment of this Act on the activities that have been
undertaken by each State grantee to address the outdoor
environment component of their asthma control program.
Childhood Lead Poisoning.--The Committee includes an
increase of $25,000,000 to support the expansion of direct CDC
assistance and funding to additional State and local public
health departments. The Committee recognizes that CDC's
expertise and technical assistance can be a valuable asset.
Furthermore, the Committee encourages CDC to require that
States receiving funding for lead prevention report all blood
tests in a standardized format through the Nationally
Notifiable Noninfectious Diseases and Conditions reporting
system.
Climate and Health.--The Committee includes an increase of
$65,000,000 to expand to more States and territories to
identify potential health effects associated with climate
change and implement health adaptation plans. Climate-related
events affect everyone, but not everyone is affected equally.
Newborn Screening.--The Committee includes an increase of
$3,000,000 to further support newborn screening efforts so that
affected newborns can receive early and often life-saving
treatment through the timely implementation for all Recommended
Uniform Screening Panel conditions. 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 supports the Newborn
Screening Quality Assurance Program to support State
laboratories as they implement screening for new disorders. The
increase in funding will enable States to establish testing for
new conditions and improve testing of current conditions; build
technical capacity in States by providing education, training
and technical assistance to address testing challenges and
determine appropriate testing methods for rapid screening; and
ensure test results for new conditions are accurate by
improving test result interpretation and expanding data
analytic capacity.
Vessel Sanitation Program.--The Committee includes
$4,000,000 to support the critical public health functions of
the vessel sanitation program. The Committee requests
additional information in the fiscal year 2024 Congressional
Budget Justification on the program budget, including user fee
and no year funding balances, estimated user fee collections,
and the anticipated workload.
INJURY PREVENTION AND CONTROL
Appropriation, fiscal year 2022....................... $714,879,000
Budget request, fiscal year 2023...................... 1,283,169,000
Committee Recommendation.............................. 897,779,000
Change from enacted level......................... +182,900,000
Change from budget request........................ -385,390,000
Programs supported within Injury Prevention and Control
provide national leadership on violence and injury prevention,
conduct research and surveillance, and promote evidence-based
strategies to inform real-world solutions 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:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Domestic Violence and Sexual Violence................. $37,700,000
Child Maltreatment................................ 7,250,000
Child Sexual Abuse Prevention..................... 3,000,000
Community and Youth Violence Prevention............... 100,000,000
Domestic Violence Community Projects.................. 9,500,000
Rape Prevention....................................... 71,750,000
Suicide Prevention.................................... 22,000,000
Adverse Childhood Experiences......................... 10,000,000
National Violent Death Reporting System............... 34,500,000
Traumatic Brain Injury................................ 11,250,000
Elderly Falls......................................... 4,050,000
Drowning.............................................. 2,000,000
Injury Prevention Activities.......................... 31,950,000
Opioid Overdose Prevention and Surveillance........... 515,579,000
Injury Control Research Centers....................... 12,500,000
Firearm Injury and Mortality Prevention Research...... 35,000,000
------------------------------------------------------------------------
Adverse Childhood Experiences.--The Committee includes an
increase of $3,000,000 to expand efforts including technical
assistance to States to analyze data and burden.
Child Sexual Abuse Prevention.--The Committee includes an
increase of $1,000,000 and recognizes the severe and often
life-long physical, cognitive and emotional impact of child
sexual abuse. CDC's child sexual abuse prevention research
includes opportunities to improve surveillance systems and data
collection, increase the understanding of risk and protective
factors, and develop and disseminate effective prevention
efforts.
Community and Youth Violence Prevention.--The Committee
includes an increase of $84,900,000 for a new evidence-based
community violence intervention, which aims to prevent
intentional violence, such as mass casualty violence or gang
violence. The Committee continues to recognize all forms of
violence as a health crisis that is in desperate need of
increased data collection and funding to support effective
prevention and intervention efforts grounded in public health
approaches. There is increasing evidence of the profound
negative effects of violence and the exposure to violence on
child development, the long-term mental and physical health of
affected populations, and the economic development of
communities, especially communities of color. The Committee
encourages CDC to fund a broad range of interventions,
including programs to provide de-escalation and conflict
mitigation skills.
Core State Injury Prevention Program (Core SIPP).--The
Committee includes an increase of $3,000,000 for Core SIPP to
enhance efforts to identify and respond to injury threats with
data-driven public health actions.
Domestic Violence and Sexual Violence.--The Committee
includes an increase of $2,000,000 for intimate partner
violence. The Committee notes the importance of the collection,
reporting, and sharing of data on domestic violence and sexual
violence across agencies. The Committee looks forward to
receiving the National Domestic Violence Prevention Action Plan
in 2023, as requested in House Report 117-96.
Domestic Violence Community Projects.--The Committee
includes an increase of $4,000,000 to expand the reach of the
Domestic Violence Prevention Enhancement and Leadership Through
Alliances (DELTA) program.
Drowning.--The Committee includes an increase of $1,000,000
to support proven drowning prevention programs with national
organizations working with underserved and diverse youth, to
support State drowning surveillance efforts, and to begin
implementation of a national plan on water safety.
Elderly Falls.--The Committee includes an increase of
$2,000,000, doubling efforts related to fall prevention.
Firearm Injury and Mortality Prevention Research.--The
Committee includes an increase of $22,500,000 for research on
firearm injury and mortality through a public health approach
that focuses on data to understand its causes and to inform
prevention strategies, including emergency room data on
nonfatal gunshot injuries. The Committee continues to be
concerned by the prevalence of firearm-related violence across
the country, especially in our nation's schools, and urges CDC
to conduct policy evaluation research to prevent violence in
our schools. Furthermore, the Committee recognizes that
community gun violence, such as gang violence, constitutes a
significant portion of gun homicides in the U.S. There is a
disproportionate impact of community gun violence on low-income
communities of color, which is not often reflected in the
national narrative surrounding gun violence. The Committee
encourages CDC to support research on community gun violence,
reflecting the diversity of the victims of gun violence.
Furthermore, the Committee urges CDC to investigate the impact
of access to teen and youth services in a community on rates of
community violence.
High School Sports Injuries.--The Committee encourages CDC
to consider the feasibility of collecting and reporting data
related to injuries in high school sports to improve the safety
of student athletes.
Injury Control Research Centers.--The Committee includes an
increase of $3,500,000 to increase the number of awards for
multidisciplinary research on the causes, outcomes, and
prevention of injuries and violence.
National Violent Death Reporting System.--The Committee
includes an increase of $10,000,000 to increase efforts so that
data can inform prevention efforts and save lives, including
collecting data on gender identity and sexual orientation.
Opioid Abuse and Overdose Prevention.--The Committee
includes an increase of $25,000,000 to enhance activities,
including outreach capacity and to help eliminate racial
disparities in overdose deaths and improve access to prevention
and treatment services. In addition, the Committee notes that
CDC is currently conducting efforts focused on chronic pain as
directed in House Report 117-96, and requests an update in the
fiscal year 2024 Congressional Budget Justification on the
status of these efforts. In addition, the Committee requests an
update in the fiscal year 2024 Congressional Budget
Justification on the percentage of funding provided to local
communities for each entity receiving funds under this heading.
Rape Prevention.--The Committee includes an increase of
$15,000,000 to support rape prevention and education programs.
Suicide.--The Committee includes an increase of $2,000,000
to expand surveillance and comprehensive prevention efforts, as
suicide is devastating communities across the U.S. In addition,
the Committee requests report, in consultation with SAMHSA,
within 180 days of the date of enactment of this Act on the
impact of online forums promoting suicide on suicide rates,
including the popularization of a specific method and
disseminating information on its antidote. If the data for
creating such a report is insufficient, CDC is directed to
provide recommendations for how existing databases can be
supplemented or the creation of new ones to capture this
information.
Traumatic Brain Injury.--The Committee provides an increase
of $4,000,000 to initiate concussion surveillance, particularly
among children and youth.
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
Appropriation, fiscal year 2022....................... $351,800,000
Budget request, fiscal year 2023...................... 345,300,000
Committee Recommendation.............................. 363,300,000
Change from enacted level......................... +11,500,000
Change from budget request........................ +18,000,000
The National Institute for Occupational Safety and Health
(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 2023
Budget Activity Committee
------------------------------------------------------------------------
National Occupational Research Agenda................ $121,000,000
Agriculture, Forestry, and Fishing............... 29,500,000
Education and Research Centers....................... 33,000,000
Personal Protective Technology....................... 24,000,000
Mining Research...................................... 62,500,000
National Mesothelioma Registry and Tissue Bank....... 1,200,000
Firefighter Cancer Registry.......................... 5,500,000
Other Occupational Safety and Health Research........ 116,100,000
------------------------------------------------------------------------
Agriculture, Forestry, and Fishing.--The Committee includes
an increase of $2,000,000 to expand efforts to protect workers
in this sector by providing leadership in applied research,
disease and injury surveillance, education and prevention.
Education and Research Centers.--The Committee includes an
increase of $2,000,000 to support efforts to reduce work-
related injuries and illnesses through prevention research,
education, and implementation of programs to improve
occupational health and safety and minimize the dangers faced
by workers across the country.
Firefighter Cancer Registry.--The Committee includes an
increase of $2,500,000, as the registry prepares to recruit and
enroll participants.
Occupational Injury and Illness.--The Committee requests a
report within 180 days of the date of enactment of this Act on
the estimate of the total incidence and economic burden of
fatal and nonfatal occupational injury and illness in the U.S.
The report shall adjust for known underreporting of
occupational injury and illness, estimate the incidence or
prevalence of occupational illnesses from public health data
through attributable risk proportions or other standard
methodologies, and estimate both medical and indirect costs,
such as lost earnings, benefits, and home production. This
report shall also estimate the proportion of the total economic
burden not absorbed by worker's compensation insurance and
shifted onto federal programs such as Medicare, Medicaid, and
Social Security Disability Insurance.
Personal Protective Technologies.--The Committee includes
an increase of $2,000,000 to enhance efforts regarding personal
protective technologies in response to the COVID-19 pandemic
and to protect workers every day.
PFAS Exposure.--The Committee urges CDC to include farming
and agricultural sectors in its PFAS exposure research on
health impacts.
Radiation Exposure in Medical Procedures.--The Committee
notes that many patients, doctors and health care workers are
exposed to excessive radiation during medical procedures. The
Committee requests a report within 90 days of the date of
enactment of this Act on appropriate standards of practice
recommendations for providers to follow to increase the use of
radiation protection technologies such as non-lead/non-vinyl/
PVC shielding and reduce avoidable exposures.
Total Worker Health.--The Committee includes an increase of
$2,000,000 to expand the Total Worker Health program, which
supports and conducts ground-breaking research to advance the
overall safety, health, and well-being of U.S. workers.
World Trade Center Health Program.--The Committee
recognizes that thousands of eligible members of the World
Trade Center Health Program (WTCHP) reside in States outside of
New York today. In consideration of migration trends and with a
greater need to provide clinical services, in particular,
monitoring and treatment of WTCHP certified conditions, and
improve access to research within the regions where eligible
members live, the Committee encourages CDC to assess where
eligible persons are located when planning future Clinical
Centers of Excellence competitions.
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM
Appropriation, fiscal year 2022....................... $55,358,000
Budget request, fiscal year 2023...................... 55,358,000
Committee Recommendation.............................. 55,358,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Energy Employees Occupational Illness Compensation
Program provides compensation to employees and 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
Appropriation, fiscal year 2022....................... $646,843,000
Budget request, fiscal year 2023...................... 747,843,000
Committee Recommendation.............................. 757,843,000
Change from enacted level......................... +111,000,000
Change from budget request........................ +10,000,000
Through its Global Health 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.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Global AIDS Program.................................. $128,921,000
Global Tuberculosis.................................. 14,722,000
Global Immunization Program.......................... 230,000,000
Polio Eradication................................ 180,000,000
Other Global/Measles............................. 50,000,000
Parasitic Diseases and Malaria....................... 31,000,000
Global Public Health Protection...................... 353,200,000
------------------------------------------------------------------------
Global Health Security.--The Committee supports CDC's work
to protect global health security through programs that detect,
prevent, and respond to infectious diseases and other health
threats, including the development of new tools, especially
diagnostics, the application of advanced molecular detection
for the identification and tracking of diseases and disease
variants at home and abroad, and core technical contributions
to developing and validating tools for use by U.S. bilateral
and multilateral global health programs and laboratory efforts
to monitor and combat drug and insecticide resistance,
functions essential to ensuring that global health programs are
responsive, efficient, and tailored for maximum impact. The
Committee urges CDC to ensure that the importance of research
and development to global health security is appropriately
reflected in their international engagements.
Global Public Health Protection.--The Committee includes an
increase of $100,000,000 to support CDC's mission to protect
the health of our nation including by working across the globe.
The Committee supports CDC's global efforts to detect epidemic
threats earlier, respond more effectively, and prevent
avoidable crises.
Parasitic Disease and Malaria.--The Committee provides an
increase of $4,000,000 recognizing the important role CDC plays
in the fight against malaria and parasitic disease and
encourages CDC to continue to research, monitor, and evaluate
efforts for malaria and parasitic disease in collaboration
across the agency and with other agencies.
Polio Eradication.--The Committee includes an increase of
$2,000,000 to advance polio eradication efforts.
Population-based Surveillance Platforms.--The Committee
provides $10,000,000 to support existing longitudinal
population-based infectious disease surveillance platforms that
enable comparative analysis between urban and rural populations
in the developing world.
Soil Transmitted Helminth and Related Diseases of
Poverty.--The Committee includes $1,500,000 to extend the
currently funded CDC projects aimed at surveillance, source
remediation and clinical care to reduce soil transmitted
helminth infection.
Tuberculosis.--The Committee includes an increase of
$5,000,000 to advance tuberculosis prevention, diagnosis, and
treatment efforts.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriation, fiscal year 2022....................... $862,200,000
Budget request, fiscal year 2023...................... 842,200,000
Committee Recommendation.............................. 882,200,000
Change from enacted level......................... +20,000,000
Change from budget request........................ +40,000,000
The Public Health Preparedness and Response (PHPR) account
supports programs that build and strengthen national
preparedness for public health emergencies, both naturally-
occurring and intentional. PHPR supports needs assessments,
response planning, training, epidemiology and surveillance, and
upgrades for laboratory capacity and communications systems.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Public Health Emergency Preparedness Cooperative $735,000,000
Agreement...........................................
Academic Centers for Public Health Preparedness...... 8,200,000
CDC Preparedness and Response........................ 139,000,000
------------------------------------------------------------------------
Public Health Preparedness Cooperative Agreements.--The
Committee includes an increase of $20,000,000 to enhance
investments in State, local, and territorial health departments
to quickly detect, monitor, and respond to health threats.
Public health system investments serve as the backbone for
disaster and outbreak response in every State and the pandemic
has shown that increased funding for preparedness is necessary
for a baseline of consistent protection. The Committee directs
that grant recipients incorporate Limited English Proficient
(LEP) Individuals into their emergency response. Grant
recipients must ensure that they are conducting tailored and
robust outreach efforts to LEP communities. In addition, the
Committee requests the fiscal year 2024 Congressional Budget
Justification include a State distribution table, which should
also include how funding is being allocated to local health
departments and how States are determining these allocations.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2022....................... $30,000,000
Budget request, fiscal year 2023...................... 55,000,000
Committee Recommendation.............................. 55,000,000
Change from enacted level......................... +25,000,000
Change from budget request........................ - - -
This account supports capital projects as well as repairs
and improvements to restore, maintain, and improve CDC's assets
at facilities in seven States and San Juan, Puerto Rico.
The Committee continues language 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.
Maintenance Backlog.--The Committee includes an increase of
$25,000,000 to make significant progress on reducing CDC's
backlog of maintenance and repairs.
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT
Appropriation, fiscal year 2022....................... $493,570,000
Budget request, fiscal year 2023...................... 968,570,000
Committee Recommendation.............................. 1,118,570,000
Change from enacted level......................... +625,000,000
Change from budget request........................ +150,000,000
This account supports public health leadership and support
activities at CDC.
The Committee recommendation includes $958,570,000 in
discretionary funds and $160,000,000 in transfers from the PPH
Fund.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Preventive Health and Health Services Block Grant.... $160,000,000
Public Health Leadership and Support................. 123,570,000
Infectious Disease Rapid Response Reserve Fund....... 35,000,000
Public Health Infrastructure and Capacity............ 750,000,000
Center for Forecasting and Outbreak Analytics........ 50,000,000
------------------------------------------------------------------------
Center for Forecasting and Outbreak Analytics.--The
Committee includes funding for the new Center for Forecasting
and Outbreak Analytics to facilitate the use of data, modeling,
and analytics to improve preparedness and response. The
Committee urges CDC to continue to work with schools of public
health and other academic institutions to engage the nation's
expertise in disease modeling, public health data analysis,
research, and training to build workforce capacity in this
emerging field.
Infectious Disease Rapid Response Reserve Fund.--The
Committee includes an increase of $15,000,000. As utilized
during the initial response to COVID-19, the Reserve Fund will
provide an immediate source of funding to quickly respond to an
imminent infectious disease crisis. Funds are available until
expended.
Local Health Departments.--The Committee notes that Federal
funding intended for both State and local health departments
does not consistently reach local health departments beyond
those directly-funded and recognizes the important role of
local health departments in our nation's governmental public
health partnership to protect the public's health.
Preventive Health and Health Services Block Grant.--The
Committee continues to support the Preventive Health and Health
Services Block grant, of which at least $7,000,000 is to
support direct services to victims of sexual assault and to
prevent rape.
Public Health Infrastructure and Capacity.--The Committee
includes an increase of $550,000,000 to provide consistent and
reliable funding for State, local, territorial, Federal public
health agencies. This disease-agnostic funding can be used to
address cross-cutting needs, including bolstering the public
health workforce, addressing local priorities, ensuring
capacity to meet urgent needs during emergencies, and improving
data collection and sharing processes. The Committee encourages
CDC to provide States with clear guidance on the suballocation
of this funding to local health departments that do not receive
funding directly. The Committee further urges CDC to publicly
track and report on the suballocation of funding through State
health departments to local health departments. The Committee
directs that no less than 70 percent of this funding be awarded
to health departments.
Public Health Leadership and Support.--The Committee
includes an increase of $10,000,000 to support CDC's
foundational public health activities and to facilitate
partnerships.
National Institutes of Health
Appropriation, fiscal year 2022....................... $44,959,000,000
Budget request, fiscal year 2023...................... 45,233,218,000
Committee Recommendation.............................. 47,459,000,000
Change from enacted level......................... +2,500,000,000
Change from budget request........................ +2,225,782,000
The Committee recommendation for the National Institutes of
Health (NIH) program level includes $46,038,300,000 in
discretionary appropriations and $1,420,700,000 in Public
Health Service Act (PHS Act) section 241 evaluation set-aside
transfers.
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 includes funding for initiatives
established in the 21st Century Cures Act (Cures Act),
including a total of $216,000,000 for the Cancer Moonshot
Initiative; $541,000,000 for the All of Us precision medicine
initiative (including $419,000,000 from the Cures Act); and
$620,000,000 for the Brain Research through Application of
Innovative Neurotechnologies (BRAIN) Initiative (including
$450,000,000 from the Cures Act).
The Committee includes specific funding allocations for
several initiatives and activities detailed in the Institute-
and Center-specific sections below.
NATIONAL CANCER INSTITUTE (NCI)
Appropriation, fiscal year 2022....................... $6,912,522,000
Budget request, fiscal year 2023...................... 6,713,851,000
Committee Recommendation.............................. 7,378,579,000
Change from enacted level......................... +466,057,000
Change from budget request........................ +664,728,000
The Committee recommendation includes $7,162,579,000 in
discretionary appropriations and $216,000,000 made available in
the Cures Act.
Mission.--NCI leads, conducts, and supports cancer research
across the Nation to advance scientific knowledge and help all
people live longer, healthier lives.
Brain Cancer.--The Committee recognizes that certain types
of brain cancers are associated with high mortality and
morbidity rates. Brain and other nervous system cancers have a
five-year survival rate of 33 percent. Certain brain tumors
that occur in humans also occur spontaneously and naturally in
dogs. These brain cancers in dogs share many of the same
molecular underpinnings of their human counterparts. There is
great potential for developing treatments for brain cancers
that will benefit dogs and humans and provide an intermediate
step to evaluate human treatments in a more meaningful and
related species. The Committee encourages NIH to continue to
support research that brings together researchers and
clinicians from pediatrics, adult oncology, veterinary
medicine, and biomedical engineering to leverage the linkage
between brain cancers in dogs and humans to evaluate and
develop treatments and safe delivery systems to benefit both
species.
Cancer Immunotherapy and Correlative Research.--
Understanding the complex factors that determine whether a
particular cancer immunotherapy will succeed for a given
patient is a vital area of research. Central to this research
is the analysis of blood, tumor, and other tissues in
conjunction with the outcome of clinical trials (known as
correlative studies), which can help explain why a treatment
worked or not, and why it did or did not produce serious side
effects, as well as providing critical insights to help
optimize subsequent trials. For example, by evaluating
peripheral blood and tumor biopsies obtained from patients
prior to and during treatment, researchers can better
understand the factors that influence successful anti-tumor
immune response and the development of treatment resistance. In
general, correlative studies are most useful when conducted in
a timely manner as an integrated part of clinical trials. The
Committee urges NCI to continue to explore approaches to
support and streamline the incorporation of correlative studies
in immunotherapy trials and commends NCI for the establishment
of the Cancer Immune Monitoring and Analysis Centers (CIMACS)
and the Cancer Immunologic Data Commons (CIDC) as part of the
Cancer Moonshot. This network carries out comprehensive
molecular analysis of clinical trial specimens for biomarkers
and pathways associated with response to immunotherapy and
conducts correlative studies and profiling of tumors and immune
cells for NCI-funded early trials of immunotherapy. The
Committee encourages NCI to continue funding for correlative
studies through existing funded networks.
Cancer Moonshot.--The Committee directs NIH to transfer
$216,000,000 from the NIH Innovation Account to NCI to support
the Cancer Moonshot initiative. These funds were authorized in
the Cures Act.
The Committee also encourages NCI to leverage Cancer
Moonshot efforts to continue supporting research aimed at
addressing health disparities and expanding the scientific
understanding of the genetic and molecular drivers of cancer,
including for diseases with significant differences in outcomes
between White and non-White patients, such as acute myeloid
leukemia (AML). According to research using data from NCI's
Surveillance, Epidemiology, and End Results (SEER) Program,
there is a wide disparity and higher mortality rate among
African American patients compared to White patients with AML.
The Committee encourages NCI to continue intramural and
extramural research efforts to identify the underlying causes
of health disparities associated with AML, including hereditary
blood cancers.
Cancer Survivorship.--As of January 2019, there were an
estimated 16.9 million cancer survivors in the U.S. and the
number of cancer survivors is projected to increase to 22.2
million by 2030. The Committee encourages NCI to continue to
address the unique needs of cancer survivors with resources to
support cancer survivors whether through additional research on
essential elements of survivorship care, leveraging Federal
resources, or improving coordination among providers. An
investment in quality of life after a diagnosis is a critical
component of our Nation's fight against the disease.
Cancer Vaccines.--The Committee recognizes that the success
of the COVID 19 vaccines--which became available less than a
year from the outset of the pandemic and now deliver up to 95
percent protection rates--is because these vaccines were built
on messenger RNA technology, or mRNA, an approach that had been
initiated for cancer research. The Committee understands that
with further research, mRNA cancer vaccines could potentially
be among the most cost-effective methods of preventing
recurrences and the high costs of cancer care. In addition, the
fiscal year 2023 budget request explicitly acknowledged that a
potential area of transformative research within NIH is the
preparation of mRNA vaccines against common forms of cancer.
The Committee encourages NIH to continue to support research
efforts that move the field forward for mRNA vaccines in
cancer. Areas of particular scientific opportunity include
focus on enhancing immune recognition of solid tumors,
overcoming suppression in the tumor microenvironment, and
personalization of mRNA vaccines. Together, these strategies
have high potential for increasing the effectiveness for cancer
immunotherapy treatment and prevention.
Childhood Cancer Data Initiative (CCDI).--The Committee
includes no less than $50,000,000 for the CCDI, the same as the
fiscal year 2022 level. Within this total, the Committee
includes no less than $750,000 to continue to support
enhancement of the CCDI Molecular Characterization Initiative
and other efforts as applicable through continued expansion to
focus on ultra-rare tumor types, such as atypical teratoid
rhabdoid tumor (ATRT), and other ultra-rare pediatric tumor
types with limited therapeutic options. The effort should
include comprehensive clinical and molecular data for each
patient to the extent possible. The dataset should include
clinical, radiographic, histopathologic, and molecular
information to the extent possible and be stored in a manner
that allows for interrogation of patient level data. The data
collected will be used to identify risk factors, aid in
prognostication and treatment recommendations, and assist with
the development of novel therapeutics for these diseases.
Childhood Cancer STAR Act.--The Committee includes no less
than $30,000,000, the same as the fiscal year 2022 enacted
level, for continued implementation of sections of the
Childhood Cancer Survivorship, Treatment, Access, and Research
(STAR) Act to expand existing biorepositories for childhood
cancer patients enrolled in NCI-sponsored clinical trials to
collect and maintain relevant clinical, biological, and
demographic information on children, adolescents, and young
adults, with an emphasis on selected cancer subtypes (and their
recurrences) for which current treatments are least effective,
and to continue to conduct and support childhood and adolescent
survivorship research. This amount also includes the $2,000,000
provided for the CDC's ongoing efforts to enhance cancer
registry case capture efforts for childhood and adolescent
cancers.
Clinical Trials Reporting of Data.--The Committee
recognizes that children have often been historically
underrepresented in clinical trials. However, children with
cancer participate in clinical trials at a high rate, thanks in
large part to NCI support for clinical trials through the
Children's Oncology Group, the Pediatric Early Phase Clinical
Trials Network, the Pediatric Brain Tumor Consortium, and NCI's
Pediatric Oncology Branch at the NIH Clinical Center. The
Committee encourages NCI to continue to make information
available to the public regarding adult trials that allow
enrollment of patients under age 18.
Colorectal Cancer.--The Committee recognizes that
colorectal cancer is the second leading cause of cancer death
for men and women in the U.S. While colorectal cancer incidence
rates in individuals over 50 have largely stabilized or
declined due to significant advancements in preventive
screening, incidence rates for early-onset colorectal cancer
(individuals diagnosed at ages 20 to 49) have been consistently
increasing. Three out of four early-onset colorectal cancer
patients have no family history of the disease and over 60
percent of early-onset colorectal cancer patients are diagnosed
at a late stage. There are several racial/ethnic disparities in
colorectal cancer screening and outcomes. Black individuals
have the highest incidence and mortality and face lower
survival than White individuals. American Indians/Alaskan
Natives also have elevated rates and deaths compared to the
general population and represent the only racial/ethnic group
for whom colorectal cancer mortality rates are not declining.
Racial and ethnic minorities are also more likely than White
individuals to present with late-stage, incurable disease.
Notably, the sharpest increase in metastatic, early-onset
colorectal cancer is among people 20 to 39 years old,
especially Black and Hispanic individuals. Mortality rates
across all ages for late-stage colorectal cancer have remained
stagnant due to minimal progress in treatments for colorectal
cancer patients.
Given these challenges, the Committee urges NCI to
prioritize research on colorectal cancer. The Committee directs
NCI to submit a plan to the Committee within 180 days of
enactment of this Act guided by a multidisciplinary and multi-
agency advisory council to include diverse representatives from
the colorectal cancer community, including colorectal cancer
patients, patient organizations, industry, academic
researchers, and community-based providers, to include all
relevant health care agencies. Specifically, this plan should
identify research priorities, gaps, and opportunities, and
include detailed sections focused on the following non-
exhaustive list of topics: the lack of progress in the
development of effective therapeutics for colorectal cancer,
the rising rates of colorectal cancer in people under the age
of 50, with a special focus on the rapidly increasing rates of
early onset colorectal cancer in the 20 to 39 year old age
range; and the persistent health disparities in colorectal
cancer prevalence, screening, and outcomes. The plan should
describe how NCI plans to play a role in addressing these
challenges and what existing and future innovative grant
mechanisms can be leveraged to advance progress.
Deadliest Cancers.--The Recalcitrant Cancer Research Act
(RCRA) of 2012 focuses on cancers with a five-year survival
rate below 50 percent, which account for 44 percent of all U.S.
cancer deaths. In House Report 117-96, the Committee directed
NCI to develop a scientific framework using the process
outlined in the RCRA for gastric and esophageal cancers. The
Committee also notes that NCI has taken an important step by
receiving approval for a Program in Origins of Gastroesophageal
Cancers from the National Cancer Advisory Board and Board of
Scientific Advisors. Given the toll all recalcitrant cancers
exact on society and the lack of diagnostic and treatment
resources currently available to help patients, the Committee
encourages NCI to continue to invest in the most promising
research opportunities to advance progress against each of the
deadliest cancers (gastric, esophageal, and GE junction; liver,
including cholangiocarcinoma; lung, including mesothelioma;
ovary; pancreas; and brain, including adult and pediatric brain
tumors), and to provide an update on research focused on each
of these areas in the fiscal year 2024 Congressional
Justification.
Endometrial Cancer.--The Committee remains concerned about
the significant racial and ethnic disparities in mortality
rates for endometrial cancer that adversely impact Black women.
The age-adjusted mortality rate for Black women with
endometrial cancer is nearly twice the rate of White women,
which is partly attributed to cancer stage at diagnosis. The
Committee commends NCI's efforts to address these disparities
through projects like the Discovery and Evaluation of Testing
for Endometrial Cancer in Tampons (DETECT) Study, and
encourages NCI to continue supporting research activities that
will lead to the development of targeted interventions to
improve early diagnosis among Black women with endometrial
cancer. The Committee also encourages NCI to research
innovative community-based outreach methods to improve access
to high-quality care, with the goal of increasing enrollment
and participation by Black women in clinical trials. The
Committee requests an update on NCI's activities regarding
endometrial cancer in the fiscal year 2024 Congressional
Justification, including progress made in endometrial cancer
early diagnosis, survival rates, and clinical trial enrollment
by race and ethnicity.
Environmental Exposures and Cancer in Firefighters.--The
Committee is aware that firefighters have increased rates of
cancer diagnoses and death relative to the general population.
Firefighters are exposed to a complex mix of known and possible
cancer-causing chemicals through breathing hazardous substances
and absorbing them through their skin. Despite an understanding
of the risks associated with firefighter environmental
exposures, there has been no large-scale, systematic
examination of the mechanisms by which the environmental
exposures experienced by these frontline responders can cause
cancer. The Committee recognizes the work NIH and CDC/NIOSH
have performed to better understand the cancer risks
firefighters may experience and encourages these agencies to
continue conducting this research, including efforts measuring
environmental exposures in firefighters and determining the
mechanisms by which these exposures lead to increased cancer
incidence, morbidity, and mortality. The Committee also
encourages NIH to continue to support research to improve
health equity among firefighters, including through inclusion
of participants across race, ethnicity, gender, and workplace
environment groups to evaluate potential differences in
exposures and risk.
Glioblastoma (GBM).--Glioblastoma is a cancer with less
than a five percent five-year relative survival rate, and the
average survival time from diagnosis has improved by only six
months over the last 30 years. To date, there have only been
five drugs and one medical device approved by the FDA for the
treatment of GBM. With prior Congressional investment in NCI
programs, glioblastomas have been molecularly characterized,
resulting in a new and promising understanding of these tumors,
including the identification of potential clinical strategies
and agents, trial designs, and imaging and pathology
technologies.
The Committee commends NCI for its establishment and
initial implementation of the GBM Therapeutics Network (GTN).
The GTN's cross-cutting teams' capabilities to conduct pre-
clinical studies and early-phase clinical trials enables the
careful evaluation of potential treatments, including small
molecule drugs, immunotherapies, radiation, and devices. The
overall goal of the GTN is advancing progress towards future
cures and improved quality of life for GBM patients.
Given this initial progress, the Committee urges NCI to
continue to enhance and accelerate its implementation of the
GTN and continue to fund to the full extent necessary so that
this program can rapidly launch clinical trials that speed
access to promising qualified treatments to patients consistent
with NCI's Glioblastoma Working Group recommendations in 2019.
Gynecologic Cancers.--The Committee continues to be
concerned about the growing racial, socioeconomic, and
geographic disparities in gynecologic cancers. In contrast to
most other common cancers in the U.S., relative survival for
women with newly diagnosed advanced cervical or endometrial
cancer has not significantly improved since the 1970s.
Furthermore, historical data demonstrates that Black and Latina
women with gynecologic cancers are not as likely to receive
standard therapy and/or die more frequently. The current COVID-
19 pandemic has only exacerbated the health care disparities
that were already present in minority and underrepresented
communities. For example, in early 2021, CDC published findings
that cervical cancer screenings among women aged 21-29 in
California decreased by as much as 78 percent during the
pandemic. This is concerning because cervical cancer incidence
and mortality rates are disproportionately higher in Hispanic
women and non-Hispanic Black women.
The Committee urges NCI to expand the number of clinical
trials, research grants, and contract opportunities for
investigators that focus on discoveries that will positively
impact access to prevention, early detection, diagnosis, and
treatment for gynecologic cancers and address these now well-
documented disparities. The Committee requests an update on
NCI's research program for gynecologic cancers in the fiscal
year 2024 Congressional Justification, including specific
grants and strategies where the intent is to overcome these
racial disparities in gynecologic cancers outcomes and
opportunities to increase participation of minority women in
gynecologic cancer clinical trials.
Health Disparities Research.--The Committee commends NCI
for supporting research related to cancer health disparities,
including studies on the molecular basis for disparities that
could lead to improved screening and treatment strategies, as
well as best practices for increasing participation of
underrepresented populations in NCI-supported clinical trials.
The Committee includes an increase of $10,000,000 for NCI to
support research related to identifying and reducing health
disparities as described in the fiscal year 2023 budget
request.
HPV Associated Cancers.--The Committee encourages NCI to
expand research related to human papillomavirus (HPV) and HPV-
associated cancers.
Improve Native American Cancer Outcomes.--The Committee
continues to be concerned that Native Americans experience
overall cancer incidence and mortality rates that are
strikingly higher than non-Native populations and encourages
NCI to expand research efforts to reduce American Indian cancer
disparities and improve outcomes. The Committee notes NCI's
successful efforts through the Cancer Moonshot's Accelerating
Colorectal Cancer Screening and Follow-Up through
Implementation Science (ACCSIS) program, and parallel efforts
by NCI Designated Cancer Centers collaborating with American
Indian communities, that are improving colorectal cancer
screening, follow-up, and referral for care among populations
that have low colorectal cancer screening rates. The Committee
encourages NCI to continue efforts such as the ACCSIS
initiative to develop durable capacity for tribally-engaged
cancer disparities research through an integrated program of
research, education, outreach, and clinical access.
Liver Cancer.--The Committee notes that liver cancer is the
second most common cause of cancer worldwide, with cases in the
U.S. increasing over 250 percent since 2000. The incidence of
liver cancer is three times higher in men than women, and the
burden is higher in African Americans, Hispanics, and Asians.
The incidence of liver cancer geographically parallels the
prevalence of viral hepatitis, with hepatis B estimated to
cause up to 60 percent of the cases of liver cancer. For these
reasons, the Committee applauds NCI for its collaboration in
the effort to update the Strategic Plan for Trans-NIH Research
to Cure Hepatitis B. The Committee also is supportive of the
NCI intramural Liver Cancer Program, the Hepatobiliary and
Hepatocellular Carcinoma (HCC) SPOREs, the new Diversity SPORE,
the Translational Liver Cancer Network, the Hepatocellular
Carcinoma Epidemiology Consortium, the large Genome-Wide
Association Study (GWAS) of liver cancer and the need to expand
the GWAS study to include a focus on Hispanic and African
Descent populations. The Committee also urges NCI to continue
its support of the Translational Liver Cancer Consortium, which
supports research focused on early detection, and to support
research to explore the usefulness of current and new
interventions in reducing HBV associated HCC and whether early
treatment with direct action antivirals or other strategies can
reduce cancer risk.
Lung Cancer.--The recent decline in cancer mortality fueled
by progress in lung cancer is directly attributable to NIH-
funded research to inform development of new effective
therapeutics and to continue progress in tobacco prevention and
cessation. Ongoing understanding of the molecular underpinnings
of lung cancer and identification of additional oncogene driver
subsets has led to rapid development of new targeted therapies,
which, together with efforts to broaden uptake of comprehensive
biomarker testing, has the potential to deliver the promise of
precision medicine to more patients than ever before. The
Committee encourages NIH and its Office of Disease Prevention
to continue to fund important research across each of these
areas to broaden the base of lung cancer survivors across
different disease types, including small cell lung cancer.
Lung Cancer Disparities.--The Committee is concerned that
lung cancer disproportionally impacts communities of color. The
Committee commends NCI for its role in supporting research that
established low-dose computed tomography as an effective lung
cancer screening approach and for the Institute's continued
research in this area, which has directly informed updates to
the United States Preventive Services Task Force (USPSTF) lung
cancer screening guidelines. In 2021, USPSTF expanded the
recommended age range for screening to 50 to 80 years
(previously 55 to 80 years) and reduced the pack-year history
to 20 pack-years of smoking (previously 30 pack-years). By
expanding who is eligible for screening, the changes to this
recommendation are particularly relevant to Black people and to
women. Data shows that both groups tend to smoke fewer
cigarettes than White men. Data also shows that Black people
have a higher risk of lung cancer than White people. These
changes will mean that many more Black people and women who
smoke will be eligible for this potentially life-saving
screening. Unfortunately, lung cancer screening is currently
underutilized. Therefore, the Committee encourages NCI to
continue to support research focused on approaches to encourage
broader uptake of lung cancer screening among the USPSTF
recommended populations, including evaluating strategies with a
focus on increasing screening uptake among communities with
lung cancer death rates higher than the national average, with
a goal of reducing lung cancer mortality disparities among
people of color and women.
Melanoma.--As UV radiation is established as the primary
carcinogen for melanoma, the Committee urges NCI to continue to
support research directed at genomic and mechanistic
characteristics of mutagenesis; optimization of prevention
strategies; and early detection and risk declassification
strategies that leverage artificial intelligence, access to
large databases, noninvasive technologies, and molecular
markers that will support precision medicine.
Although SEER data show a decline in mortality with the
advent of new categories of treatment, some patients do not
respond to initial treatment, and many of the responders have
disease that will recur. The Committee encourages NCI to expand
research on mechanisms of primary and secondary drug resistance
and validation of predictive biomarkers that allow selection of
optimal therapy and prediction of comprehensive longitudinal
monitoring. Basic and translational goals should be facilitated
through development and use of ever-improving models of human
melanoma.
Building on the success of adjuvant therapies, and the
promising results of neoadjuvant therapies, the Committee
encourages NCI to continue support of research addressing tumor
cell dormancy and metastases. The Committee encourages NCI to
explore opportunities for multicenter trials that will
determine whether shorter courses of therapy will decrease
toxicity while maintaining benefit, refine adjuvant therapies,
and continue to develop neoadjuvant therapies.
The Committee also encourages NCI to continue to support
research on novel targets, especially for rare subtypes. The
Committee requests an update on these requests and the status
of NCI-funded melanoma research in the fiscal year 2024
Congressional Justification.
Metastatic Cancer Research.--While the early detection and
treatment of early-stage disease for many cancers results in
cures, for most tumors, metastatic cancer remains incurable.
More than 90 percent of cancer deaths are due to metastatic
disease. In addition to genetic alterations in the cancer
itself, recent research has revealed that there is a genetic
basis for susceptibility to metastatic cancer or resistance to
metastasis. More research is required to develop a
comprehensive understanding of this complex process involving
tumor and host interactions. Clinical trials are an important
aspect of that progress, and diverse representation of patients
in clinical trials is integral to the development of
medications and therapies that effectively treat metastatic
disease. Ethnicity, gender, age, and genetics all play a role
in the safety and efficacy of a treatment for an individual.
The Committee commends NIH and the Department of Defense (DoD)
for work already underway to support research needs and
opportunities identified in the April 2018 Task Force Report to
Congress on Metastatic Cancer. The Committee encourages NIH to
maintain collaborative efforts with DoD and the Department of
Veterans' Affairs (VA) to provide subject matter expertise, as
appropriate, as DoD provides updates and continues to implement
recommendations from the report aimed at achieving
representation of the demographic of the U.S. population in
clinical trials.
NCI Paylines.--Grant applications to NCI have increased by
approximately 50 percent since 2013, outpacing available
funding, with requests for cancer research ten-fold greater
than other Institutes and Centers. With such a high demand for
NCI grants, only a fraction of highly meritorious research
proposals can be funded. To support more awards and improve
success rates, the Committee provides an increase of
$200,000,000 for NCI to prioritize competing grants and to
sustain commitments to continuing grants.
Pediatric Cancer Research.--NCI has supported research to
advance significant achievements in childhood cancer diagnosis,
prevention, treatment, and quality of life improvements.
Children that are diagnosed with cancer deserve a fighting
chance and effective and less toxic therapies. Childhood
cancers are rare, and they need specialized treatments, not
just lower dose treatments that adults receive. The Committee
urges NCI to continue this important work to examine novel
systems to better understand rare cancers, and to support and
accelerate the development of life-saving therapeutics for
pediatric patients who often have no other options.
Prostate Cancer.--The Committee remains concerned that
prostate cancer lacks treatments for men with advanced disease
as well as adequate diagnostic and imaging methodologies. To
ensure Federal resources are leveraged to the greatest extent
possible, the Committee encourages NCI to coordinate, when
appropriate, its research efforts with other Federal agencies,
including DoD, as well as private research foundations and
advocacy groups.
Radiopharmaceutical Development.--Recognizing the promise
of radiotherapy treatments and other diagnostic uses, NCI has
organized a Radiopharmaceutical Development Initiative (RDI),
which is a specialized infrastructure for the clinical
evaluation of novel theranostic radiopharmaceutical cancer
therapies and which complements academic and industry
development of these agents with early phase combination
studies to test tolerability and early signs of efficacy. While
clinical trials for radiopharmaceuticals are presently ongoing,
domestic production of such drugs relies on a very small number
of reactors, and the future loss of such reactors would not
only deal a significant blow to domestic patients due to the
short half-life of many of these drugs, but would also limit
NCI's ability to continue to support and conduct this important
research. The Committee is aware of alternative technologies to
produce radionuclides by accelerators, such as the one located
at Brookhaven National Laboratory; however, some radionuclides
can be produced only in nuclear reactors. Therefore, the
Committee requests NIH, in conjunction with the Department of
Energy, to provide an update in the fiscal year 2024
Congressional Justification regarding the impact shortages of
medical isotopes and radiopharmaceuticals have on the ability
to conduct cancer research.
Rare Blood Cancers and Germline Mutations.--The Committee
commends NCI for collaborating with NHGRI in running natural
history studies of patients with germline mutations and their
families, which frequently lead to blood cancers including
acute myeloid leukemia (AML). More research on how genetic
dispositions, such as RUNX1 familial platelet disorder (RUNX1-
FPD), lead to rare blood cancers will ultimately support the
discovery of treatments that could prevent malignancy through
advances in early detection and early treatment for all blood
cancers. Interest in this field has grown significantly in
recent years, and the Committee strongly urges NCI to initiate
new and expanded funding opportunities related to germline
predispositions to rare blood cancers. The Committee is pleased
to hear that NCI will soon be launching a precision medicine
clinical trial for AML and myelodysplastic syndromes and
requests an update in the fiscal year 2024 Congressional
Justification.
Rare Cancer Equity.--Nearly half a million Americans are
diagnosed with a rare form of cancer every year. Rare cancers
could account for hundreds, if not thousands, of distinct forms
of cancer. The Committee encourages NCI to continue research to
better understand the molecular drivers of all cancers,
including through molecular characterization and molecular
diagnostics for patients. The Committee also encourages NCI to
continue to support research on cancer subtypes, which could
benefit rare cancers.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)
Appropriation, fiscal year 2022....................... $3,808,494,000
Budget request, fiscal year 2023...................... 3,822,961,000
Committee Recommendation.............................. 3,943,702,000
Change from enacted level......................... +135,208,000
Change from budget request........................ +120,741,000
Mission.--NHLBI provides global leadership for a research,
training, and education program to promote the prevention and
treatment of heart, lung, and blood disorders and enhance the
health of all individuals so that they can live longer and more
fulfilling lives.
Blood Donor Questionnaire Educational Materials.--The
Committee is concerned that certain FDA guidance in the
educational materials provided in the blood donor questionnaire
are inappropriate and misguided. The recommendations for
deferral should not hinge on a person's sexual orientation, and
rather should focus on risk factors that might expose a
potential donor to blood-borne illness. The Committee strongly
recommends that NHLBI evaluate the need for additional research
studies to inform the FDA on removing or replacing the
recommended deferment of blood for men who have had sex with
men in the last three months.
Community Engagement Alliance (CEAL) Against COVID-19
Disparities Initiative.--The Committee continues to support the
CEAL initiative, which connects researchers with community
organizations and leaders to conduct outreach and increase
participation of people from underrepresented communities in
clinical trials for COVID-19 treatments, vaccines, and ongoing
COVID-19 related research needs.
COVID-19-Associated Illnesses.--The Committee recognizes
the growing burden of COVID-associated critical illnesses,
including sepsis and pneumonia. The Committee encourages NIH to
accelerate research into sepsis, pneumonia, and acute lung
injury.
Duchenne and Becker Muscular Dystrophy.--Now that life
expectancy for Duchenne patients has increased, there is a need
for more research related to clinical care and long-term
cardiac impacts. Furthermore, there is a paucity of data on
Becker patients to understand cardiac implications long term.
The Committee urges NHLBI to work with NINDS to explore
research collaborations to follow patients throughout the
lifespan to fully clinically characterize cardiac muscle
function and better establish the relationship between cardiac
muscle function and the impact of its progressive deterioration
on both lifespan and quality of life.
Developing gene therapies to treat Duchenne muscular
dystrophy is a complex and multifaceted process. The Committee
encourages NIH to support research aimed at gene therapy safety
utilizing viral vectors and support the development of less
immunogenetic non-viral delivery systems. The Committee also
supports further NIH investment in the development of more
sensitive outcome measures and biomarkers for both Duchenne and
Becker.
Harmful Algal Blooms.--The Committee strongly encourages
NHLBI to support research to address the human health concerns
of cyanotoxin exposure from harmful algal blooms and emergent
chemicals of concern, and particularly the need for research
directed on health issues relating to aerosolized exposure to
water contaminated with HABS and ECC toxins. This research
could take advantage of unique laboratory facilities at the
Nation's national laboratories and prioritize new preventative,
diagnostic, and therapeutic strategies to combat the harmful
health effects of airborne HAB and ECC toxin exposure,
especially in vulnerable, at-risk populations.
Health Disparities Research.--The COVID-19 pandemic has
highlighted and exacerbated health disparities in the U.S. The
Committee includes an increase of $15,000,000 for leveraging
lessons learned by NHLBI to support research related to
identifying and reducing health disparities.
Kleine-Levin Syndrome (KLS).--The Committee commends NIH
for its December 2021 publication of the Sleep Research Plan.
The Committee recommends the inclusion of KLS, a complex
neurological disorder characterized by long, recurring episodes
of excessive sleep and derealization, as a sleep disorder
requiring attention and study in the next publication of the
Sleep Research Plan. The cause of KLS is still unknown, and
there are no known treatments. Because KLS shares symptoms with
other sleep disorders and mental health conditions, the
Committee encourages NIH to expand its support for research
about KLS, which could provide the KLS community and many
others with critical information and answers.
Long-Term Impact of COVID-19.--The Committee notes with
concern that an estimated ten percent of individuals who have
recovered from COVID-19 are experiencing longer term health
consequences, including residual lung damage. More studies are
needed to understand if such changes resolve or are permanent.
The Committee urges NHLBI to prioritize research into the
understanding, treatment, and prevention of post-COVID
respiratory conditions, particularly among minority populations
disproportionately impacted by COVID-19.
Lung Health Research.--The Committee recognizes that, over
the past year, lung failure was the number one cause of death
in the U.S. More than one million Americans have died as a
direct result from a respiratory pandemic. Even prior to
emergence of SARS CoV-2, deaths from chronic obstructive
pulmonary disease were already the third leading cause of death
in the world, and pneumonia was the leading cause of death
worldwide among children under the age of five. The risks to
lung health are only increasing as global air quality
deteriorates from dust and particle pollution among other
factors. All of these exposures drive lung inflammation and
ultimately made COVID-19 more devastating as well. Furthermore,
the Nation's capability to address acute lung injury or acute
respiratory distress syndrome (ARDS) has been demonstrated to
be deeply inadequate.
The Committee supports the activities of NHLBI's lung
health research program, which supports mechanisms of lung
injury and repair as well as clinical intervention trials
addressing both acute and chronic lung diseases. These
investments will help to identify the biological pathways of
lung injury to find ways to help the lung recover from injury.
Mitral Valve Prolapse (MVP) Research.--The Committee
encourages NHLBI to advance technological imaging and precision
medicine to generate data on individuals with valvular disease,
identify individuals who are at high risk of sudden cardiac
death as a result of valvular heart disease, develop prediction
models for high-risk patients, and enable interventions and
treatment plans to keep these patients healthy throughout their
lives.
National Chronic Obstructive Pulmonary Disease (COPD)
Action Plan.--The Committee notes NHLBI's role in crafting the
National COPD Action Plan and encourages NHLBI to continue this
important work by supporting additional research activities and
collaborating with other PHS agencies to facilitate
implementation of the plan's recommendations.
National Commission on Lymphatic Diseases.--The Committee
requests an update on the establishment of a National
Commission on Lymphatic Diseases and strongly encourages the
Director to engage with relevant Institutes, Centers, and
external stakeholders to demonstrate key progress within 90
days of the enactment of this Act.
NIH Sleep Research Plan.--The Committee commends the
National Center on Sleep Disorders Research (NCSDR) for the
release of the NIH Sleep Research Plan and supports the full
implementation of the Plan. The Committee specifically
encourages strong consideration of the Plan's proposal for
multi-center studies and clinical trials.
Pulmonary Fibrosis (PF).--Many PF patients wait more than a
year for diagnosis after symptom onset, and patients with some
types of PF have a life expectancy of only 3-5 years. The
Committee urges NHLBI to support research into biomarkers that
can aid in earlier, safer diagnosis of pulmonary fibrosis, as
well as tools that can help predict which patients will
experience disease progression. The Committee also encourages
NHLBI to support the development of novel outcome measures for
clinical trials in pulmonary fibrosis, such as imaging, and to
continue to fund research involving early phase clinical
assessment of novel drugs and personalized approaches to
therapies. The Committee requests an update on PF research in
the fiscal year 2024 Congressional Justification.
Pulmonary Hypertension.--The Committee continues to note
the relationship between the long-term effects of COVID-19 and
pulmonary hypertension. The Committee encourages NHLBI to
increase their collaboration with key stakeholders in advancing
critical research priorities.
Sickle Cell Disease.--Sickle cell disease (SCD) is the most
common inherited blood disorder in the U.S. The Committee
commends NIH, including NHLBI, for past research efforts aimed
at developing more effective treatments and cures, but believes
more can be done. As such, the Committee encourages NIH to
renew its focus and continue to prioritize efforts by
supporting extramural grants for research projects that will
support the development of a treatment approach for SCD,
research into potential cures, and provide better outreach and
education for health care providers. The Committee encourages
NIH to consider programs both domestically and globally to
evaluate the effectiveness of screening technologies for
infants and children with the sickle cell trait and disease and
to develop different innovative technologies and medicines to
treat and cure SCD. The Committee also encourages NHLBI to
increase its focus on disease modifying therapies that could
improve day-to-day care for the vast majority of patients and
address issues such as organ damage and pain management.
Lastly, the Committee encourages NHLBI to fund the training of
more sickle cell disease clinicians and researchers to maintain
this essential workforce pipeline and to make advances on the
transition from childhood medical care to adult.
Support for The Heart Truth Program.--For over a decade,
``The Heart Truth'' program has worked to raise awareness about
women's risk of heart disease. The program's goals are to
increase awareness that heart disease is the leading cause of
death among women and to increase the conversations between
women and their health care providers. Accordingly, the
Committee encourages NHLBI to robustly fund ``The Heart Truth''
program.
Thalassemia.--Donated blood has a relatively short shelf
life and is generally stored for only 42 days. However, stored
blood begins to degrade before the end of that 42-day period,
with possible stiffening of cell membranes as early as after 21
days. For patients in need of emergency blood transfusions,
that degradation may not be significant; however, studies are
needed to determine the impact of older red blood cells on
patients who require chronic transfusion, such as those with
thalassemia, especially in terms of iron loading in the heart
and internal organs. The Committee urges NHLBI to establish
research initiatives focused on this issue.
Valvular Heart Disease Research.--Many people in the U.S.
have heart valve defects or disease but do not have symptoms.
For some, the condition remains the same throughout their lives
and does not cause significant or life-threatening problems.
Unfortunately, over 25,000 people die each year in the U.S.
from heart valve disease, primarily due to underdiagnosis and
undertreatment of the condition. The Committee strongly
supports more research into valvular heart disease. Such
research should focus on advances in technological imaging and
precision medicine to generate data on individuals with
valvular heart disease, identify individuals who are at high
risk of sudden cardiac death, and develop prediction models for
high-risk patients, enabling interventions and treatment plans
to help keep these patients healthy throughout their lives. The
Committee thanks NHLBI for hosting a workshop on this issue.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH (NIDCR)
Appropriation, fiscal year 2022....................... $501,231,000
Budget request, fiscal year 2023...................... 513,191,000
Committee Recommendation.............................. 526,051,000
Change from enacted level......................... +24,820,000
Change from budget request........................ +12,860,000
Mission.--The mission of NIDCR is to advance fundamental
knowledge about dental, oral, and craniofacial (DOC) health and
disease and translate these findings into prevention, early
detection, and treatment strategies that improve overall health
for all individuals and communities across the lifespan.
Pain Management Research.--The Committee commends NIDCR for
supporting research related to pain and pain management,
including studies to develop safer, non-opioid pain medications
and interventions. The Committee includes an increase of
$9,000,000 for NIDCR to support additional research in this
area as described in the fiscal year 2023 budget request.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
(NIDDK)
Appropriation, fiscal year 2022....................... $2,203,926,000
Budget request, fiscal year 2023...................... 2,206,080,000
Committee Recommendation.............................. 2,283,489,000
Change from enacted level......................... +79,563,000
Change from budget request........................ +77,409,000
Mission.--The NIDDK mission is to conduct and support
medical research and research training and disseminate science-
based information on diabetes and other endocrine and metabolic
diseases; digestive diseases, nutritional disorders, and
obesity; and kidney, urologic, and hematologic diseases, to
improve people's health and quality of life.
Chronic Kidney Disease (CKD).--The Committee urges NIDDK to
continue support for kidney research. The Committee applauds
recent changes to clinical practice in the diagnosis of kidney
disease and concurs with recommendations for new markers for
estimating kidney function. NIDDK is encouraged to prioritize
research into endogenous filtration markers, activities that
spur the adoption of new equations for estimating GFR that do
not include race as a modifier, and interventions to eliminate
racial and ethnic disparities. Finally, the Committee
encourages NIDDK to continue investment in research that
bridges existing deficits in CKD management and treatments to
reduce incidence and progression, increases the number of CKD
clinical trials and diversity of participants, improves the
delivery of evidenced-base care in underrepresented
populations, and improves patients' quality of life. The
Committee requests an update on these priorities in the fiscal
year 2024 Congressional Justification.
Dietary Supplements.--The Committee supports efforts by
NIDDK to monitor drug-induced liver injury. Recently, more than
20 percent of cases are reported to be caused by dietary
supplements. These products need to be analyzed for their label
claims; it is essential to identify the component that may
cause liver injury. It has been reported that more than 70
percent of products analyzed do not meet label claims, and many
of them are laced with steroids and pharmaceuticals. The
Committee continues to support NIDDK research into dietary
supplements.
Inflammatory Bowel Disease.--The CDC estimates that in
2015, three million Americans were living with IBD, and the
Global Burden of Disease Study 2017 reported that IBD
prevalence in the U.S. increased by nearly 24 percent between
1990 and 2017. Many patients may be undiagnosed until the
disease has become severe, and despite the therapeutic options
on the market, some patients remain without an effective
treatment. The Committee continues to support NIH in funding
basic, translational, and clinical studies on the diagnosis and
treatment of IBD.
Interstitial Cystitis.--The Committee notes the progress of
interstitial cystitis research through the Multidisciplinary
Approach to the Study of Chronic Pelvic Pain program and
encourages NIDDK and stakeholders to continue collaboration on
a scientific workshop to examine mechanisms for scientific
opportunity. The Committee requests an update on the progress
of the conference in the fiscal year 2024 Congressional
Justification.
Pain Management Research.--The Committee commends NIDDK for
supporting research related to pain and pain management,
including studies to develop interventions to reduce opioid use
in people on hemodialysis. The Committee includes an increase
of $10,000,000 for NIDDK to support additional research in this
area as described in the fiscal year 2023 budget request.
Polycystic Kidney Disease (PKD).--The Committee commends
NIDDK for its continued commitment to PKD Research and
Translation Centers and the Pediatric Centers of Excellence in
Nephrology, which improve our understanding of the causes of
autosomal dominant PKD and autosomal recessive PKD. The
Committee continues to encourage NIDDK to fund innovative,
high-impact PKD research and promote the development of new
therapeutic strategies.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (NINDS)
Appropriation, fiscal year 2022....................... $2,611,370,000
Budget request, fiscal year 2023...................... 2,768,043,000
Committee Recommendation.............................. 2,833,590,000
Change from enacted level......................... +222,220,000
Change from budget request........................ +65,547,000
The Committee recommendation includes $2,608,590,000 in
discretionary appropriations and $225,000,000 made available in
the Cures Act.
Mission.--The NINDS mission is to seek fundamental
knowledge about the brain and nervous system and use that
knowledge to reduce the burden of neurological disease.
Amyotrophic Lateral Sclerosis (ALS).--The Committee
recognizes the devastating toll that ALS takes on those
affected by the disease and their loved ones. ALS causes
progressive and cumulative physical disabilities in patients,
and leads to death due to respiratory muscle failure. The
Committee strongly urges NINDS to expand support for research
on ALS, including but not limited to its causes, diagnosis, and
treatment. The Committee directs NIH to provide an update on
NIH-supported research related to ALS in the fiscal year 2024
Congressional Justification.
Brain Aneurysm Research.--The Committee remains 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 or no warning.
Ruptured brain aneurysms are fatal in about 50 percent of
cases. The Committee continues to be concerned about the lack
of research focused on prevention and early detection of brain
aneurysms and encourages NIH to expand its support for research
in this area.
BRAIN Initiative.--The Committee directs NIH to transfer
$225,000,000 from the NIH Innovation Account to NINDS to
support the BRAIN Initiative. These funds were authorized in
the Cures Act. This collaborative effort is revolutionizing the
understanding of how neural components and their dynamic
interactions result in complex behaviors, cognition, and
disease, while accelerating the development of transformative
tools to explore the brain in unprecedented ways, making
information previously beyond reach accessible.
Cerebral Palsy.--The Committee encourages NIH to continue
to prioritize and invest in research on cerebral palsy (CP)
including the establishment of a cerebral palsy Notice of
Special Interest (NOSI) to significantly strengthen and
accelerate progress toward CP research priorities across the
lifespan. Cerebral palsy research should focus on basic and
translational discoveries, as well as implementation,
observational, and clinical studies aimed at early detection
and intervention, comparative effectiveness, and functional
outcomes. While some progress has been made in the
understanding of CP, the most common lifelong physical
disability, large gaps remain that must be addressed to improve
outcomes and treatment for the cerebral palsy population and
their families, impacting quality of life and reducing medical
costs. Similarly, to address the racial and socioeconomic
health equity challenges experienced by the cerebral palsy
population, it is imperative that greater investment is made to
address disparities in access to interventions and stakeholder
engagement. The Committee encourages NIH to support greater
investment in research focused on the areas in need of growth,
as outlined in the Strategic Plan on Cerebral Palsy Research
directed by the Joint Explanatory Statement accompanying the
fiscal year 2022 Appropriations Act, including research on
lifespan issues to address the needs of transition-age youth
and adults with cerebral palsy, and research to support the
development and delivery of new and improved screening tools,
treatments and interventions.
The Committee also encourages NIH to consider a
neuroplasticity workshop and research opportunities focusing on
the motor and health benefits of physical activity specifically
for individuals with CP across all gross motor functional
classification levels, which is vital to help prevent chronic
disease and premature aging.
Dystonia.--The Committee requests an update in the fiscal
year 2024 Congressional Justification on the status of the
implementation of the recommendations from the NINDS workshop
Defining Emergent Opportunities in Dystonia Research that was
held in 2018.
Lyme Disease.--The Committee recognizes that there have
been only a small number of clinical trials involving Lyme
disease, which lacks a gold standard test, and that those
trials have involved a relatively small number of patients. For
other diseases, high quality multi-site trials involving robust
number of well-characterized patients have been considered
essential to facilitate advancements in the development of more
effective treatments and improved outcomes. Because of the
clear neurological dysfunction of Lyme disease and the
existence of the Network for Excellence in Neuroscience
Clinical Trials, the Committee encourages NINDS to evaluate how
it may contribute to improvements in tools to manage Lyme
disease.
Multiple Sclerosis (MS).--The Committee encourages NINDS to
prioritize studies that develop the medical understanding of
the progression of MS and advance research on prevention
strategies, treatments, and cures for MS.
Opioid, Stimulant, and Pain Management Research.--The
Committee includes no less than the fiscal year 2022 enacted
level within NINDS for the Helping to End Addiction Long-Term
(HEAL) Initiative, which is a trans-NIH effort to accelerate
scientific discovery related to prevention and treatment of
opioid use disorder and improving pain management. The
Committee also includes an additional $11,500,000 in NINDS to
support related research on pain and pain management, as
described in the fiscal year 2023 budget request.
Parkinson's Disease (PD).--The Committee commends NINDS for
taking critical steps in identifying priority research
recommendations to advance research on PD, which impacts
between 500,000 and 1,500,000 Americans and is the second most
prevalent neurodegenerative disease in the U.S. The Committee
recognizes that NINDS is prioritizing public health concerns
with severe gaps in unmet medical needs and supports the
research recommendations set forth by the NINDS planning
strategy to bring us closer to better treatments and a cure for
PD. The Committee also encourages NINDS to submit an update on
its progress on implementing these recommendations in the
fiscal year 2024 Congressional Justification.
Parkinson's Disease and Dementia.--The Committee recognizes
that although PD is often thought of only as a movement
disorder, most PD patients also develop dementia. Common
symptoms include difficulty with problem solving and speed of
thinking, memory, and other cognitive skills. Because people
with PD usually develop these symptoms several years after
their diagnosis, PD represents an under-explored opportunity to
study the onset and progression of dementia. Therefore, the
Committee strongly urges NIA and NINDS to put a higher priority
on PD, both before and after onset of dementia, within their
overall dementia research portfolios. The Committee requests an
update on these activities in the fiscal year 2024
Congressional Justification.
Prion Research and Brain Health.--The Committee supports
the efforts of NINDS to support research across the spectrum of
neurodegenerative disease, including through the BRAIN
Initiative and the Alzheimer's disease research portfolio. The
Committee encourages NINDS to support enhanced research on the
processes whereby misfolded proteins (prions) are replicated in
the brain. Such proteins are critically implicated in numerous
neurodegenerative diseases, many of which are both lethal and
incurable. The Committee also encourages NINDS to enhance its
focus on the identification of genetic and other biomarkers for
disorders that involve misfolded proteins, such as traumatic
brain injury, ALS, Huntington's disease, Parkinson's disease,
and Alzheimer's disease, and the development of related
diagnostic tools and therapies.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)
Appropriation, fiscal year 2022....................... $6,322,728,000
Budget request, fiscal year 2023...................... 6,268,313,000
Committee Recommendation.............................. 6,642,608,000
Change from enacted level......................... +319,880,000
Change from budget request........................ +374,295,000
Mission.--The NIAID mission is to conduct and support basic
and applied research to better understand, treat, and
ultimately prevent infectious, immunologic, and allergic
diseases.
Antimicrobial Resistance.--The Committee includes
$560,000,000 to support antimicrobial resistance research,
$20,000,000 above the fiscal year 2022 enacted level. Increased
funding would support the training of new investigators;
strengthen clinical trial infrastructure to boost preparedness;
enhance basic, translational, and clinical research on
mechanisms of resistance, therapeutics, vaccines and
diagnostics; and support the development of a clinical trials
network to reduce barriers to research on difficult-to-treat
infections.
Celiac Disease.--The Committee supports research to improve
the quality of life for patients with celiac disease, efforts
to find the cause of the disease, and efforts to find a cure.
The Committee commends NIH for issuing a Notice of Special
Interest to spur additional research on the study of celiac
disease. Today, the only known treatment for this disease is a
gluten-free diet; however, recent public and private sector
research confirms that such a ``treatment'' is insufficient for
many who suffer from celiac disease. The Committee urges NIH to
support focused research on the study of celiac disease; to
better coordinate existing research; and, to focus new research
efforts toward causation, diagnosis, management, treatment,
and, ultimately, a cure of this disease. The Committee thanks
NIH for establishing a Research Condition, Disease
Categorization (RCDC) for celiac disease.
Cellular Immunity.--To better understand diseases like
COVID-19, the Committee is aware of the enormous value in
assessing cellular immunity, in addition to antibodies, which
may help us answer questions about the efficacy of vaccines,
the need for boosters, and the degree to which they prime the
body to protect against future variants, as well as the role of
cellular immune response diagnostics. With more comprehensive
immune response data, the Committee understands that it may be
possible to identify features of immune responses to viruses
like SARS-CoV-2 that make some people more susceptible to
severe disease, long COVID, and reinfection. The Committee
believes enhanced cellular immunity assessment will help to
generate deeper insights into the immune response, and may help
identify new strategies to improve countermeasures, including
cellular immune response diagnostics, for SARS-CoV-2 and other
potential pathogens in the future. The Committee encourages
NIAID to incorporate cellular immunity assessment into the wide
range of intramural and extramural COVID-19 and other disease
studies conducted and supported by NIH, including but not
limited to vaccine schedule studies and understanding post-
acute sequalae of SARS-CoV-2 infection (PASC/long COVID). The
Committee requests that NIAID provide an update on these
efforts in the fiscal year 2024 Congressional Justification.
Centers for AIDS Research.--As part of the Ending the HIV
Epidemic initiative, the Committee includes $71,000,000 for the
longstanding HIV research efforts of the Centers for AIDS
Research (CFARs) as well as CFAR activities and similar efforts
to support the EHE, the same as the fiscal year 2022 enacted
level and the fiscal year 2023 budget request. These Centers
and related efforts offer evidence-based practices on
prevention and treatment to initiative partners and support for
evaluating the initiative. The Committee encourages CFAR to
assess whether resources are targeting areas with the highest
prevalence and to develop targeted interventions that address
high-need communities.
Centers for Research and Emerging Infectious Diseases.--The
Committee recognizes the importance of the connection between
animal health and its impacts on human health. The NIH Centers
for Research on Emerging Infectious Diseases, a global network
of researchers dedicated to investigating how and why viruses
emerge from animals to cause disease in humans, has been
established by NIAID to investigate how and where viruses and
other pathogens can emerge from wildlife and spill over to
cause disease in people. The Committee commends the work of
this program and supports its continuation.
Consortium of Food Allergy Research (CoFAR).--The Committee
recognizes the serious issue of food allergies, which affect
approximately eight percent of children and ten percent of
adults in the U.S. The Committee commends the ongoing work of
NIAID in supporting a total of 17 clinical sites for this
critical research, including seven sites as part of the CoFAR.
The Committee includes $12,100,000, an increase of $3,000,000,
for CoFAR to expand its clinical research network to add new
centers of excellence in food allergy clinical care and to
select such centers from those with proven expertise in food
allergy research.
Health Disparities Research.--The Committee includes an
increase of $10,000,000 for NIAID to support research related
to identifying and reducing health disparities as described in
the fiscal year 2023 budget request.
Hereditary Angioedema (HAE).--The Committee recognizes
NIAID for its ongoing stewardship of the HAE research
portfolio, including advancements that have taken HAE from a
debilitating and fatal condition to a manageable chronic
disease. The Committee notes the potential of gene therapy and
other cutting-edge research to further improve health outcomes
for HAE patients and encourages NIAID to maintain its
commitment to the HAE research.
Late-Stage Antifungal Research and Development.--Fungal
diseases, like Valley fever, pose a threat to public health,
including life-threatening drug resistant infections. The
Committee supports research to further the research and
development of novel anti-fungal therapies for multi-drug
resistant pathogens to minimize their impact on public health.
Next-Generation Vaccine Platforms.--The Committee notes
that many current vaccines protect from disease but do not
always prevent the spreading of pathogens. When this occurs,
protected people might not experience symptoms but are still
infectious. Next-generation viral vectors, designed to target
specific tissue like mucosal sites or specific immune cells,
offer new abilities to induce the desired immune responses and
protect the necessary tissues. This will open novel
opportunities to prevent diseases and transmission. The
Committee encourages NIAID to maintain a balanced portfolio of
vaccine platform approaches to include next-generation viral
vectors, particularly in vaccine centers that have experience
in developing viral vectors covering multiple virus-based
vaccine platforms and that have established collaborations with
high containment laboratories (e.g., BSL-3 and BSL-4) for
preclinical studies.
Primary Immunodeficiencies (PI) Research.--The Committee
applauds NIH for recognizing the need for research on primary
immunodeficiencies and other related conditions by issuing a
Notice of Special Interest for research on inborn errors of
immunity/primary immunodeficiencies. The Committee encourages
NIH to fund as many meritorious proposals as possible and to
consider building upon the notice by issuing a targeted funding
announcement focused on research topics of significance to the
PI research and patient communities.
Regional Biocontainment Laboratories (RBLs).--The Committee
provides $52,000,000 to be evenly divided among the 12 RBLs to
support efforts to prevent, prepare for, and respond to
infectious disease outbreaks, including, but not limited to:
(1) conducting research on developing new antiviral compounds,
vaccines, and point of care tests; (2) conducting research on
prophylactic methods to prevent infections; (3) supporting
operations costs and purchase of equipment to speed drug
discovery and testing; and (4) training new researchers in
biosafety level 3 practices. The Committee recognizes the need
for RBLs to be able to utilize funding for all four of the
aforementioned areas. The Committee urges NIAID to identify
appropriate grant mechanisms that will allow RBLs to access
funding to support these four critical areas.
Tick-Borne Disease Research.--The Committee is supportive
of the NIH Strategic Plan for Tickborne Disease Research
published in 2019. The Committee encourages NIAID to increase
efforts to understand causes of the increase in tick-borne
diseases, to support research on tick-borne tularemia
(Francisella tularensis), and to determine whether information
learned on ways that ticks respond to bacterial infections
offer avenues to thwart tick infections in humans.
Universal Influenza Vaccine.--The Committee includes no
less than $260,000,000, an increase of $15,000,000 over the
fiscal year 2022 level and the same as the fiscal year 2023
budget request, to support basic, translational, and clinical
research to develop a universal influenza vaccine that provides
robust, long-lasting protection against multiple subtypes of
flu, rather than a select few. Such a vaccine would eliminate
the need to update and administer the seasonal flu vaccine each
year and could provide protection against newly emerging flu
strains, potentially including those that could cause a flu
pandemic. The Committee requests an update on these efforts
within 60 days of enactment of this Act.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)
Appropriation, fiscal year 2022....................... $3,092,373,000
Budget request, fiscal year 2023...................... 3,097,557,000
Committee Recommendation.............................. 3,200,157,000
Change from enacted level......................... +107,784,000
Change from budget request........................ +102,600,000
The Committee recommendation includes $1,779,457,000 in
discretionary appropriations and $1,420,700,000 in PHS Act
section 241 evaluation set-aside transfers.
Mission.--NIGMS supports basic research that increases our
understanding of biological processes and lays the foundation
for advances in disease diagnosis, treatment, and prevention.
Health Disparities Research.--The Committee includes an
increase of $10,000,000 for NIGMS to support research and
activities related to identifying and reducing health
disparities as described in the fiscal year 2023 budget
request.
Institutional Development Awards (IDeA).--The Committee
provides $423,076,000 for IDeA, $13,119,000 above the fiscal
year 2022 enacted level. The program increases our Nation's
biomedical research capability by improving research in States
that have historically been less successful in obtaining
biomedical research funding. IDeA funds only merit-based, peer-
reviewed research that meets NIH research objectives in the 23
IDeA States and Puerto Rico. NIH IDeA is comprised of these key
initiatives: Centers of Biomedical Research Excellence (COBRE)
and IDeA Networks of Biomedical Research Excellence (INBRE).
The program aims to strengthen an institution's ability to
support biomedical research, enhance the competitiveness of
investigators in securing research funding, and enable clinical
and translational research that addresses the needs of
medically underserved communities.
COBRE is a proven successful method to increase the number
of new scientists at institutions in States eligible for IDeA
awards. The Committee recognizes the success of the COBRE
program and encourages NIH to continue working to increase the
number of new scientists at institutions in eligible IDeA
States.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT (NICHD)
Appropriation, fiscal year 2022....................... $1,683,009,000
Budget request, fiscal year 2023...................... 1,674,941,000
Committee Recommendation.............................. 1,756,630,000
Change from enacted level......................... +73,621,000
Change from budget request........................ +81,689,000
Mission.--NICHD's mission is to lead research and training
to understand human development, improve reproductive health,
enhance the lives of children and adolescents, and optimize
abilities for all.
Endometriosis Research.--The Committee urges NICHD to
continue to expand basic, clinical, and translational research
into the mechanics of endometriosis, identify early diagnostic
markers, and develop new treatment methods.
Health Impacts on Children of Technology and Social Media
Use.--The Committee remains concerned about the impacts of
technology use and media consumption on infant, children, and
adolescent development. The Committee appreciates NIH's ongoing
engagement on this important topic and encourages NIH to
prioritize research into the cognitive, physical, and
socioemotional impacts of young people's use of technologies as
well as long-term developmental effects on children's social,
communication, and creative skills. The Committee also
encourages NIH to study the repercussions of increased use of
digital media and technologies on suicidal thoughts and
ideation among children. The Committee asks NIH to consider
different forms of digital media and technologies, including
mobile devices, smart phones, tablets, computers, and virtual
reality tools, as well as social-media content, video games,
and television programming. The Committee includes no less than
$15,000,000 for this activity.
Impact of COVID-19 on Children.--The Committee includes no
less than $10,000,000, an increase of $2,500,000 above the
fiscal year 2022 enacted level, for NICHD to support additional
research into multisystem inflammatory syndrome in children
(MIS-C) and other ways in which COVID-19 affects children, as
described in the fiscal year 2023 budget request.
Impact of COVID-19 on Pregnant and Lactating Women.--The
Committee includes an increase of $3,000,000, the same as the
fiscal year 2023 budget request, to support research on the
effects of COVID-19 on pregnancy, lactation, and postpartum
health with a focus on individuals from racial and ethnic
minority groups.
IMPROVE Maternal Health Initiative.--The Committee includes
no less than $30,000,000 for the Implementing a Maternal Health
and Pregnancy Outcomes Vision for Everyone (IMPROVE)
Initiative, the same as the fiscal year 2022 enacted level and
the fiscal year 2023 budget request. The IMPROVE Initiative
advances research to reduce preventable causes of maternal
deaths and improve health for pregnant and postpartum
individuals before, during, and after delivery.
Learning Disabilities Research.--The Committee is
increasingly concerned with the decline in achievement for
students with disabilities and recognizes the need for
continued research and improved interventions, particularly in
light of the COVID-19 crisis, which has led to significant loss
of in-person instruction for many students. The Committee
recognizes the importance of NICHD's funding of Learning
Disabilities Research Centers and Learning Disabilities
Innovation Hubs, which are a source of Federal funding
available to researchers interested in exploring child
development and learning disabilities to conduct randomized
control trials and explore the relationships between different
variables at work. While learning disabilities do impact an
individual's education and academic achievement, these
disorders are brain-based, and so clinical research using the
latest technology and advances in neuroscience is essential. To
continue robust research into language, reading development,
learning disabilities, and disorders that adversely affect the
development of listening, speaking, reading, writing, and
mathematics abilities, the Committee urges NICHD to continue
its investment in its Learning Disabilities Research Centers
and Learning Disabilities Innovation Hubs.
Male Reproductive Health.--The Committee urges NICHD to
continue to support research on male mechanisms of infertility.
There is a gap in the knowledge of how to diagnose and treat
male infertility, often resulting in women undergoing
unnecessary treatments due to undiagnosed or untreated male
partner infertility. The Committee notes that NICHD has
recently recognized the importance of male reproduction in its
strategic plan and included andrology as a research priority.
The Committee is concerned, however, that none of the NICHD
branches focus on male fertility, leaving a gap in
representation. The Committee encourages NICHD to consider
forming a distinct Male Fertility Health branch to prioritize
research in this area, including identifying new proteins and
sperm structures necessary for normal sperm function and,
consequently, for fertility and healthy embryo development.
Maternal-Fetal Medicine Units Network.--The Committee
supports the Maternal-Fetal Medicine Units Network of centers
across the country that conduct clinical studies to improve
maternal, fetal, and neonatal health that ultimately improves
the clinical practice of obstetrics. Many Institutes at the NIH
support at least one grant or project related to pregnancy,
which further improves maternal and infant health outcomes and
addresses maternal mortality.
Pelvic Floor Disorders.--Pelvic floor disorders, including
urinary incontinence, accidental bowel leakage, and pelvic
organ prolapse, negatively impact the quality of life of more
than 25 million U.S. women each year. There are socioeconomic
disparities amongst women suffering from pelvic floor
disorders, with differences in symptoms, knowledge, access to
care, availability of treatments, and treatment outcomes noted
in patients from different backgrounds. The Committee urges
NICHD to prioritize research activities into underrepresented
patient populations and pelvic floor disorders. Such activities
may include the development of educational programs for general
practitioners, the evaluation of effectiveness of screening
protocols for pelvic floor disorders in the primary care
setting, investigating medical literacy amongst minority women
as it pertains to pelvic floor disorders, as well as assessing
socioeconomic and socio-cultural disease perspectives by
designing qualitative studies using focus groups of women with
varying socio-economic, cultural, and ethnic backgrounds,
evaluating current educational resources, determining gaps in
patient knowledge, and designing culture-specific educational
materials and resources. The Committee requests an update on
this research in the fiscal year 2024 Congressional
Justification.
Population Research.--The Committee congratulates NICHD for
leading efforts to promote research regarding the effects of
COVID-19 on child development and health disparities. The
Committee encourages NICHD to sustain these research priorities
through its support of the Population Dynamics Research Centers
Program and population-representative longitudinal datasets,
such as the Fragile Families and Child Wellbeing Study, Baby's
First Years, Panel Study of Income Dynamics Child Supplement
Survey, and National Longitudinal Survey of Youth. The
Committee urges NICHD to engage the population research field
to develop informed frameworks for conceptualizing and
measuring social determinants of health, including structural
racism. The Committee also encourages NICHD to support research
exploring the direct and indirect effects of COVID-19 on
reproductive health, marriage, and divorce and to expand
research and data collection on mortality, especially during
adolescence and the transition to adulthood. Within 90 days of
enactment of this Act, the Committee requests a report on the
Institute's efforts to address these priority areas.
Pregnancy Loss Research.--The Committee supports NIH
research into pregnancy loss and encourages NIH to expand and
coordinate research activities with respect to pregnancy loss.
Research in Pregnant and Lactating Women.--The Committee is
pleased with the progress being made by the Task Force on
Research Specific to Pregnant Women and Lactating Women in
identifying and developing strategies to address gaps in
knowledge and research on safe and effective therapies for
pregnant and lactating women. The Committee encourages NIH to
continue implementing these recommendations to the extent
appropriate and feasible under the legal authorities available
to the Secretary.
Sudden Infant Death Syndrome (SIDS).--The Committee urges
NICHD to strengthen support for research into the causes and
prevention of SIDS.
Trans-NIH Pediatric Research Consortium (N-PeRC).--The
Committee is aware of the N-PeRC that was established in 2018
to better coordinate pediatric research activities across
multiple Institutes and Centers. The Committee supports the
goals and objectives of N-PeRC and requests that NIH update the
Committee on its activities and focus of multi-Institute or -
Center pediatric research projects implemented as a result of
N-PeRC. Additionally, the Committee requests a report in the
fiscal year 2024 Congressional Justification on how N-PeRC
plans to encourage longitudinal studies of the physical,
mental, and behavioral health impacts of COVID-19 on children,
including multisystem inflammatory syndrome in children (MIS-
C), as well as plans for N-PeRC's focus over the coming three
years.
Uterine Fibroids.--The Committee encourages NIH to support
the activities outlined in the Stephanie Tubbs Jones Uterine
Fibroid Research and Education Act of 2022 (H.R. 2007), as
introduced in the House, to support research related to uterine
fibroids etiology, prevention, diagnosis, disparities, and
treatment.
NATIONAL EYE INSTITUTE (NEI)
Appropriation, fiscal year 2022....................... $863,918,000
Budget request, fiscal year 2023...................... 853,355,000
Committee Recommendation.............................. 891,186,000
Change from enacted level......................... +27,268,000
Change from budget request........................ +37,831,000
Mission.-- The mission of the National Eye Institute is to
eliminate vision loss and improve quality of life through
vision research.
Blepharospasm.--The Committee continues to encourage NEI to
expand research into blepharospasm, a form of dystonia, and
requests an update on collaborative efforts amongst
stakeholders and other Institutes and Centers in the fiscal
year 2024 Congressional Justification.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)
Appropriation, fiscal year 2022....................... $842,169,000
Budget request, fiscal year 2023...................... 932,056,000
Committee Recommendation.............................. 878,750,000
Change from enacted level......................... +36,581,000
Change from budget request........................ -53,306,000
Mission.--NIEHS's mission is to discover how the
environment affects people in order to promote healthier lives.
The Committee includes an additional $10,000,000 for NIEHS
to support and coordinate research on the rise in and
exacerbation of a wide range of health conditions related to
the environment, which may include infectious disease, injury
and trauma, and chronic conditions such as asthma, mental
health, and health disparities. Such research may include
evaluation of both preventive and intervention strategies for
such conditions.
Harmful Algal Blooms (HABs) Human Health Effects
Research.--Harmful algal blooms are occurring with increasing
frequency and severity across the country. While we know of the
temporary physical discomfort caused by the toxic bacteria, we
do not know if exposure presents a long-term threat to human
health. The Committee supports NIEHS research to determine the
impact of red tide and other HABs on human health. The
Committee commends NIEHS for its collaborations with other
agencies, including NSF, NOAA, EPA, and CDC, to advance such
research and translate key research findings for clinical and
public health benefits.
Indoor Amplified Microbial Growth Research.--The Committee
believes that a more robust and focused NIH commitment to
research relating to mold and amplified microbial growth in
damp and water-damaged buildings would yield significant
advancements of knowledge and insight regarding how fungi,
mycotoxins, actinobacteria, and endotoxins within indoor
environments affect public health. The Committee encourages NIH
to expedite planned and ongoing studies already nominated and
established through the National Toxicology Program (NTP). The
Committee also urges the Director of NIEHS, in coordination
with the Division of the National Toxicology Program (DNTP), as
well as the NTP, to prioritize new research and explore the
causal links to the potential neurotoxic, immunosuppressive,
immunoreactive, nephrotoxic, carcinogenic, and inflammatory
responses due to inhalation of indoor amplified microbial
growth in damp and water-damaged indoor environments. The
Committee encourages NIH to improve applied research,
communication and education, and coordination with other
Federal, State, and local health and environmental agencies
regarding mold and microbial growth in damp and water-damaged
indoor environments.
Parkinson's Disease.--Research suggests that Parkinson's
disease (PD) is caused by a combination of genetic and
environmental factors. Agricultural exposure to pesticides,
including herbicides, has been associated with an increased
risk of developing the disease, yet other exposures common to
soldiers, firefighters, first responders, and others, such as
burn pits, insecticides, solvents and heavy metals, need to be
explored or should be considered. The Committee urges NIEHS to
expand its research and collaborate with appropriate partners
to understand the effects of these chemicals on PD development
and progression. Research should include fundamental approaches
to identify other environmental triggers and to understand the
expression of PD traits that result from the interplay of genes
and environment to advance the development of individualized
precision environmental health strategies to prevent and treat
PD. The Committee requests an update on these activities in the
fiscal year 2024 Congressional Justification.
NATIONAL INSTITUTE ON AGING (NIA)
Appropriation, fiscal year 2022....................... $4,219,936,000
Budget request, fiscal year 2023...................... 4,011,413,000
Committee Recommendation.............................. 4,443,196,000
Change from enacted level......................... +223,260,000
Change from budget request........................ +431,783,000
Mission.--NIA's mission is to understand the nature of
aging and the aging process, and diseases and conditions
associated with growing older, in order to extend the healthy,
active years of life.
Alzheimer's Disease and Related Dementias (ADRD).--The
Committee recommends an increase of $200,000,000 for ADRD
research. The Committee encourages NIA to continue addressing
the research targets outlined in the fiscal year 2023
Professional Judgment Budget. The Committee encourages NIA to
take the necessary steps to ensure that NIH-sponsored clinical
trials take into account racial and ethnic diversity and the
impact of Alzheimer's disease on underserved populations. In
addition, with various treatments for Alzheimer's disease in
the pipeline, the Committee encourages NIA to support a wide
range of trials, including those with a patient-based national
registry of regulatory grade, longitudinal evidence for
patients receiving any FDA-approved disease modifying therapies
for Alzheimer's disease in real-world clinical practice.
Autism Spectrum Disorder (ASD) in Older Adults.--The
Committee recognizes recent research which indicates that
individuals with ASD are more likely to be diagnosed with
neurodegenerative conditions, including dementia, compared to
the general population. The Committee supports ongoing research
at NIA to understand how ASD affects the aging process and to
develop tools for identifying ASD and related mental health
needs and evidence-based services, and commends the NIA for
convening a workshop in 2022 to discuss possible linkages
between ASD and Alzheimer's disease. The Committee requests an
update on opportunities for research activities in this area
within 180 days of enactment of this Act.
Geroscience.--The Committee commends NIA for its support of
geroscience, which seeks to understand the genetic, molecular,
and cellular mechanisms that make aging a major risk factor and
driver of numerous chronic conditions and diseases, including
Alzheimer's disease, cancer, cardiovascular diseases, and many
others. A growing body of research suggests it is possible to
develop treatments that would address many late-life diseases,
as opposed to solely tackling each disease individually, as
under the current prevailing model. Significant advances in
recent years highlight the need to develop a comprehensive
strategy for addressing research gaps and opportunities.
Therefore, the Committee urges NIA to convene a meeting of
experts across NIH, other relevant Federal agencies, academic
researchers, and the private sector to identify gaps and
opportunities for this research field. The Committee also
recognizes that there is a shortage of investigators who
combine clinical, social, and behavioral research skills with a
knowledge of aging biology and experience in the care of older
adults and the processes of aging at the individual and
societal level. The Committee encourages NIA to expand its
translational geroscience training programs to support the
pipeline of such investigators. The Committee requests an
update on these topics in the fiscal year 2024 Congressional
Justification.
National Strategy for Recruitment and Participation in
Alzheimer's Disease and Related Dementias Clinical Research.--
The Committee applauds NIA's efforts to initiate, identify, and
develop the National Strategy for Recruitment and Participation
in Alzheimer's and Related Dementias Clinical Research. An
effective way of determining whether those recommended
strategies are being well-implemented and having the desired
impact is through data collection and reporting. The Committee
urges NIA to provide an assessment of the data and metrics it
collects related to the planning, recruitment, and retention of
clinical trial participants from underrepresented communities
and how those data have been or will be used in grantmaking
decisions. The assessment should also address how NIA plans to
provide more timely data to Congress and greater transparency
to the public about the planning, engagement, and recruitment
efforts of its extramural grantees, including a focus on
addressing barriers to inclusive and representative enrollment
such as eligibility criteria, language accessibility, and
adequate planning for diverse enrollment among grantees. The
Committee requests that NIA provide this assessment to the
Committee within 180 days of the enactment of this Act.
Parkinson's Disease and Dementia.--The Committee recognizes
that although PD is often thought of only as a movement
disorder, most PD patients also develop dementia. Common
symptoms include difficulty with problem solving, speed of
thinking, memory, and other cognitive skills. Because people
with PD usually develop these symptoms several years after
their diagnosis, PD represents an under-explored opportunity to
study the onset and progression of dementia. The Committee
strongly urges NIA and NINDS to put a higher priority on PD,
both before and after onset of dementia, within their overall
dementia research portfolios. The Committee requests an update
on these activities in the fiscal year 2024 Congressional
Justification.
Population Research.--The Committee recognizes NIA for
supporting a robust population aging research portfolio within
its Division of Behavioral and Social Research (DBSR) and
encouraging enhanced collaborations between DBSR and the
Institute's other scientific research divisions. The Committee
is pleased to learn these collaborations include, for example,
integrating the population sciences into the Institute's
geroscience research agenda and initiatives regarding
Alzheimer's disease and the long-term social, behavioral, and
economic consequences of COVID-19 on older people and their
families. Continued support for large-scale, longitudinal, and
representative studies, such as Health and Retirement Study and
the National Health and Aging Trends Study, the Centers on the
Demography and Economics of Aging, research networks, training
grants, and early career opportunities are needed to sustain
and enhance the field of population aging research. The
Committee asks NIA to report on its plans for ensuring long-
term investment and support for population aging research
activities within 90 days of enactment of this Act.
Thalassemia.--Thalassemia patients and others dealing with
chronic diseases are now living well into adulthood, some even
into their 60s. While this is a tremendous victory for
research, it has opened new questions. For example, even in
well-managed cases, individuals with thalassemia are likely to
be exposed to levels of iron loading that, while too low to
create immediate damage, are significantly in excess of what
occurs in the typical population. Such exposure may occur for
decades in many patients. The long-term effect of this exposure
on patient health and outcomes is unknown. In addition, many
thalassemia patients develop low bone mass issues early in life
and may be prescribed treatments which are in the general
population typically prescribed much later in life; the long-
term efficacy and possible consequences of this extended
exposure is unknown. In addition, there are female and male
reproductive issues, the impact of other non-disease related
medicines, the relationship to diseases of aging such as
Alzheimer's disease, Parkinson's disease, arthritis,
osteoporosis, and more. The Committee encourages NIA to develop
a plan to research comorbidities in thalassemia and other rare
disease patient populations as they continue to age. In
addition, individuals with thalassemia trait are asymptomatic,
aside from perhaps an occasional mild anemia, and do not
require clinical care. However, research is lacking in the
possible effects of thalassemia trait on an older adults.
Research is warranted to determine if thalassemia trait
carriers do experience adverse effects related to the trait as
they age.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
(NIAMS)
Appropriation, fiscal year 2022....................... $655,699,000
Budget request, fiscal year 2023...................... 676,254,000
Committee Recommendation.............................. 676,395,000
Change from enacted level......................... +20,696,000
Change from budget request........................ +141,000
Mission.--NIAMS's mission is to support research into the
causes, treatment, and prevention of arthritis and
musculoskeletal and skin diseases; the training of basic and
clinical scientists to carry out this research; and the
dissemination of information on research progress in these
diseases.
Alopecia Areata.--The Committee notes the importance of
research into autoimmune skin conditions such as alopecia
areata. The Committee requests an update in the fiscal year
2024 Congressional Justification on research initiatives into
this condition and opportunities to advance research.
Thalassemia.--Individuals with thalassemia frequently
develop low bone mass issues, often several decades earlier
than is typical in the general population. Most currently
recognized treatment options for low bone mass issues have been
developed for populations that develop these issues at an older
age than in thalassemia, and which may not have the same
characteristics as those with thalassemia. More research in
treatments for and prevention of low bone mass for this
population, including the proper use of low intensity vibration
therapy, may be warranted.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
(NIDCD)
Appropriation, fiscal year 2022....................... $514,885,000
Budget request, fiscal year 2023...................... 508,704,000
Committee Recommendation.............................. 531,136,000
Change from enacted level......................... +16,251,000
Change from budget request........................ +22,432,000
Mission.--NIDCD conducts and supports biomedical and
behavioral research and research training in the normal and
disordered processes of hearing, balance, taste, smell, voice,
speech, and language. NIDCD also conducts and supports research
and research training related to disease prevention and health
promotion; addresses special biomedical and behavioral problems
associated with people who have communication impairments or
disorders; and supports efforts to create devices which
substitute for lost and impaired sensory and communication
function.
Hearing Loss.--The Committee is concerned about the rapidly
escalating public health crisis of hearing loss, which now
impacts one in five people in the U.S. alone. The Committee
encourages NIDCD to convene a workshop involving key
stakeholders including industry, academia, and patient
advocates, to develop a roadmap for bringing these much-needed
therapies to patients. The Committee also urges NIDCD, to the
extent practicable, to involve other agencies who serve
disproportionately impacted populations, including VA and DoD.
Spasmodic Dysphonia.--The Committee notes the research
NIDCD continues to facilitate on spasmodic dysphonia and
collaborative efforts with relevant Institutes, Centers, and
stakeholders. The Committee continues to encourage sustained
collaboration with key stakeholders and agencies.
NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)
Appropriation, fiscal year 2022....................... $180,862,000
Budget request, fiscal year 2023...................... 198,670,000
Committee Recommendation.............................. 208,571,000
Change from enacted level......................... +27,709,000
Change from budget request........................ +9,901,000
Mission.--The mission of NINR is to lead nursing research
to solve pressing health challenges and inform practice and
policy--optimizing health and advancing health equity into the
future.
Health Disparities Research.--The Committee includes an
increase of $22,000,000 for NINR to support research related to
identifying and reducing health disparities, the same as the
fiscal year 2023 budget request.
NATIONAL INSTITUTE ON ALCOHOL EFFECTS AND ALCOHOL-ASSOCIATED DISORDERS
(NIAAA)
Appropriation, fiscal year 2022....................... $573,651,000
Budget request, fiscal year 2023...................... 566,725,000
Committee Recommendation.............................. 591,757,000
Change from enacted level......................... +18,106,000
Change from budget request........................ +25,032,000
Mission.--NIAAA's mission is to generate and disseminate
fundamental knowledge about the adverse effects of alcohol on
health and well-being, and apply that knowledge to improve
diagnosis, prevention, and treatment of alcohol-related
problems, including alcohol use disorder, across the lifespan.
Alcohol-Associated Liver Disease.--The Committee is aware
that alcohol use disorder and alcohol-associated liver disease
are distinct diseases. However, it is rare for patients to have
the latter without first having the former. Combining the
research in this area in a holistic approach could lead to
advancements for both, which are needed urgently given the
increased rates of alcohol consumption during the pandemic. The
Committee requests an update in the fiscal year 2024
Congressional Justification on the viability of this approach,
including NIAAA's capacity to award related grants and the
field's capacity to develop scientifically valid research
projects.
NATIONAL INSTITUTE ON DRUGS AND ADDICTION (NIDA)
Appropriation, fiscal year 2022....................... $1,595,474,000
Budget request, fiscal year 2023...................... 1,843,326,000
Committee Recommendation.............................. 1,712,832,000
Change from enacted level......................... +117,358,000
Change from budget request........................ -130,494,000
Mission.--NIDA's mission is to advance science on the
causes and consequences of drug use and addiction and to apply
that knowledge to improve individual and public health.
Addiction Intervention.--The Committee is deeply concerned
by alarming trends of drug use and addiction in the U.S. The
number of alcohol-related deaths doubled in the U.S. from 1999
to 2017. Staggeringly, the number of drug overdose deaths
doubled from 2015-2021. Difficulty managing impulsivity, a key
function of cognitive self-control, is associated with
substance use disorders. The Committee recognizes that Episodic
Future Thinking is a promising intervention that can help
individuals with substance use disorders consider the positive
outcomes of abstaining from use through a mental simulation of
positive events that might occur in the future. The Committee
encourages NIDA to support transdisciplinary research that
incorporates neuroscience, behavioral research, neuroeconomics,
brain imaging, engineering, and computer science to deploy
Episodic Future Thinking intervention strategies across a range
of substance use disorders.
Barriers to Research.--The Committee is concerned that
restrictions associated with Schedule I of the Controlled
Substance Act effectively limit the amount and type of research
that can be conducted on certain Schedule I drugs, especially
opioids, marijuana or its component chemicals, and new
synthetic drugs and analogs. At a time when as much information
as possible about these drugs is needed, including research on
their therapeutic potential and on overdose reversal agents, it
would be helpful to lower regulatory and other barriers to
conducting this research. The Committee appreciates NIDA's
completion of a report on the barriers to research that result
from the classification of drugs and compounds as Schedule I
substances, including the challenges researchers face as a
result of limited access to sources of marijuana including
dispensary products.
COVID-19 Pandemic and Impact on Substance Use Disorders.--
The Committee is acutely aware of the risks that the ongoing
COVID-19 pandemic poses to individuals with substance use
disorders (SUDs). According to CDC, drug overdose deaths
accelerated during the pandemic. Moreover, NIDA-supported
research found that individuals with substance use disorders
are at increased risk for COVID-19 and its adverse outcomes.
The Committee commends NIDA for conducting research on the
adverse impact of the pandemic on people with SUDs and
encourages NIDA to continue to support research on these
issues.
Development of Cocaine Overdose Treatment.--The Committee
continues to recognize the ``fourth wave'' of the overdose
public health crisis involves rising overdoses involving
stimulants. The Committee is concerned about the increase in
overdose deaths involving cocaine and the lack of FDA-approved
cocaine overdose reversal medications to address the increase
in fatalities. The Committee understands that NIH has
previously supported research and development of treatments
that can rapidly reverse cocaine toxicity and reduce mortality
rates. The Committee encourages NIDA to fund additional
research to advance a life-saving treatment for overdoses
caused by cocaine and other stimulants.
Electronic Cigarettes.--The Committee understands that
electronic cigarettes (e-cigarettes) and other vaporizing
equipment are increasingly popular among adolescents, and
encourages NIDA to continue to fund research on the use and
consequences of these devices.
Headache Disorders and Migraines.--Migraine is the second
leading cause of disability, and 60 million Americans have
migraines. There is a critical need for more effective and
safer treatments for headache disorders, especially because
current treatment using opioids can worsen migraine frequency
and severity. Ten percent of Americans with migraines are
opioid users and 59 percent receive opioids in U.S. emergency
departments. The HEAL Initiative calls for disease burden to be
a crucial consideration when prioritizing research programs.
The Committee supports efforts to address the need for more
effective pain management for those suffering from headache
disorders and migraines.
Kratom.--The Committee recognizes that NIH- and NIDA-funded
research has contributed to the continued understanding of the
health impacts of kratom, including its constituent compounds,
mitragynine and 7-hydroxymitragynine. The Committee is aware of
the potential promising results of kratom for acute and chronic
pain patients who seek safer alternatives to sometimes
dangerously addictive and potentially deadly prescription
opioids and of research investigating the use of kratom's
constituent compounds for opioid use disorder. The Committee
acknowledges NIDA's support of preclinical research on the
toxicology of mitragynine, which will enable future studies of
its safety, tolerability, and clinical pharmacokinetics in
humans. The Committee also urges NIDA to consider a human
clinical trial on its therapeutic effects to treat opioid use
disorder, especially in light of the increases in overdose
deaths reported during the COVID-19 pandemic.
Marijuana Research.--The Committee supports the development
of an objective standard to measure marijuana impairment to
ensure highway safety. Essential to that development are high-
quality scientific studies using marijuana and products
containing marijuana lawfully available to patients or
consumers in a State on a retail basis. The Committee notes
that a majority of Federal research on marijuana has been
limited to a single strain of marijuana that is not fully
representative. The Committee emphasizes the need for research
that encompasses the diversity, quality, and potency of
products commonly available to patients or consumers in a State
on a retail basis. The Committee requests an update on efforts
to expand researcher access to different marijuana strains in
the fiscal year 2024 Congressional Justification.
Medications for Opioid Use Disorder and Neonatal Opioid
Withdrawal Syndrome.--The Committee recognizes the increasing
incidence of neonatal opioid withdrawal syndrome (NOWS), with
nearly 80 newborns diagnosed with NOWS in the U.S. daily.
Currently, hospital stays for newborns with NOWS are six times
as long and eight times as expensive as hospital stays for
newborns without NOWS. The Committee also recognizes that
medications for opioid use disorder (MOUD) are the gold
standard for treatment for opioid use disorder, including in
pregnant people. MOUD in pregnancy reduces the risk of adverse
birth outcomes, including preterm birth, but may lead to NOWS.
The Committee encourages NIDA to support research on types of
MOUD that would not cause NOWS or would have fewer symptoms of
NOWS compared to currently available medications.
Opioid, Stimulant, and Pain Research.--The Committee
continues to be concerned about the high mortality rate due to
the opioid epidemic and appreciates the important role that
research plays in the various Federal initiatives aimed at the
overdose crisis. The Committee is also aware of the most recent
provisional data from CDC that shows opioid overdose fatalities
exceeded 100,000 in 2021, primarily driven by illicitly
manufactured fentanyl and fentanyl analogs. More research is
needed to find new and better agents to prevent or reverse the
effects caused by this class of chemicals and to provide
improved access to treatments for those addicted to these
drugs. The Committee is also concerned that, according to
provisional data released by CDC, over 45,000 overdose deaths
involved drugs in the categories that include methamphetamine
and cocaine in the 12-month period ending in June 2021, an
increase of 25 percent in a single year. The sharp increase has
led some to refer to stimulant overdoses as the ``fourth wave''
of the current overdose crisis in America following the rise of
opioid-related deaths involving prescription opioids, heroin,
and fentanyl-related substances. To combat this crisis, the
Committee includes no less than the fiscal year 2022 enacted
level for NIDA's share of the HEAL Initiative, and in response
to rising rates of stimulant use and overdose, the Committee
has maintained bill language expanding the allowable use of
these funds to include research related to stimulant use and
addiction. The Committee also includes an additional
$67,000,000 in NIDA to support basic research on pain and pain
management, as described in the fiscal year 2023 budget
request.
Overdose Prevention Centers.--The Committee recognizes that
overdose prevention centers, or supervised consumption sites,
are part of a larger effort of harm reduction interventions
intended to reduce the risk of drug overdose death and reduce
the spread of infectious disease. The Committee encourages NIH
to discuss in the fiscal year 2024 Congressional Justification
significant advances in research on the potential public health
impact of overdose prevention centers in the U.S.
Raising Awareness and Engaging the Medical Community in
Drug Use 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 health care 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). The
Committee encourages NIDA to continue its efforts in this area,
providing physicians and other medical professionals with the
tools and skills needed to incorporate substance use and misuse
screening and treatment into their clinical practices. The
Committee encourages NIDA to increase its support for the
education of scientists and practitioners to find improved
prevention and treatments for substance use disorders.
Youth and Perinatal Marijuana Use.--The Committee includes
$2,000,000 for NIDA to enter into a contract with NASEM to
commission a study to determine the scope of the problem of
underage youth and perinatal marijuana use and effective ways
of reducing it. Topics explored should include but not be
limited to the demographics of underage and perinatal marijuana
use; its economic and social costs; adolescent and perinatal
decision making and risk and protective factors; and the
effectiveness of various prevention programs and approaches,
including media campaigns, school-based education, pricing, and
access. NASEM will develop a strategy for reducing and
preventing underage and perinatal consumption of today's
marijuana and THC products, specifically focused on the impacts
of THC on the developing brain. To help develop an effective
strategy, NASEM shall review existing Federal, State, and non-
governmental programs, including media-based programs, that
have been shown to be effective with other substances that can
be harmful to youth, including any done on marijuana, that are
designed to change the attitudes and health behaviors of youth
(those under the age of 21). In addition, NASEM shall review
existing Federal, State, and non-governmental programs
including media-based programs, that have been shown to be
effective with other substances that can be harmful to babies
of pregnant and breast-feeding women, including with any
completed on marijuana, that are designed to change the
attitudes and health behaviors of pregnant and breast-feeding
women. Based on its reviews, NASEM shall produce a strategy
designed to prevent and reduce underage consumption of today's
marijuana and THC products in addition to a strategy designed
to prevent and reduce consumption of today's marijuana and THC
products by pregnant and breast-feeding women. This shall
include, but not be limited to: an outline and implementation
strategy; message points that will be effective in changing the
attitudes and health behaviors of youth concerning underage
marijuana consumption; and an outline and implementation
strategy, and message points that will be effective in changing
the attitudes and health behaviors of pregnant and breast-
feeding women, target audience identification, goals and
objectives of both campaigns, and the estimated costs of
development and implementation.
NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)
Appropriation, fiscal year 2022....................... $2,216,976,000
Budget request, fiscal year 2023...................... 2,210,828,000
Committee Recommendation.............................. 2,428,775,000
Change from enacted level......................... +211,799,000
Change from budget request........................ +217,947,000
The Committee recommendation includes $2,203,775,000 in
discretionary appropriations and $225,000,000 made available in
the Cures Act.
Mission.--NIMH's mission is to transform the understanding
and treatment of mental illnesses through basic and clinical
research, paving the way for prevention, recovery, and cure.
Autism.--The Committee strongly encourages NIH to support
greater investment in research related to autism, particularly
in priority areas outlined in the IACC Strategic Plan for ASD.
While significant progress has been made in the understanding
of autism, large gaps remain in the ability to improve outcomes
and access to services for autistic individuals across their
life span. Research has shown that autistic individuals have
higher rates of some co-occurring physical and mental health
conditions, impacting quality of life and increasing medical
utilization and costs. Additionally, there are significant
unaddressed racial, ethnic, and socioeconomic health equity
challenges experienced by autistic individuals across their
life span and by their families. As such, the Committee further
encourages NIMH to work collaboratively with NIMHD to support
research on the socioeconomic, racial, and ethnic health
disparities associated with autism spectrum disorder, and to
work collaboratively with other Institutes to support research
on understanding the impact of social and environmental factors
leading to co-occurring health conditions.
BRAIN Initiative.--The Committee directs NIH to transfer
$225,000,000 from the NIH Innovation Account to NIMH to support
the BRAIN Initiative. These funds are authorized by the Cures
Act. This collaborative effort is revolutionizing our
understanding of how neural components and their dynamic
interactions result in complex behaviors, cognition, and
disease, while accelerating the development of transformative
tools to explore the brain in unprecedented ways making
information previously beyond reach accessible.
Impact of COVID on Mental Health.--The Committee includes
an increase of $5,000,000 for NIMH to expand research to
understand and mitigate the impact of the COVID-19 pandemic on
mental health, as described in the fiscal year 2023 budget
request.
Mental Health Impact of Alopecia.--The Committee notes
recent events that have highlighted the effect on an
individual's mental health because of alopecia. The Committee
encourages NIMH to work with key stakeholders to advance
research and resource development aimed at understanding this
connection and opportunities for innovative discovery.
Mental Health Research.--The Committee supports the high-
quality basic research on serious mental illnesses being
conducted at NIMH. The Committee requests an update on the
evaluation of funding allocations at NIMH detailing the
percentage of funds spent on both basic and clinical research.
The Committee also encourages NIMH to provide ARPA-H with a
roadmap of clinical research gaps needed to conduct deeper
clinical studies and invest in breakthrough technologies and
treatments to continue improving the field of mental health
research and improve the lives of those experiencing serious
mental illnesses.
Prioritizing Black Youth Suicide Prevention.--The Committee
commends NIMH for consistently expanding resources for suicide
screening and prevention research over the last four fiscal
years and strongly encourages the Institute to provide
additional increases for this purpose in fiscal year 2023, with
special emphasis on producing models that are interpretable,
scalable, and practical for clinical implementation, including
utilization of healthcare, education and criminal justice
systems that serve populations at risk. Specifically, this
includes Black youth, whose suicide death rate is increasing
faster than any other racial/ethnic group. In addition, the
Committee encourages NIMH to prioritize research efforts
related to primary care settings to evaluate suicide prevention
interventions, strategies, and programs, including assessments
of the effects of the COVID-19 epidemic. The Committee requests
that NIMH provide an update on all of these efforts in the
fiscal year 2024 Congressional Justification.
Psychiatric Drug Prescription Research.--The Committee
encourages NIH to conduct research to support the creation of
best practices for follow-up and outreach following the
prescription of psychiatric medication that could increase
suicidal thoughts or behaviors in order to better allow for
timely intervention in individuals experiencing increased
suicidal ideation following such prescriptions.
Suicide Prevention.--The Committee is encouraged that 2020
was the second year in two decades in which the suicide rate
decreased. However, suicide was the 12th leading cause of death
overall in the U.S. in 2020, and third among youth and young
adults ages 10-24. The Committee remains committed to providing
the resources necessary to address the current youth mental
health crisis. The Committee commends NIMH for consistently
expanding resources for suicide screening and prevention
research in recent years and strongly encourages the Institute
to continue to prioritize suicide prevention research in fiscal
year 2023, with special emphasis on producing models that are
interpretable, scalable, and practical for implementation. In
addition, the Committee encourages NIMH to prioritize research
efforts related to school-based suicide prevention models to
evaluate suicide prevention interventions, strategies, and
programs, including assessments of the effects of the COVID-19
epidemic on young adults and children. The Committee requests
that NIMH provide an update on these efforts in the fiscal year
2024 Congressional Justification.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)
Appropriation, fiscal year 2022....................... $639,062,000
Budget request, fiscal year 2023...................... 629,154,000
Committee Recommendation.............................. 659,233,000
Change from enacted level......................... +20,171,000
Change from budget request........................ +30,079,000
Mission.--NHGRI's mission is to accelerate scientific and
medical breakthroughs that improve human health by driving
cutting-edge research, developing new technologies, and
studying the impact of genomics on society.
Germline RUNX1 Mutations.--The Committee commends NHGRI for
collaborating with NCI to launch and maintain the NIH RUNX1-FPD
Clinical Research Study, the only longitudinal natural history
study of patients with germline RUNX1 mutations and their
families. This study has broad implications for the fields of
hematology and oncology because it offers researchers the
opportunity to monitor the genomic evolution of cancer within a
precancerous population in real-time. Insights gained from such
careful monitoring can result in the development of improved
early detection methods and novel treatment interventions.
Given the critical importance of such natural history studies,
the Committee encourages NHGRI to leverage NIH resources and
toolkits to advance participant recruitment and enrollment,
timely data dissemination, and to ensure optimal execution and
implementation of the NIH RUNX1-FPD Clinical Research Study.
The Committee strongly urges NHGRI to collaborate with
other NIH Institutes to identify additional resources that
would leverage the expertise across NIH Institutes so that the
study can include more patients each year. In addition, the
Committee encourages NHGRI to continue to adhere to the NIH
Genomic Data Sharing Policy for the benefit of the entire
research community and the patients and their families
searching for answers.
Pharmacogenomics.--NHGRI supports pharmacogenomic research
in a variety of ways, including by working to develop community
research resources. For instance, the program funds the
Clinical Pharmacogenetics Implementation Consortium, an
international consortium of experts that create, curate, and
make publicly accessible detailed gene-drug clinical practice
guidelines that inform medical management decisions. The
Committee encourages NIH to continue support for this research.
Proteomics.--The Committee recognizes the promise of
research into the proteome in the study of biological systems.
The ability to effectively and efficiently analyze protein
patterns and their changes over time has potential to provide
valuable insights into a person's real-time state of health
including identifying existing disease, understanding the
biological drivers of that disease, predicting near-term health
events, and guiding effective therapeutic interventions. The
Committee encourages NHGRI to utilize existing resources to
expand its research into this cutting-edge field.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING (NIBIB)
Appropriation, fiscal year 2022....................... $424,590,000
Budget request, fiscal year 2023...................... 419,493,000
Committee Recommendation.............................. 437,991,000
Change from enacted level........................... +13,401,000
Change from budget request.......................... +18,498,000
Mission.--The NIBIB mission is to improve health by leading
the development and accelerating the application of biomedical
technologies.
Medical Imaging and Data Resource Center (MIDRC).--The
Committee supports NIBIB's work to develop the MIDRC, a growing
repository of over 85,000 images and associated data to help
accelerate strategies for COVID-19 diagnosis and therapeutic
management. This resource is creating and enabling broader use
of machine learning algorithms in medical image analysis for
coronavirus patients and may serve as a model for understanding
other diseases to improve patient outcomes across medical
disciplines, including diagnosis, monitoring, and predictive
prognoses. The Committee encourages NIBIB to continue its
engagement with external stakeholders to advance this promising
project.
Neurotechnology.--The Committee recognizes that recent
developments in wearable devices, remote monitoring,
implantable medical devices, 3-D neural constructs, and
bioprinting have accelerated the rate of discovery of methods
to sense and modulate the activity of the nervous system. The
rate of discovery now strains the ability of academic
laboratories and medical centers to perform the necessary
product development and early human clinical trial work, in a
timely manner, to demonstrate the efficacy of these
neurotechnology interventions. New neurotechnology diagnostics
and therapies could enable injury prevention in both able-
bodied and at-risk populations and transform treatment of
children and adults living with the chronic effects of
neurological disease and injury, in particular, with
impairments in mobility, cognition, pain, mood, perception, and
systemic health. The Committee encourages NIBIB, in
collaboration with NINDS, to prioritize additional funding to
accelerate the pace of bench-to-bedside clinical development of
environmental, 3-D printable, wearable, and implantable
artificial and biological neurotechnology.
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES (NIMHD)
Appropriation, fiscal year 2022....................... $459,056,000
Budget request, fiscal year 2023...................... 659,817,000
Committee Recommendation.............................. 505,292,000
Change from enacted level......................... +46,236,000
Change from budget request........................ -154,525,000
Mission.--NIMHD's mission is to lead scientific research to
improve minority health and reduce health disparities.
Health Disparities Research.--The Committee includes an
increase of $23,000,000 for NIMHD to support additional
research related to identifying and reducing health
disparities.
Long COVID Research.--The Committee urges NIMHD to support
research on racial and ethnic health disparities prevalent in
the diagnosis, treatment, recovery, and quality of life of long
COVID-19 patients.
Racial and Ethnic Disparities in Alopecia.--The Committee
notes the disproportionate effect of alopecia on people of
color, specifically women. The Committee encourages NIMHD to
collaborate with relevant Institutes and Centers, such as
NIAMS, and relevant stakeholders to identify key research areas
of concern.
Research Centers at Minority Institutions (RCMIs).--The
Committee includes no less than $89,765,000, an increase of
$5,000,000 above the fiscal year 2022 enacted level, for RCMIs
to ensure critical infrastructure development in historically
minority graduate and health professional schools.
Research Grants on Cosmetic Safety, Health Disparities and
Communities of Color and Professional Salon Workers.--The
Committee is concerned about the prevalence of cosmetics
containing dangerous levels of mercury made available through
online sales and increased global travel. Evidence suggests
that these harmful unregulated cosmetics, such as skin
lightening creams and hair chemical relaxers, are
disproportionately used by women of color. The Committee
encourages NIH to support competitive research grants to fund
epidemiological, social, and behavioral sciences research into
the negative health impacts of chemicals in cosmetic products
and to disseminate the results of these studies, including
public health information strategies to reduce potentially
unsafe exposure. The Committee urges NIH to support research
grants investigating unsafe cosmetic chemical exposures
impacting communities of color and as well as grants
researching the same impacts on professional nail, hair,
barbershop, and beauty salon workers. The Committee thanks
NIMHD for their report submitted in September 2021 summarizing
the state of science and describing NIMHD's collaboration with
FDA.
Research Endowment Program.--The Committee includes no less
than $12,000,000 to support the Research Endowment Program, an
increase of $8,000,000 above the estimated fiscal year 2022
funding level. The Committee notes the recent passage of the
John Lewis NIMHD Research Endowment Revitalization Act to
reinvigorate the Research Endowment Program. The Committee has
provided funds to implement the revitalized program and urges
NIMHD to work swiftly on its implementation. The Committee
further notes that the statutory goal of the program is to
assist eligible institutions in achieving a research endowment
that is comparable to the mean endowment of health professions
schools in its health professions discipline. The Committee
requests a report no later than 60 days after enactment of this
Act on implementation plans and engagement with key
stakeholders.
Sleep Health and Health Disparities.--The Committee
applauds ongoing and emerging efforts by NIMHD to advance
health equity and address health disparities, including cross-
Institute initiatives and the initiatives identified by the
recent Minority Health and Health Disparities Research
Framework. The Committee notes the disproportionate impact of
sleep deficiencies among populations that experience health
disparities in the U.S., including American Indians/Alaska
Natives, Asian Americans, African Americans, Hispanics/Latinos,
Native Hawaiians and other Pacific Islanders, sexual and gender
minorities, the socioeconomically disadvantaged, and those
living in underserved rural areas. The Committee encourages
further work in and collaboration with community stakeholders
on the issue of sleep health disparities.
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH)
Appropriation, fiscal year 2022....................... $159,365,000
Budget request, fiscal year 2023...................... 183,368,000
Committee Recommendation.............................. 164,395,000
Change from enacted level......................... +5,030,000
Change from budget request........................ -18,973,000
Mission.--The mission of NCCIH is to define, through
rigorous scientific investigation, the usefulness and safety of
complementary and integrative health interventions and their
roles in improving health and health care.
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)
Appropriation, fiscal year 2022....................... $882,265,000
Budget request, fiscal year 2023...................... 873,654,000
Committee Recommendation.............................. 901,678,000
Change from enacted level......................... +19,413,000
Change from budget request........................ +28,024,000
Mission.--NCATS was established to transform the
translational process so that new treatments and cures for
disease can be delivered to patients faster.
Clinical and Translational Science Awards (CTSA) Program.--
The Committee includes no less than $626,059,000 for the CTSA
Program, an increase of $19,413,000 above the fiscal year 2022
enacted level. The Committee reiterates that CTSA funding,
including these additional resources, are intended, to the
greatest extent possible, to enhance support for CTSA hubs so
that they can continue to effectively provide important
collaborative national research infrastructure, train the next
generation of physician-scientists, and provide important local
services and partnerships. The Committee applauds the CTSA
program for its contributions to the rapid response to COVID-
19, efforts to address health disparities and deliver
innovative care in rural areas, and to provide critical support
for other national priorities and translational research
activities.
Cures Acceleration Network.--The Committee includes up to
$60,000,000 for the Cures Acceleration Network, the same as the
fiscal year 2022 enacted level.
Collaboration with Business Incubators.--The Committee
urges NCATS to redouble its efforts to leverage its mission by
exploring opportunities or potential collaborations with
business incubators that host small to mid-size science,
research, and pharmaceutical companies that use service-based
approaches to nurture and guide their member companies to
success.
Full Spectrum of Medical Research.--The Committee
recognizes the emerging role that the full spectrum of medical
research is playing in across NIH Institutes and Centers to
ensure that advancements in basic science are translated into
innovative therapies and diagnostic tools, and improved care
and public health information. The Committee notes the
relevance of the CTSA program to a variety on ongoing and
emerging NIH research activities, including the importance of
training and career development to adequately enhance the
translational science workforce.
National COVID Cohort Collaborative (N3C).--The Committee
continues to support NCATS N3C's open-science platform to
accelerate biomedical research and discovery. N3C is the
largest public clinical repository of COVID-19 data in the
U.S., enabling collaborative research between more than 3,500
researchers from over 300 institutions to answer research
questions such as the cause of long COVID-19 and how COVID-19
affects children. The Committee encourages NCATS to consider
expanding the platform to accelerate research and cures for
other high-priority diseases such as cancer and other rare
diseases.
Rare Disease Research.--The Committee encourages NCATS to
increase support for rare disease funding opportunities,
including for the Rare Disease Clinical Research Network, the
Therapeutics for Rare and Neglected Diseases program, and other
grant opportunities to help increase the speed of rare disease
therapeutic and diagnostic development. Accelerating rare
disease research will allow society to capitalize on the
evolution of science in rare diseases, leading to new
treatments for the 93-95 percent of rare diseases with no
approved treatments and innovative diagnostics to help shorten
the average 6.3 year-long diagnostic odyssey and lower the
nearly $1 trillion annual economic burden of rare diseases.
JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)
Appropriation, fiscal year 2022....................... $86,880,000
Budget request, fiscal year 2023...................... 95,801,000
Committee Recommendation.............................. 99,622,000
Change from enacted level......................... +12,742,000
Change from budget request........................ +3,821,000
Mission.--FIC's mission is to support and facilitate global
health research conducted by U.S. and international
investigators, building partnerships between health research
institutions in the U.S. and abroad, and training the next
generation of scientists to address global health needs.
The Fogarty International Center supports cross-cutting
research and research training programs that apply to a broad
range of health threats, enabling grantees and trainees to
anticipate and respond effectively to new global challenges.
Fogarty programs also support training for researchers in the
development and use of powerful tools such as data science,
mobile health, and bioinformatics, which are applied to
anticipating and controlling a wide range of global health
threats that could impact the U.S. The Committee encourages FIC
to continue to expand training and research partnerships with
schools and programs of public health and related academic
institutions in support of this core mission, including new
investments to support health disparities and pandemic research
preparedness and response.
In light of the global impact of COVID-19, the Committee
recognizes the need to continue steadily increasing the
resources of FIC to support its work to strengthen health
research systems, train health researchers and improve pandemic
preparedness in low- and middle-income countries (LMICs). Over
more than five decades, FIC has developed strong partnerships
in LMICs to train researchers to respond to and prevent
emerging and enduring infectious disease and other health
threats. The COVID-19 pandemic underscores the value of FIC's
efforts to strengthen research capacity in LMICs, increasing
the likelihood that emerging diseases can be quickly addressed
wherever they appear--ultimately protecting American health
security. The Committee also recognizes that investing in
health research capacity in LMICs leads to reciprocal
innovation and produces tools that can drive down health care
costs and increase impact and effectiveness in low-resource
settings everywhere, including in the U.S. The Committee
believes FIC's long-standing partnerships and unique
capabilities position it to play an expanded role in pandemic
preparedness and health research capacity building, including
by strengthening international research coordination, building
capacity for computational modeling and outbreak analytics,
supporting research to reduce health disparities, and improving
implementation of health interventions in low-resource
settings.
Health Disparities Research.--The Committee includes an
increase of $10,000,000 for FIC to support additional research
related to identifying and reducing health disparities, as
described in the fiscal year 2023 budget request.
Obstetric Fistula Research.--Worldwide, an estimated
500,000 women and girls live with obstetric fistula, with
thousands more occurring annually. It occurs disproportionately
among impoverished, vulnerable, and marginalized girls and
women. Skilled health personnel at birth and emergency
obstetric and newborn care can ensure obstetric fistula is
prevented. The Committee is concerned that fistula repairs were
widely halted due to COVID-19, as they were deemed non-urgent
and unsafe during the pandemic. This may result in an increased
backlog of fistula cases. The Committee is concerned that not
enough funding is provided to support existing academic
curricula for the education and training for health care
providers on obstetric fistula. The Committee requests a report
regarding the annual support level for this training funding
over the past five years, including the types of grants
supported, in the fiscal year 2024 Congressional Justification.
NATIONAL LIBRARY OF MEDICINE (NLM)
Appropriation, fiscal year 2022....................... $479,439,000
Budget request, fiscal year 2023...................... 471,998,000
Committee Recommendation.............................. 494,572,000
Change from enacted level......................... +15,133,000
Change from budget request........................ +22,574,000
Mission.--As a leader in computational health and the
world's largest medical library, NLM collects, organizes,
preserves, and disseminates data and information important to
biomedicine and health; 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 Network of the National Library of Medicine;
provides grants for research in biomedical communications,
medical library development, and training health information
specialists; conducts and supports research and research
training in biomedical informatics, computational health,
computational biology, and data science; supports development,
maintenance, and dissemination of health data standards that
promote interoperability among clinical and research
information systems; and manages and maintains information
resources for genomics, molecular biology, clinical trials,
medical images, environmental health, public health, and health
services research.
OFFICE OF THE DIRECTOR (OD)
Appropriation, fiscal year 2022....................... $2,629,120,000
Budget request, fiscal year 2023...................... 2,314,665,000
Committee Recommendation.............................. 2,549,813,000
Change from enacted level......................... -79,307,000
Change from budget request........................ +235,148,000
The Committee recommendation includes $2,537,213,000 in
discretionary appropriations and an additional $12,600,000 made
available in the Gabriella Miller Kids First Research Act.
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.
The items below include issues and programs specific to the
Office of the Director as well as those that involve multiple
Institutes and Centers.
Adoption of Dogs, Cats, and Rabbits Used in Research.--The
Committee encourages NIH to recommend that grantees receiving
extramural funds from NIH for research using dogs, cats, or
rabbits implement post-research adoption policies for those
animals and to maintain records on the aggregate number of
animals released for adoption. The post-research adoption
policies and animal release numbers should be made publicly
available.
Advancing Cell-Based Therapies.--The Committee recognizes
that cell-based therapies hold promise for a broad range of
conditions, including neurological conditions, musculoskeletal
conditions, cancer, radiation damage, cardiovascular disease,
diabetes, wound healing, and immunological disease. The
Committee encourages NIH to support research, development, and
manufacturing of adult cell-based therapies for patients with
serious or life-threatening conditions. The Committee
encourages NIH to support clinical trials and pre-clinical
research exploring the use of adult cell-based therapies for
serious or life-threatening conditions; support development,
characterization, optimization, and scaling of manufacturing of
cell-based therapies; support sharing of best practices and
lessons learned; workforce development activities; and
collaborative evidence development, including continued NIH
collaboration with FDA and HRSA to enhance transparency
regarding outcomes from cellular therapies from adult (somatic)
cells that are FDA-approved or being administered under FDA
Investigational New Drug or Investigational Device Exemption
protocols by ensuring that results are submitted to appropriate
databases such as the Stem Cell Therapeutics Outcomes Database
and ClinicalTrials.gov.
All of Us Research Program.--The Committee provides a total
of $541,000,000 for the All of Us Research Program Precision
Medicine Initiative, the same as the fiscal year 2022 enacted
level and the fiscal year 2023 budget request. The total
includes $419,000,000 authorized in the Cures Act to be
transferred from the NIH Innovation Account. All of Us' mission
is to accelerate health research and medical breakthroughs to
enable individualized prevention, treatment, and care for all
of us. As of the beginning of June 2022, the All of Us Research
Program enrolled 497,000 participants, more than 341,000 of
whom have completed the initial steps of the program. About 80
percent of these individuals are from populations that have
largely been overlooked in past research, including rural
communities, people with lower incomes, those who self-identify
as belonging to racial or and ethnic minority groups, and
others. In March 2022, the program released nearly 100,000
whole genome sequences and data from 165,000 genotyping arrays
in its Researcher Workbench for the research community to
analyze. This data can be used in concert with the robust
information the program's participants have previously donated,
including responses to surveys and electronic health records.
Nearly half of the genomic information comes from people who
identify with a racial or ethnic minority group, making the
dataset one of the most diverse in the world. To date, more
than 90 percent of participants in genome-wide association
studies worldwide have been of European descent. All of Us'
efforts to recruit and retain participants that have been
historically underrepresented in research is imperative to
ensure that future discoveries benefit all.
ALS Research, Treatments, and Expanded Access.--The
Committee believes it is critically important that NIH
continues to grow its investment in ALS research to capitalize
on the momentum to find new treatments for ALS and a cure for
the disease. The Committee recognizes that each year, only a
small portion of research funds are spent on new research
projects. The Committee strongly urges NIH to maintain the ALS
drug ecosystem with additional grant funding for extramural
research through NINDS. In addition, The Committee urges NIH to
continue to increase support and momentum for ALS research that
can lead to new treatments and better care as quickly as
possible, as well as support expanded access research for ALS
investigational drugs. In addition, the Committee urges NIH to
handle funding of expanded access grants as authorized in the
ACT for ALS (P.L. 117-79) as separate, and not competing with,
funding for other research on ALS and includes $75,000,000 for
this purpose, an increase of $50,000,000 above the fiscal year
2022 enacted level.
Amyloidosis.--The Committee strongly encourages NIH to
expand its research efforts in amyloidosis, a group of rare
diseases characterized by abnormally folded protein deposits in
tissues. Although amyloidosis is often fatal, Federal and
foundation support over the past years has given hope for
successful new treatments. More efforts are needed to
accelerate research and awareness of the disease and to help
patients with amyloidosis related multi-organ dysfunction. The
Committee also directs NIH to provide an update in the fiscal
year 2024 Congressional Justification on the steps NIH has
taken to expand research into the causes of amyloidosis and the
measures taken to improve the diagnosis and treatment of this
devastating group of diseases.
Artificial Intelligence to Address Chronic Diseases.--The
Committee supports NIH's efforts to use artificial intelligence
(AI) to gain a deeper understanding of the underlying causes of
chronic diseases, including health disparities, and to identify
successful early treatments. The Committee provides sufficient
resources to support NIH efforts to employ advanced
technologies such as AI, machine learning, deep learning, and
related approaches to enhance the collection, integration,
analyses, and interpretation of data related to the onset,
progression, and treatment of chronic diseases.
Autoimmune Diseases.--The Committee recognizes that a
recent report by NASEM recommends that NIH establish an office
to support the coordination of all autoimmune diseases research
across Institutes and Centers. The Committee encourages NIH to
implement this recommendation, and additionally urges NIH to
develop clear, consistent, and uniform guidance around
autoimmunity, including a shared, working definition applicable
to autoimmune disease research and how these efforts should be
worked into the broader policies. The Committee also encourages
NIH to establish long-term systems in determining numbers of
autoimmune patients and mortality rates in the U.S. comparable
to NCI's SEER database, support the development of population
cohorts of the progression and coexisting morbidities, and
provide funding and support for a national research agenda that
addresses critical gaps. The Committee encourages NIH to work
with health partners and relevant patient organizations to
ensure a bidirectional relationship is developed between the
agency and the autoimmune community that includes a more
consistent approach to communicating new or updated guidance
pertinent to the community, and that creates a foundation for
improving the quality of lives for patients of autoimmune
diseases.
Autism Spectrum Disorder (ASD).--Recent reports indicate
that an estimated one in 44 children in the U.S. is diagnosed
with an ASD. While early intervention affords the best
opportunity to support healthy development, many children with
an autism diagnosis lack access to quality care and
interventions. The Committee is encouraged by the growing
evidence that caregiver-mediated early intervention can lead to
improved child developmental outcomes, improved caregiver-
reported skills and knowledge, and reduced stress. The
Committee encourages NIH to invest in implementation-focused
research that targets caregiver-mediated interventions,
including caregiver skills training and naturalistic
developmental behavioral interventions. The Committee strongly
encourages NIH to work collaboratively across Institutes and
Centers in this effort to ensure culturally competent
approaches. Furthermore, the Committee is supportive of the
research recommendations included in the Interagency Autism
Coordinating Committee's (IACC) Strategic Plan for ASD. The
Committee urges the NIH to provide an update on its investment
across the priority areas outlined in the IACC Strategic Plan
in the fiscal year 2024 Congressional Justification.
Biomedical Research Facilities.--The Committee includes
$60,000,000, the same as the fiscal year 2022 enacted level,
for grants to public and/or nonprofit entities to expand,
remodel, renovate, or alter existing research facilities or
construct new research facilities as authorized under 42 U.S.C.
section 283k. The Committee urges NIH to make awards to support
a significant number of newly constructed or renovated
facilities.
Biomedical Research Workforce Diversity.--The Committee is
concerned with the impact of COVID-19 on the diversity of the
biomedical research workforce, particularly women and women of
color across career stages. The Committee strongly encourages
NIH to study the race/ethnicity and sex/gender breakdown of the
impact of COVID on participation in the workforce by monitoring
the sex/gender and race/ethnicity of principal investigators
designated on applications from and awards to institutions for
two years. If the data demonstrate that fewer women are
designated on applications from institutions for grants, then
it is imperative that NIH take steps to address this disparity.
The Committee requests a status update in the fiscal year 2024
Congressional Justification as well as a description of the
steps being taken to maintain and strengthen the diversity of
the biomedical research workforce.
Black Men and Women Pursuing Medicine and Science.--The
Committee supports the efforts of the National Academies
Roundtable on Black Men and Black Women in Science,
Engineering, and Medicine and its efforts to develop specific
programs to increase numbers and effectiveness of Black men and
women pursuing medicine and science and commends NIH for
participating. The Committee directs the Immediate Office of
the Director to allocate increased resources from the Common
Fund of the diversity program consortium to the National
Academies Roundtable on Black Men and Black Women in Science,
Engineering, and Medicine to address the increasing
underrepresentation of Black men in medical schools and in the
biomedical research profession.
Cannabis Research.--The Committee recognizes that although
concrete steps have been taken towards ameliorating the
regulatory and supply issues hampering cannabis research in the
U.S., funding levels have not kept pace with widespread use of
cannabis and substantial clinical interest in the field.
Cannabis is fully legal in 18 States and the District of
Columbia, effectively so in 20 others that permit some form of
medical marijuana, and consumed by nearly half of American
teens and adults at some time in their lives, yet there is
surprisingly little information about its effects on body
chemistry and cognition. The Committee is concerned that
marijuana policies on the Federal level and in the States
(medical marijuana, recreational use, etc.) are being changed
without the benefit of scientific research to help guide those
decisions. While there are FDA-approved prescription
medications that contain cannabidiol or THC which are used to
treat various conditions such as certain seizure disorders and
nausea associated with chemotherapy, research is needed to
determine if cannabis or cannabis products could effectively
treat chronic pain, certain mental illnesses, opioid use
disorder or other substance use disorders, among other
conditions. Therefore, the Committee encourages NIH to fund
cannabis research to study efficacy of cannabinoid therapies
for patients. NIH is encouraged to continue supporting a full
range of research on the health effects of marijuana and its
components, including research to understand how marijuana
policies affect public health.
Childhood Post-Infectious Neuroimmune Disorders/PANS/
PANDAS.--The Committee strongly encourages NIH to advance
research and education related to the devastating diseases of
Pediatric Acute-Onset Neuropsychiatric Syndromes (PANS) and
Pediatric Autoimmune Neuropsychiatric Disorders Associated with
Streptococcus (PANDAS). Although NIH has undertaken some
research in this area, more research is necessary to fully
understand causes, diagnosis, and treatment. Training the
medical community is essential to early identification and
intervention, reducing the risk of chronic illness and
associated costs to families, school systems, health care
systems, and insurers. The association between neuropsychiatric
illness and infections has become even more evident because of
SARS-CoV-2 and provides increasing opportunities for
breakthroughs in research and treatment. The Committee
encourages NIH to prioritize research in this area, and report
to the Committee in the fiscal year 2024 Congressional
Justification on the progress being made on the understanding
of the costs, causes, diagnostic criteria, and treatment of
these conditions.
Clinical Trial Diversity.--The Committee recognizes NIH's
efforts to increase meaningful participation across the
lifespan of ethnic and racial minority populations and
underrepresented communities in clinical trials. The Committee
encourages NIH to continue improving clinical research
diversity, equity, inclusion, and accessibility by engaging in
proactive outreach efforts to people including women and racial
and ethnic minority groups, underrepresented communities, and
health care organizations serving these populations, to improve
awareness of clinical research, including trials, and
understanding of how people can participate. The Committee
requests an update on these activities in the fiscal year 2024
Congressional Justification.
Collection and Reporting of Animal Research Numbers and
Agency Funding.--Congress has long expressed interest in
reducing the use of animals in NIH-funded research and
replacing them with valid, reliable alternatives. In the NIH
Revitalization Act of 1993, Congress first requested the agency
create a plan for doing so. The Committee also recognizes the
scientific community's stated commitment to the three Rs of
replacement, reduction, and refinement, which requires accurate
counting of animals used in research and accurate reporting of
NIH funding dedicated to projects involving animals. It has
been NIH's policy since 1985 to collect an average daily
inventory of vertebrate animals housed in recipient
institutions that receive agency funding. Domestic facilities
are required to file such documentation every four years as
part of an Animal Welfare Assurance and copies of the documents
are available to the public only through FOIA requests. The
Committee directs that the report requested in the Joint
Explanatory Statement for the Consolidated Appropriations Act,
2022 outlining a plan to improve the accuracy and transparency
of collected data, also include how the agency plans to
annually collect from each NIH funded research facility the
total number of animals bred, housed, and used in the previous
year, sorted by species and pain and distress categories. The
Committee directs NIH to include a draft form for collecting
this information, and details on how the agency will create a
publicly accessible online database for dissemination of this
new information. NIH currently collects such information with
every grant application using the Research & Related Other
Project Information form. NIH's plan should ensure that the
answers for each funded project are publicly searchable via the
Expenditures and Results module of NIH's Research Portfolio
Online Reporting Tools website.
Common Data Elements.--The Committee recognizes the
increasing importance of common data elements (CDEs) that
enable standardized and consistent use of data in research,
especially translational and clinical research, and that
facilitate efforts to replicate and validate findings,
including clinical trials, for a disease area. NIH encourages
use of CDEs including use of the NIH's CDE repository. To
encourage development and use of CDEs in disease areas where
they currently do not exist, the Committee directs the Office
of Data Science Strategy to work with Institutes and Centers to
support efforts to develop CDEs, including through
collaborations with research stakeholders. The Committee also
directs NIH to develop a list of diseases and diseases areas
that stand to benefit most from development of CDEs, including
complex diseases with heterogeneous presentations, such as
autoimmune and immune-mediated conditions, to inform further
NIH efforts to support development of such elements.
Common Fund.--The Committee recommends $678,151,000 for the
Common Fund, and an additional $12,600,000 provided to support
the Gabriella Miller Kids First Research Act for the ninth year
of the ten-year Pediatric Research Initiative. This is
$20,750,000 above the fiscal year 2022 enacted level and
$32,212,000 above the fiscal year 2023 budget request.
Communications with the Committee.--The Committee relies on
its relationships with agency budget offices to do its work.
The Committee expects the NIH Office of Budget to improve the
quality and timeliness of the information that it provides to
the Committee.
Cybersecurity.--The Committee continues to support expanded
cybersecurity efforts at NIH, including enhanced Security
Operations Center functions, expanded threat mitigation and
incident response capabilities, implementation of important
architectural improvements to the NIH network, and
implementation of tools and technologies to identify patterns
of activities that may forecast security risks and allow real
time monitoring of activity across a variety of sources as well
as implementation of mitigation and remediation efforts.
Diabetic Neuropathy.--Diabetic neuropathy is the most
common complication of diabetes, affecting at least 50 percent
of individuals with diabetes and resulting in numbness,
unsteadiness, and chronic pain. Additionally, the annual cost
of managing complications from diabetic neuropathy in the U.S.
is estimated to be more than $10 billion. Despite its high
incidence rate and major impact on quality of life for affected
patients, there are limited treatment options available, and
available options are not effective for all individuals with
diabetic neuropathy. The Committee encourages NIH to fund
collaborative research awards for diabetic neuropathy research
and treatment. The Committee also encourages NIH to fund
additional research on diabetic neuropathy-induced chronic pain
through existing programs such as the HEAL Initiative.
Diet and Chronic Diseases.--The Committee is aware of
ongoing efforts to better understand the impact of diet on
mucosal immunity and the microbiome and the relevance of this
topic to multiple immune-related conditions including Crohn's
disease, ulcerative colitis, allergies, celiac disease,
rheumatoid arthritis, metabolic syndrome, and obesity. The
Committee encourages NIH to identify gaps and research needs
and to encourage research focused on this topic.
Diversifying Research on Health and Wellbeing to include
Asian Americans, Native Hawaiians, and Pacific Islanders.--The
Committee notes that in the last decade, less than one percent
of the NIH's total budget went to research centered on Asian
American, Native Hawaiian, and Pacific Islander (AANHPI) health
outcomes. The lack of data available on AANHPIs, or the failure
to disaggregate from this group, has resulted in misleading
narratives and conclusions made from the lack of available
research. The Committee encourages NIH to support research on
the health and wellbeing of AA and NHPI communities, including
specific AA and NHPI subgroups. In addition to the expansion of
research, the Committee encourages NIH to support in-language
and culturally competent recruitment, outreach, education, and
testing materials to ensure outcomes are representative of
diverse AANHPI populations. The Committee directs NIH to
provide a report to the Committee within one year of enactment
of this Act describing research projects targeted to AA and
NHPI communities, as well as participation barriers, including
language access.
Diversity in NIH Kidney Disease Research Populations.--The
Committee recognizes NIH's commitment to understanding,
evaluating, and resolving racial and ethnic disparities in
health outcomes and adverse social determinants of health for
individuals with chronic kidney disease (CKD) and end stage
renal disease. The Committee directs NIH to submit to the
Committee an update in the fiscal year 2024 Congressional
Justification on NIH research related to kidney disease,
including research focusing on health disparities in the
prevention, diagnosis, and treatment of kidney disease among
racial and ethnic minority populations.
Early-Career Pediatric Researchers.--The Committee remains
concerned about the ongoing challenges in developing the next
generation of researchers--including physician scientists--
focusing their careers in pediatrics. Challenges to the
pediatric research workforce include declining numbers of
graduating medical students choosing to enter the field of
pediatrics, declining numbers of pediatric residents choosing
to enter most pediatric subspecialties, lower transition rates
from early-career to full awards, increased clinical demands,
and limited mentorship opportunities compared to other fields.
If unaddressed, a contraction of the pediatric researcher
pipeline will result in both limited breakthroughs in child
health research and to diminished understanding of adult-onset
conditions given the growing body of research that many such
conditions have their roots in childhood. To begin addressing
this problem, the Committee encourages NIH, through the Trans-
NIH Pediatric Research Consortium (N-PeRC), to explore programs
for NIH-wide early career development focused on early-career
researchers in the field of pediatrics and encourages NIH to
include efforts to recruit researchers from diverse
backgrounds, including those that are from groups
underrepresented in the biomedical research workforce. The
Committee requests an update on progress in the fiscal year
2024 Congressional Justification.
Early-Career Researchers.--The Committee notes that the
mean age of a first R01 award has continued to increase over
the past 25 years. Accordingly, the Committee directs NIH to
examine existing efforts to expand early career research,
including the Next Generation Researchers Initiative, and
provide an update in the fiscal year 2024 Congressional
Justification. The Committee requests that NIH consider
additional actions, including larger payline differentials for
new or early-stage investigator applications, to further
prioritize early career research.
Eating Disorders.--The Committee commends NIH for
supporting multi-Institute research on the chronic, fatal, and
serious mental illnesses encompassing eating disorders that
impact nearly 30,000,000 Americans during their lifetimes, and
their association with other conditions such as co-morbid
mental illnesses, substance use disorder, and metabolic,
cardiovascular, neurological, and reproductive disturbances.
The Committee encourages NIH to increase resources for eating
disorders research and directs NIMH, NIMHD, NICHD, and NIDA to
provide the Committee with an update within 180 days of
enactment of this Act on research gaps in the genetics,
prevention, diagnosis, and treatment of eating disorders.
Ehlers-Danlos Syndrome.--The Committee encourages NIH to
support research activities with respect to Ehlers-Danlos
Syndrome and related connective tissue disorders.
Environmental Influences on Child Health Outcomes (ECHO).--
The Committee includes $180,000,000, the same as the fiscal
year 2022 enacted level and the fiscal year 2023 budget
request, for the ECHO Project, which has the potential to
greatly increase understanding of critical determinants of
health across the lifespan, through its observational cohorts
and the IDeA States Pediatric Clinical Trials Network. The
Committee encourages continued communication about to the
program's progress toward goals, milestones, and projected
funding estimates with both external stakeholders and Congress.
Faculty Institutional Recruitment for Sustainable
Transformation (FIRST) Program.--The Committee applauds NIH for
its continuous efforts to diversify the biomedical workforce
and is encouraged by the recent FIRST program that was
established to create a more inclusive and diverse biomedical
research workforce through cluster hiring and institutional
culture shifts. To build on these investments, the Committee
directs NIH to provide increased and robust funding to the NIH
Common Fund for the continuation of the FIRST program.
Federal Advisory Committees Transparency Initiative.--The
Committee continues to focus on improving transparency for
Federal advisory committees established pursuant to 42 U.S.C.
282(b)(16). The Committee appreciates that NIH ensures all its
Federal advisory committees operate in accordance with the
provisions of the Federal Advisory Committee Act, as amended (5
U.S.C., Appendix 2), including the Literature Selection
Technical Review Committee (LSTRC). The Committee appreciates
the steps NIH has taken to further enhance the transparency of
MEDLINE processes through via its centralized MEDLINE website.
The Committee encourages NIH to continue its commitment to
ensure all its committees, including the LSTRC, operate in a
transparent manner in accordance with the provisions of the
Federal Advisory Committee Act.
Firearm Injury and Mortality Prevention Research.--The
Committee includes $25,000,000 to support research on the
prevention of firearm violence, $12,500,000 above the fiscal
year 2022 enacted level and the same as the fiscal year 2023
budget request. The Committee also directs NIH to collaborate
with the National Institute of Justice to compile, share, and
improve firearm violence data. Such data must include the
Uniform Crime Report (UCR) and include data from hospitals
treating victims of nonfatal gunshot wounds.
Foreign Threats to Research.--Foreign government actors
continue to have an interest in engaging in the theft of
intellectual property from NIH and its funding recipients,
posing risks to the integrity of NIH-supported research, fair
competition, and the public's trust in resulting outcomes. The
Committee directs NIH to provide biannual briefings on the
progress of investigations into these efforts, as well as the
institutions, scientists, and research affected. The Committee
continues to direct NIH to transfer $5,000,000 to the Inspector
General to continue additional investigations into this issue.
Foundations of Evidence-Based Policymaking Act and OPEN
Government Data Act.--The Foundations of Evidence-Based
Policymaking Act of 2018 (P.L. 115-435) and the OPEN Government
Data Act, which was enacted as part of P.L. 115-435 can aid in
the discovery and sharing of publicly-funded biomedical
research and public health data. The Committee requests a
report no later than 120 days after enactment of this Act on
the implementation and progress being made across NIH to comply
with this legislation by ensuring that all non-sensitive
government data be made available in open and machine-readable
formats by default.
Fragile X.--The Committee notes the importance of expanding
the base of researchers and clinicians who are familiar with
and trained in the fragile X-associated disorders and promoting
collaboration between basic scientists and clinicians to enable
researchers to better understand phenotypes, document
variations in how the disorder presents itself, identify
potential biomarkers and outcome measures, and develop new
interventions. The Committee also commends NIH for recognizing
the ethical, legal, and social issues in premutation screening
and testing and encourages NIH to consider at existing pilot
studies that are looking at innovative ways to screen newborns,
and to coordinate efforts with CDC as they consider at
screening solutions for FMR1-related conditions.
Gabriella Miller Kids First Pediatric Research Program.--
The Committee recognizes that pediatric cancer and birth
defects are a leading cause of death among children and are
still poorly understood. Childhood cancer also has lasting
negative health effects on children who do survive due to the
high levels of toxicity associated with treatment. The
Committee acknowledges that the Gabriella Miller Kids First
Research Program enables researchers to uncover new insights
into the biology of childhood cancer and birth defects. Since
its inception, Kids First has initiated the Gabriella Miller
Kids First Data Resource Center, which is a comprehensive data
resource for research and patient communities meant to advance
discoveries. The Committee recognizes the progress that the
Program has made towards understanding childhood cancer and
birth defects and provides $12,600,000 to support pediatric
research as authorized by the Gabriella Miller Kids First
Research Act (P.L. 113-94). The funding provided helps lay the
foundation for expanded research in future years.
Gene-Environment Interactions in Neurodegenerative
Disorders in the Diverse Populations of Black/African Americans
and Hispanics/Latinos.--In the context of NIH's robust
neurological disease research portfolio, the Committee commends
the leadership of NIH in advancing the relevant objectives of
the Cures Act and the BRAIN Initiative. The Committee is
concerned and recognizes the need to better understand the
interactions between genetics and environmental factors, in
particular with older and diverse populations of Black/African
Americans and Hispanics/Latinos. The Committee encourages NIH
to accelerate collaborative research across relevant Institutes
and Centers and the research community to better understand
structural level and intermediary levels of the social
determinants of health, namely those that may potentially
identify the interaction between environmental exposures to
toxic chemicals and genetics and their impact on
neurodegenerative disorders in diverse populations of Black/
African Americans and Hispanics/Latinos, to allow for earlier
and more accurate diagnosis and subsequent treatment to arrest
the progression of these devastating neurodegenerative
disorders.
Geroscience.--The Committee applauds NIH for recognizing
the importance of geroscience to a wide range of chronic
conditions and diseases by creating the Cellular Senescence
Network (SenNet), an effort to identify and characterize the
differences in senescent cells across the body, within the
Common Fund. While NIA serves as the lead Institute for
geroscience, programs such as SenNet demonstrate how all
Institutes and Centers benefit from a greater understanding of
this field, given the wide range of chronic conditions and
diseases that are influenced by the biology of aging. To date,
however, NIH has not analyzed which topics in geroscience are
currently being addressed across the Institutes and Centers or
how much funding the Institutes and Centers are using to
support this research. The lack of this information limits
NIH's ability to address research gaps in a strategic way.
Therefore, the Committee encourages NIH to submit a report
within 180 days of enactment of this Act that describes current
NIH research focused on geroscience and future plans in this
area. The Committee would also welcome exploration of a trans-
NIH initiative. Such an initiative might include increased
funding for basic, translational, and clinical research,
research infrastructure, workforce development, the development
of platform technologies for geroscience, and collaboration
with the FDA, industry, and academia on the discovery and
validation of biomarkers.
HEALthy Brain and Child Development (HBCD) Study.--The
Committee recognizes and supports the NIH HEALthy Brain and
Child Development Study, which will establish a large cohort of
pregnant individuals and follow them and their children up to
age 10 to characterize the influence of a variety of factors on
neurodevelopment and long-term outcomes. The study aims to
enroll approximately 7,500 pregnant individuals through 25
research sites across the U.S., including regions of the
country significantly affected by the opioid crisis. The study
cohort will comprise participants that reflect the U.S.
population but will oversample for individuals that have used
substances sometime during their pregnancy and a matching
cohort with similar characteristics, but no substance exposure
during the pregnancy. Multimodal data collection will include
neuroimaging, behavioral and cognitive assessments as well as
collection of biospecimens and brain activity measurements.
Knowledge gained will be critical to help predict and prevent
some of the known impacts of pre- and postnatal exposure to
drugs and environmental influences, including risk for future
illicit substance use, mental disorders, and other behavioral
and developmental problems as well as identify factors that
contribute to resilience and opportunities for intervention.
The Committee recognizes that the HBCD Study is supported in
part by the NIH HEAL Initiative, and NIH Institutes, Centers,
and Offices, including OBSSR, ORWH, NEI, NIMHD, NIBIB, NIMH,
NIEHS, NICHD, NINDS, NIAAA, NIMH, and NIDA, and encourages
additional NIH support for this important study.
Hearing Health Screening for Older Adults.--The Committee
recognizes the associated comorbidities and costs of untreated
hearing loss and, with the growing aging population, the
importance of hearing screening for older Americans. The
Committee urges NIH to provide an update in the fiscal year
2024 Congressional Justification on hearing screening research
for older adults across NIH. The Committee encourages NIDCD and
NIA to support studies that address the research needs and gaps
identified by the USPSTF in their review of hearing screening
recommendations for older Americans.
Hepatitis B (HBV).--The Committee applauds NIH for its work
to update the Strategic Plan for Trans-NIH Research to Cure
Hepatitis B and urges that the update identify what has been
learned since the plan was first released and what additional
research is needed to find a cure. The Committee is aware of
strong interest in more research to understand and manage HBV
reactivation and research to understand and develop biomarkers
of disease and therefore recommends these research ideas be
evaluated and supported. The Committee is also aware of the
view within the scientific community that finding a cure for
HBV is a winnable goal and is within reach in the near-term and
therefore remains concerned that the slow growth in NIH-funded
HBV research could compromise the goal of finding a cure. For
these reasons, the Committee applauds efforts to create common
resource services and materials for the research community and
further urges that targeted calls for research, based on the
needs as identified in the updated Plan, be issued and funded
in fiscal year 2023 and beyond.
Herpes Simplex Virus, Types 1 and 2.--The Committee
recognizes the serious nature of herpes simplex virus, a
neuropathic infectious disease which impacts nearly one in two
Americans, and the critical need for Federal investment in
treatment and prevention. The Committee is concerned with
potential health, quality of life, and economic impacts for
herpes simplex virus seropositive individuals, as well as the
risk for severe, persistent disease in a significant portion of
Americans. The Committee directs NIH to prioritize research and
development of curative approaches to herpes simplex virus,
with a specific focus on research projects with commercial
viability and intention of bringing new HSV treatments to
market.
The Committee understands that herpes simplex virus is a
pathogen with considerations beyond a single NIH Institute or
Center and directs NIH to assemble a multi-council working
group to ensure a coordinated and focused effort across NIH.
Institutes and Centers may include, but are not limited to:
NIAID, NIMH, NCI, NIA, NIMHD and NINDS. This working group will
assemble a review of NIH efforts in herpes simplex virus
treatment and prevention with commercial viability, outline
gaps and/or misconceptions in currently available research, and
outline future priority areas for new clinical research, with a
focus on addressing Americans holistic health and well-being.
The multi-council working group will also provide a funding
analysis to illustrate NIH priorities, gaps, and opportunities
in clinical research of HSV treatment to date.
HIV/AIDS Research.--The Committee includes no less than
$3,394,283,000 for HIV/AIDS research, an increase of
$200,000,000 above the estimated fiscal year 2022 level. While
great advancements have been made in HIV prevention, care, and
treatment over the last 30 years, more must be done to improve
the lives of the more than one million Americans with HIV,
especially with over 36,000 new diagnoses in the U.S. in 2019
alone. The targeted HIV/AIDS research funding at NIH is needed
to improve diagnosis, linkage to, and retention in care for
persons with HIV; prevent at-risk populations from HIV
acquisition and transmission; develop more effective treatments
and evidence-based interventions; and ultimately discover a
cure for HIV.
HIV and Aging.--The Committee encourages the NIH Office of
AIDS Research to fund interdisciplinary research and training
programs in HIV and aging to increase understanding of HIV
across the lifespan and to expand the diverse HIV workforce
that addresses the unique health needs of this population.
Humane Research Alternatives.--Recognizing that humane,
cost-effective, and scientifically suitable non-animal methods
are available for certain research models but underutilized,
the Committee directs NIH to establish incentives to encourage
investigators to utilize non-animal methods whenever
appropriate for the research question and establish
standardized guidelines for peer review evaluation of the
justification for research with animals.
Hypermobile Ehlers-Danlos Syndrome.--Hypermobile Ehlers-
Danlos Syndrome (hEDS) is an autosomal dominant connective
tissue disorder that attacks connective tissues in nearly every
organ System. Data from the NIH All of Us research program
shows hEDS has a disease prevalence of approximately one in
300. This chronic condition initiates during adolescence or
earlier and disproportionately affects females (90 percent
versus 10 percent male). Patients with hEDS progress from a
normal, active lifestyle to one filled with surgeries and, in
severe cases, to becoming wheelchair bound. hEDS takes an
average of 14 years to diagnose, partially due to the lack of a
clear genetic marker and very little clinical and research
attention to date. Patients suffering from hEDS are typically
young girls, who undergo an average of six surgeries before
reaching the age of 25.
The Committee is aware that researchers recently identified
the first disease gene for hEDS and have developed the first
hEDS animal model. In order to continue strides forward and
expedite translational discoveries of cures, treatments and
diagnosis, the Committee encourages NIH to increase support for
hEDS related research at academic medical centers where hEDS
patients are being treated. This investment could help lead to
diagnostic markers of disease and provide the basis for long-
term sustainable research programs. In addition, the Committee
encourages NIH to evaluate the best approach to establishing
multi-institution centers that can serve as regional institutes
to spur earlier diagnosis and improved treatment, care,
education and mechanistic understanding of hEDS.
INCLUDE Down Syndrome Research Initiative.--The Committee
includes no less than $90,000,000, an increase of $15,000,000
above the fiscal year 2022 enacted level, within OD for the
INCLUDE Initiative. The Committee is pleased that this multi-
year, trans-NIH research initiative continues to drive
important advances in understanding immune system
dysregulation, Alzheimer's disease, and leukemia that is
contributing to improvements in the health outcomes and quality
of life of individuals with Down syndrome as well as millions
of typical individuals. The Committee continues to encourage
NIH to make further investments in health equity-focused
research and care including for African Americans with Down
syndrome, mosaic Down syndrome, those with the dual diagnosis
of Down syndrome and autism or regression, with additional
attention to neurodevelopment, metabolism, large cohort studies
across the lifespan, and novel clinical trials. The Committee
requests that NIH provide an updated plan within 60 days of
enactment of this Act that includes a timeline and description
of potential grant opportunities and deadlines for all expected
funding opportunities so that young investigators and new
research institutions may be further encouraged to explore
research in this space. This plan should also incorporate and
increase pipeline research initiatives specific to Down
syndrome.
Infection-Associated Illnesses.--The Committee recognizes
the scientific and clinical opportunities in infection-
associated illnesses research and strongly encourages NIH to
continue and expand its efforts to understand the underlying
causes and risk factors for individuals with long COVID and ME/
CFS, with a focus on diagnosis, treatment, and prevention. The
Committee encourages NIH to support multidisciplinary efforts
related to expanding existing long COVID research efforts to
include study participants with ME/CFS and other overlapping
infection-associated illnesses.
Interagency Coordinating Committee on the Validation of
Alternative Methods (ICCVAM).--The Committee is aware that the
Government Accountability Office recommended that NIEHS (1)
facilitate the establishment of a workgroup of ICCVAM member
agencies to develop metrics that member agencies could use to
assess the progress made toward reducing, refining, or
replacing animal use in testing and (2) incorporate those
metrics into the committee's biennial progress reports. The
Committee urges ICCVAM to provide an update on progress made,
including publication of the Biennial Report with information
individual agency metrics.
Long COVID.--The Committee is concerned about the
prevalence of long COVID in patients who have previously been
diagnosed with COVID-19. Many people suffering with symptoms
consistent with long COVID have been reduced to part-time work
or are unable to work at all. While there are no therapeutics
currently on the market for this condition, there are current
FDA-approved services being used to treat long-term vascular
disease which may also show promise in reducing long COVID
symptoms. The Committee urges NIH to conduct clinical trials
which seek to improve long COVID-related clinical markers and
outcomes, with a specific focus on improvement of symptoms that
can lead to full resumption of daily activities and return to
work. The Committee also strongly encourages the Secretary to
increase access to treatments of vascular disease that could
also treat symptoms associated with long COVID. The agency is
directed to prioritize access to such treatments in areas with
higher prevalence of patients with heart disease.
Lyme and Other Tick-Borne Diseases.--The Committee
encourages NIH to hold a public workshop on the molecular
mechanisms that Borrelia burgdorferi (Bb) employs to evade the
human immune system, the human immune responses and
consequences of Bb infection, and how these mechanisms and
responses may influence the effectiveness of antibiotics.
The Committee recognizes that there have been only a small
number of clinical trials involving Lyme disease, which lacks a
gold standard test, and that those trials have involved a
relatively small number of patients. Because of the clear
neurological dysfunction of Lyme disease and the existence of
the Network for Excellence in Neuroscience Clinical Trials
(NeuroNEXT), the Committee encourages NINDS to evaluate how it
may contribute to improvements in tools to manage Lyme disease.
The Committee asks NIH to consider the value of
establishing a work group on long-term, not well understood
outcomes for different diseases with similar long-term
sequelae, particularly SARS-CoV-2 infection and Lyme disease,
taking into account the input of patients not fully recovered
from these infections and who offer experiences and insights,
such as called for in RECOVER.
Finally, the Committee encourages NIH to intensify research
on adverse outcomes related to Lyme disease during pregnancy
and to continue to participate with Lyme advocacy organizations
on these issues.
Maintenance of Chimpanzees on US Air Force Bases.--When
Congress passed the CHIMP Act, it intended for all chimpanzees
owned by NIH to be retired to a sanctuary. Despite this, in
2019 NIH announced 44 chimpanzees housed at the Alamogordo
Primate Facility (APF) and in 2021 announced that another 51
chimpanzees from the Keeling Center for Comparative Medicine
and Research (KCCMR) would not be transferred to Chimp Haven,
the national sanctuary. The Committee has previously noted in
its fiscal year 2022 report that the chimpanzees must be
provided an opportunity to live the remainder of their lives in
the national sanctuary. As such, the Committee strongly urges
NIH to reevaluate the remaining animals at APF, KCCMR and the
Southwest National Primate Research Center (SNPRC) and assess
options for their transport to the national sanctuary. The
Committee also directs NIH to provide a written report to the
Committee each quarter, beginning no later than January 31,
2023 that shall include: (1) the number of chimpanzees
transported to the national sanctuary over the last quarter;
(2) a census of all government-owned and supported chimpanzees
remaining, if any, at APF, KCCMR or SNPRC and results of any
reevaluations of their health; and (3) a list of any chimpanzee
deaths that have occurred at any time after January 1, 2022 at
APF, KCCMR or SNPRC.
Maternal Health Research.--Research is critically important
to optimizing the health of women and their families in the
U.S. and identifying the causes behind pregnancy-related deaths
and complications. The vast majority of research in pregnancy
in the U.S. is supported by NIH. Each Institute and Center
supports at least one grant or project related to pregnancy-
related research, with NICHD consistently providing the
greatest support of perinatal research in the U.S. NICHD's work
includes the Maternal-Fetal Medicine Units Network (MFMU), a
network of centers across the country that conduct clinical
studies to improve maternal, fetal, and neonatal health. NICHD
is also working to advance safe and effective therapies for
pregnant and lactating women as recommended in the report
released in 2018 by the Federal Task Force on Research Specific
to Pregnant Women and Lactating Women (authorized under P.L.
114-255) and the implementation plan released in 2020. NICHD
funding also supports research to address gaps in our
understanding of the best way to support pregnant and
postpartum women with a substance use disorder. Strengthened,
prioritized support for maternal health research at the NIH is
crucial to fully understanding the health inequities and
disparities in outcomes that the U.S. is facing.
Menopause.--The Committee is concerned about the lack of an
RCDC category for menopause, which limits the ability to
analyze current and future biomedical research being done on
menopause and its short- and long-term effects on the health of
women. As menopause is a female-specific condition and an
important component of understanding women's health across the
lifespan, it is critical that NIH report on and be able to
track the intramural and extramural research supported by NIH.
The Committee requests that NIH create a RCDC category for the
menopausal transition and its related health conditions.
Microbicides.--The Committee recognizes that with NIH and
USAID leadership, research has shown the potential for
antiretroviral (ARV) drugs to prevent HIV infection in women.
The Committee encourages NIH to continue coordination with
USAID, the State Department, and others to advance ARV-based
microbicide development efforts with the goal of enabling
regulatory approvals and product access of safe and effective
microbicides for women.
Mitochondrial Disease Research.--The Committee urges NIH to
increase its support for primary mitochondrial disease research
and to prioritize the development of potentially life-saving
therapeutics. The Committee strongly encourages NIH to consider
funding at least one mitochondrial disease center of excellence
to centralize a critical mass of research, clinical care, and
provider education. The Committee encourages NIH to consider
supporting research on the role of mitochondrial function in
long COVID.
Mucopolysaccharidoses and Mucolipidosis (MPS/ML).--The
Committee recognizes the severity of MPS/ML diseases and
encourages NIH to support additional research in order to
improve life expectancy and quality of life for patients.
National Laboratories.--NIH funding supports investments
which are collaborative with the ongoing work of the Department
of Energy (DOE). The Committee directs NIH to update the
Committee on the work to coordinate its efforts with DOE and
the National Laboratories, and in more strategic ways to
leverage NIH's research needs in the next generation of cancer
research, brain mapping, drug development, or other emerging
ideas in biomedical research that requires DOE's
instrumentation, materials, modeling simulation, and data
science. In 2015, the Secretary of Energy established the
Energy Advisory Board (SEAB) to evaluate the prospects for
increased collaboration between DOE researchers and biomedical
scientists supported by other agencies, especially NIH.
Increased and more effective coordination could be instrumental
to assist in the development of the Nation's health, security,
novel biomedical technologies, and in the development of more
strategic enabling technologies. The Committee supports NIH's
collaboration with DOE and the National Laboratories in an
effort to maximize utilization of DOE's capabilities,
particularly for NIH's rapidly growing data and computational
challenges, and encourages NCI to build off the success of
previous initiatives and consider additional pilots to address
key computation and imaging bottlenecks in cancer research. The
Committee requests an update within 120 days of enactment of
this Act on its ongoing collaborations with DOE and
opportunities for continued partnership growth.
Native Hawaiian/Pacific Islander Health Research.--The
Committee encourages NIH to place a high priority on addressing
Native Hawaiian and Pacific Islander (NHPI) health disparities
as well as supporting the career pathways and research of NHPI
investigators. NIMHD, working with other Institutes and
Centers, is encouraged to develop partnerships with academic
institutions with a proven track record of working closely with
NHPI communities and NHPI-serving organizations and located in
States with significant NHPI populations to support the
development of future researchers from these same communities.
The Committee directs NIMHD to provide an update in the fiscal
year 2023 Congressional Justification on NIH research to
advance NHPI health and faculty researcher development.
Neurofibromatosis (NF).--The Committee supports efforts to
increase funding and resources for NF research and treatment at
multiple Institutes, including NCI, NINDS, NIDCD, NHLBI, NICHD,
NIMH, NCATS, and NEI. Children and adults with NF are at
elevated risk for the development of many forms of cancer,
deafness, blindness, developmental delays, and autism. The
Committee encourages NCI to increase its NF research portfolio
in fundamental laboratory science, patient-directed research,
and clinical trials focused on NF-associated benign and
malignant cancers. The Committee also encourages NCI to
continue to support preclinical research and clinical trials.
Because NF can cause blindness, pain, and hearing loss, the
Committee urges NINDS and NIDCD to continue to support
fundamental basic science research on NF relevant to restoring
normal nerve function. Based on emerging findings from numerous
researchers worldwide demonstrating that children with NF have
a higher chance of developing autism, learning disabilities,
motor delays, and attention deficits, the Committee encourages
NINDS, NIMH, and NICHD to increase their support of clinical
research investigations in these areas. Since NF2 accounts for
some genetic forms of deafness, the Committee encourages NIDCD
to expand its investment in NF2-related research. NF1 can cause
vision loss due to optic gliomas. The Committee encourages NEI
to expand its investment in NF1-focused research on optic
gliomas and vision restoration.
NIH Division of Police.--The Committee notes that the
explanatory statement accompanying the Commerce, Justice,
Science, and Related Agencies Appropriations Act, 2022 directs
the Attorney General to ensure implementation of evidence-based
training programs on de-escalation and the use-of-force, as
well as on police community relations, and the protection of
civil rights, that are broadly applicable and scalable to all
Federal law enforcement agencies. The Committee further notes
that several agencies funded by this Act employ Federal law
enforcement officers and are Federal Law Enforcement Training
Centers partner organizations. The Committee directs NIH to
consult with the Attorney General regarding the implementation
of these programs for their law enforcement officers. The
Committee further directs NIH to submit a report to the
Committee no later than 180 days after consultation with the
Attorney General on their efforts relating to such
implementation. In addition, the Committee directs NIH, to the
extent that they are not already participating, to consult with
the Attorney General and the Director of the FBI regarding
participation in the National Use-of-Force Data Collection. The
Committee further directs NIH to submit a report to the
Committees on Appropriations, no later than 180 days after
enactment of this Act, on their efforts to so participate.
Office of Behavioral and Social Sciences Research
(OBSSR).--The Committee includes no less than the fiscal year
2022 enacted level for OBSSR. The Committee commends OBSSR for
effectively coordinating and supporting essential basic,
clinical, and translational research in the behavioral, social,
and population sciences to advance the NIH mission and
recognizes the critical role of OBSSR to integrate these
sciences throughout the NIH research enterprise via OBSSR's
leadership and coordination. The Committee urges NIH to provide
an update on OBSSR's activities and progress in the fiscal year
2024 Congressional Justification.
The Committee notes that multiple Surgeon General and NASEM
reports have concluded that most diseases and health problems
facing the Nation have significant behavioral components.
Meanwhile, behavioral science issues surrounding the current
pandemic, including vaccine hesitancy and health
misinformation, have made clear that it is important to better
understand healthy behavior and how to improve health
communications. The Committee notes the OBSSR's mission to
enhance NIH's behavioral sciences research enterprise across
all Institutes and Centers, but that its direct authorities to
meet its mission are limited. The Committee is pleased that an
NIH working group was established to review how better to
integrate and realize the benefits of overall health from
behavioral research at NIH, and encourages NIH to consider
appropriate OBSSR funding levels, resources, and organizational
structure to support full implementation of the working group
recommendations.
Office of Nutrition Research.--The Committee includes
$40,000,000 for the Office of Nutrition Research (ONR). With
nutrition research occurring across NIH Institutes and Centers,
ONR's work is essential for coordinating and advancing
nutrition research across NIH and with other Federal agencies.
This investment will accelerate discoveries across numerous
critical areas and positively impact public health, societal
equity, the economy, national security, as well as bolster the
Nation's resilience to current and future threats like COVID-
19.
Office of Research on Women's Health.--The Committee
recommends $64,480,000 for the Office of Research on Women's
Health, an increase of $5,000,000 above the fiscal year 2022
enacted level. This office ensures women's health research and
research on the biological and sociocultural influence of sex
and gender are included within the NIH scientific framework.
The Committee recognizes ORWH's critical leadership in
promoting women's health research and spearheading research
programs like the Specialized Centers of Research Excellence
(SCORE). SCORE is a disease-agnostic research program designed
to expedite the development and translation of basic and
preclinical knowledge to human diseases that affect women, to
learn more about the etiology of these diseases, and to foster
improved approaches to treatment and/or prevention. The SCORE
program also supports pilot research projects to train the next
generation of scientists in the study of sex differences.
Building Interdisciplinary Research Careers in Women's
Health.--Within the total for ORWH, the Committee includes
$5,000,000, an increase of $1,000,000 above the fiscal year
2022 enacted level, for the ORWH's Building Interdisciplinary
Research Careers in Women's Health (BIRCWH) program to fund
additional BIRCWH fellows at all existing sites with a goal of
increasing the diversity of the scholars, sites, and research
areas supported by the program. These funds support additional
researchers focused on women's health and sex differences,
which are priority research areas, as well as expand the
program's work in the reproductive sciences. The Committee
recognizes the effectiveness of the BIRCWH program, which is a
mentored career-development program designed to connect junior
faculty and senior faculty with shared interests.
Office of the Chief Officer for Scientific Workforce
Diversity.--The Committee includes $22,400,000 for the Office
of the Chief Officer for Scientific Workforce Diversity,
$6,210,000 above the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request.
Osteopathic Medical Schools.--The Committee recognizes that
increased access to research funding for the osteopathic
profession will bolster NIH's capacity to support recovery from
the COVID-19 pandemic, address health disparities in rural and
medically-underserved populations, and advance research in
primary care, prevention, and treatment. The Committee requests
an update on the current status of NIH funding to colleges of
osteopathic medicine and representation of doctors of
osteopathic medicine on NIH National Advisory Councils and
standing study sections in the fiscal year 2024 Congressional
Justification.
Overactive Bladder Treatment.--The Committee remains
concerned about the safety of medications used to treat
overactive bladder, which may be increasing risk of ADRD.
Overactive bladder affects 38 million Americans, and one in
three older adults in this country. Overactive bladder has a
significant impact on quality of life and the health care
system. The anticholinergic medications typically used first-
line to treat overactive bladder have been shown to increase
the risk of developing dementia. Dementia continues to grow as
a prevalent and serious public health issue. The Committee
urges NIA to study anticholinergic medications and alternative
treatments to determine the safety and effectiveness of
medications for overactive bladder, and their potential risks
related to ADRD. The Committee requests an update on the status
of research activities focused on this issue in the fiscal year
2024 Congressional Justification.
Polycystic Ovary Syndrome (PCOS).--PCOS affects up to 15
percent of women and is a significant risk factor for multiple
cardio-metabolic conditions, such as type 2 diabetes, lipid
disorders, high blood pressure, obesity, sleep disorders, and
others which may significantly increase risk for adverse COVID-
19 outcomes. The Committee encourages NIH to increase
investments into research on the metabolic, cardiovascular,
psychosocial, maternal-fetal, oncologic, pediatric,
dermatologic, and reproductive aspects of PCOS. Fifty percent
of PCOS patients become diabetic or prediabetic before age 40,
and are at higher risk for hypertension, stroke, nonalcoholic
fatty liver disease, and non-alcoholic steatohepatitis,
independent of, but exacerbated by obesity. There is also
evidence of racial and ethnic differences that
disproportionately increase the risk for cardiovascular and
metabolic disease in PCOS. The Committee urges NIH to continue
to support fundamental laboratory science, patient-directed
research, clinical trials, and large longitudinal studies
focused on the cardiometabolic features and endocrinopathy of
PCOS throughout the lifespan. The Committee also encourages NIH
to provide an update on research that has been conducted on
PCOS and its impact on cardio-metabolic health to date in the
fiscal year 2024 Congressional Justification. Additionally, the
Committee requests that PCOS--one of the most common human
disorders--be added to the NIH Research, Condition, and Disease
Categories reporting.
Prion Disease.--The Committee encourages NIH to recognize
prion disease as an ADRD. The disease mechanism and clinical
presentation of prion diseases closely resemble AD/ADRDs.
Advances in prion disease science have been valuable to the
study of other ADRDs and vice versa, and further integration of
the fields will benefit scientific pursuits in both fields.
Psychedelic Research.--The Committee encourages NIH to
assess opportunities for further private-public partnerships on
researching the use of psychedelic drugs to treat posttraumatic
stress disorder and major depressive disorders and provide a
report within six months of enactment of this Act on the
feasibility of providing potential dedicated researching
funding for such partnerships.
Psychedelic Treatments.--Despite the recent Department of
Veterans Affairs' 2020 National Veteran Suicide Prevention
Annual Report that showed there were no significant increases
in the veteran suicide rate from 2017 and 2018, the Committee
is concerned that over 17 veterans on average continue to
commit suicide each day, which is a number that has remained
persistent over the past decade. There have been many recent
studies and clinical trials demonstrating the positive impact
of alternative therapies, including psychedelics, for
treatmentresistant PTSD and major depressive disorder,
particularly for veteran participants. Further, U.S. academic
research institutions are involved in investigating psychedelic
treatments, including Johns Hopkins University, Harvard
University, Yale University, New York University and Baylor
University. In light of growing interest in this area, the
Committee encourages NIH and other relevant Federal agencies to
undertake, and where appropriate expand, research to evaluate
the effectiveness of psychedelic therapies in treating PTSD,
major depressive disorder, and other serious mental health
conditions.
Repeat Expansion Diseases.--The Committee recognizes the
rapidly emerging science on DNA repeat expansions, which causes
over 50 distinct diseases. Myotonic dystrophy (DM1 and DM2) is
one of these repeat expansion diseases and has served as
paradigm for a class of diseases caused by repeat instability
and toxic RNA, which includes C9ORF72/amyotrophic lateral
sclerosis/frontotemporal dementia, Huntington's disease, and
many common forms of dominantly inherited ataxias. Due to
recently developed molecular and cell biological tools, a
common thread has recently emerged, that repeat expansions may
underlie multiple neurodegenerative conditions. The Committee
encourages NIH to explore the most effective approaches to
support trans-NIH research on repeat expansions and consider
new funding mechanisms across multiple Institutes and Centers
to support scientific discoveries that will lead to treatments
and cures for these genetic disorders and related conditions.
The Committee requests an update on these activities in the
fiscal year 2024 Congressional Justification.
Sexual Orientation and Gender Identity (SOGI) Research
Center.--The Committee includes $2,000,000 to establish the
SOGI Research Center, which will build upon the success of the
NASEM consensus study and the Sexual and Gender Minority
Research Office to disseminate best practices in data
collection on sexual orientation, gender identity, and sex
characteristics on a government-wide basis.
Spina Bifida Research.--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 sudden death in the adult spina
bifida population; 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. The Committee requests and update in the
fiscal year 2024 Congressional Justification on research
findings on spina bifida and issues related to it. The
Committee supports the specific efforts of NICHD to understand
early human development; set the foundation for healthy
pregnancy, and lifelong wellness of women and children; and
promote the gynecological, andrological, and reproductive
health for people with spina bifida. Additionally, NIH is
encouraged to identify sensitive time periods to optimize
health interventions; improve health during transition from
adolescence to adulthood; and ensure safe and effective
therapeutics and devices for adults as well as children.
Spinal Muscular Atrophy.--The Committee commends NIH for
its past research into spinal muscular atrophy (SMA) that has
led to new therapies to treat SMA and also contributed toward
greater knowledge and research capacity into nervous system
disorders. While current SMA treatments can slow or stop future
degenerative nerve damage, they are not cures, and there
remains significant unmet need across all ages and disease
stages of SMA. Individuals with SMA, particularly adults, the
largest segment of the SMA population, face significant
challenges in muscle weakness and fatigue due to degeneration
that occurred prior to treatment. Individuals treated prior to
clinical symptoms onset may also display unmet needs, such as
bulbar impairment and gait abnormalities. The Committee urges
NIH to address these unmet needs, which are common across other
neurological and neuro-muscular diseases, by supporting new
research into the role and function of survival motor neuron
(SMN) protein, investigation into non-SMN pathways and targets
capable of modifying disease, and research into how to best
combine SMN-enhancing and non-SMN approaches for optimal
therapeutic outcomes.
Thalassemia.--Nutrition can be an important tool in the
management of rare diseases. Currently, there is no evidence-
based guidance on nutrition approaches for the management of
thalassemia, which occurs most often in African Americans and
in people of Mediterranean and Southeast Asian descent. In
addition to the possibility that thalassemia itself creates
nutritional deficits, there is concern that necessary iron
chelation therapy may create additional deficits. Research is
needed to provide practitioners with evidence-based advice for
patients, both on diets that would help improve and manage
their condition, and those that may be harmful. The Committee
encourages the Office of Nutrition Research to coordinate
across NIH on the impact of nutrition on thalassemia management
and current gaps in clinical understanding in this area.
Transformative Research Award for ALS.--The Committee
strongly supports the Transformative Research Award program for
ALS and directs NIH to continue to fund this critical
initiative in fiscal year 2023.
Undiagnosed Diseases.--NIH is helping construct and
implement the Undiagnosed Disease Network, a research study to
improve the diagnosis of undiagnosed, rare disorders so that no
family has to endure the anxiety associated with undiagnosed
diseases. The Committee recognizes that while the research is
challenging, the great effort spent on this endeavor is
beneficial for every American, especially those that are
fighting unknown diseases. The Committee encourages robust
support for the Undiagnosed Disease Network.
Wastewater Surveillance Research.--The Committee recognizes
the potential and importance of wastewater surveillance in
public health surveillance, including during the ongoing
pandemic to inform COVID-19 surveillance. The Committee
encourages NIH to continue efforts on Rapid Acceleration of
Diagnostics (RADx) to continue innovation through developing
and improving wastewater surveillance capabilities, including
for innovations that can apply to non-centralized wastewater
treatment services that would serve rural communities. NIH is
directed to report back to the Committee within 180 days of
enactment of this Act on such efforts.
Women's Health Research Study.--The Committee recognizes
persistent gaps remain in the knowledge of women's health. To
address these gaps and improve women's health, the Committee
includes $2,000,000 to contract with NASEM to conduct a study
on the gaps present in women's health research across all NIH
Institutes and Centers. Specifically, the study should be
designed to explore the proportion of research on conditions
that are more common or unique to women, establish how these
conditions are defined and ensure that it captures conditions
across the lifespan, evaluate sex and gender differences and
racial health disparities, and determine the appropriate level
of funding that is needed to address gaps in women's health
research at NIH. The Committee requests that NASEM, not later
than 18 months after enactment of this Act, submit to the
Committee a report containing the findings of the study and the
recommendations to address research gaps in women's health
research, including measurable metrics to ensure that this
research is accurately tracked to meet the continuing health
needs of women.
Wound Care and Pressure Injuries.--The Committee commends
NIH for updating RCDC with a wound care category, as it is
estimated that pressure ulcers impact over 2.5 million
Americans annually. Unfortunately, an estimated 60,000 patient
deaths occur each year due to complications directly attributed
to this painful condition. NIH is encouraged to support
research projects in this area. Further, the Committee urges
NIH to work with the U.S. National Pressure Injury Advisory
Panel.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2022....................... $250,000,000
Budget request, fiscal year 2023...................... 300,000,000
Committee Recommendation.............................. 300,000,000
Change from enacted level......................... +50,000,000
Change from budget request........................ - - -
Mission.--This account provides for the design,
construction, improvement, major repair, and demolition of
clinical, laboratory, and office buildings and supporting
facilities essential to the mission of NIH. 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; the
National Institute of Allergy and Infectious Diseases in
Hamilton, Montana; and other smaller facilities throughout the
U.S.
NIH INNOVATION ACCOUNT
Appropriation, fiscal year 2022....................... $150,000,000
Budget request, fiscal year 2023...................... 419,000,000
Committee Recommendation.............................. 419,000,000
Change from enacted level......................... +269,000,000
Change from budget request........................ - - -
This account supports NIH programs authorized in the Cures
Act.
SUBSTANCE USE AND MENTAL HEALTH SERVICES ADMINISTRATION
Appropriation, fiscal year 2022....................... $6,545,602,000
Budget request, fiscal year 2023...................... 10,283,154,000
Committee Recommendation.............................. 9,170,380,000
Change from enacted level......................... +2,624,778,000
Change from budget request........................ -1,112,774,000
The Committee recommendation for the Substance Use And
Mental Health Services Administration (SAMHSA) program level
includes $9,024,713,000 in discretionary budget authority,
$133,667,000 in Public Health Service (PHS) Act section 241
evaluation set-aside transfers, and $12,000,000 in transfers
from the Prevention and Public Health Fund (PPHF).
SAMHSA is the agency within the U.S. Department of Health
and Human Services (HHS) that leads public health efforts to
advance the behavioral health of the nation. SAMHSA's mission
is to reduce the impact of substance misuse and mental illness
on America's communities.
The Committee continues to include bill language that
exempts the Mental Health Block Grant and the Substance Use
Prevention and Treatment Block Grant as a source for the PHS
Act section 241 evaluation set-aside in fiscal year 2023.
MENTAL HEALTH
Appropriation, fiscal year 2022....................... $2,081,129,000
Budget request, fiscal year 2023...................... 4,215,726,000
Committee Recommendation.............................. 3,807,191,000
Change from enacted level......................... +1,726,062,000
Change from budget request........................ -408,535,000
Within the total provided for Mental Health Programs of
Regional and National Significance, the Committee includes the
following amounts:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Seclusion and Restraint........................... $1,147,000
Project AWARE..................................... 229,000,000
Mental Health Awareness Training.................. 44,963,000
Healthy Transitions............................... 49,451,000
Infant and Early Childhood Mental Health.......... 30,000,000
Children and Family Programs...................... 7,229,000
Consumer and Family Network Grants................ 4,954,000
Project LAUNCH.................................... 25,605,000
Mental Health System Transformation............... 3,779,000
Primary and Behavioral Health Care Integration.... 102,877,000
Mental Health Crisis Response Grants.............. 60,000,000
988 Program....................................... 746,901,000
Behavioral Health Crisis and 988 Coordinating 10,000,000
Office.......................................
National Strategy for Suicide Prevention.......... 28,200,000
Zero Suicide.................................. 26,200,000
American Indian and Alaska Native Set- 3,400,000
Aside....................................
Garrett Lee Smith-Youth Suicide Prevention
State Grants.................................. 33,806,000
Campus Grants................................. 11,488,000
American Indian and Alaska Native Suicide 3,931,000
Prevention.......................................
Tribal Behavioral Health Grants................... 25,000,000
Homeless Prevention Programs...................... 35,696,000
Minority AIDS..................................... 9,224,000
Criminal and Juvenile Justice Programs............ 16,269,000
Assisted Outpatient Treatment..................... 21,420,000
Assertive Community Treatment for Individuals with 9,000,000
Serious Mental Illness...........................
Interagency Task Force on Trauma-Informed Care.... 3,000,000
Science and Service:
Garrett Lee Smith-Suicide Prevention Resource 10,000,000
Center...........................................
Practice Improvement and Training................. 7,828,000
Consumer and Consumer Support Technical Assistance 1,918,000
Centers..........................................
Primary and Behavioral Health Care Integration 1,991,000
Technical Assistance.............................
Minority Fellowship Program....................... 14,059,000
Disaster Response................................. 1,953,000
Homelessness...................................... 2,296,000
------------------------------------------------------------------------
Assisted Outpatient Treatment.--The Committee includes
$21,420,000 to expand access to evidence-based mental health
services for individuals with serious mental illness.
Behavioral Health Crisis Services and 988 Program
The Committee recognizes that suicide is a leading cause of
death, taking more than 45,000 lives every year. According to
the CDC, mental health and suicidal ideation have worsened
significantly since the onset of the COVID-19 pandemic;
approximately twice as many individuals have reported serious
thoughts of suicide and 40 percent of adults reported
struggling with mental health or substance use. The Committee
includes a total of $746,901,000, an increase of $640,280,000,
to support the entirety of the 988 Program, which includes
continuing to enhance the National Suicide Prevention Lifeline
(NSPL) and crisis response infrastructure for the new 988
number which is launching in July 2022. SAMHSA estimates that
the 988 call centers will respond to approximately 7.6 million
individuals in fiscal year 2023, compared to approximately 3.3
million estimated in fiscal year 2022. The 988 Program has the
potential to make it simpler for people experiencing a mental
health crisis to connect with lifesaving crisis intervention
services. This funding will support the NSPL infrastructure
including national back-up services; expand local call center
and crisis capacity across the continuum of care; promote
ongoing Federal direction and leadership through coordination,
standards setting, technical assistance and evaluation; and
facilitate partner engagement, audience research, content and
strategy development to ensure that there is public awareness
of the health benefits of the 988 Program, particularly for
populations at high risk of suicide. The Committee requests a
briefing within 90 days of the date of enactment of this Act on
implementation of the 988 Program, including an operating plan
outlining how SAMHSA intends to allocate funding across 988
Program activities. The Committee also directs that as SAMHSA
continues to enhance the NSPL and crisis response
infrastructure, it should expand existing capabilities for
response in a manner that, to the extent possible, utilizes
existing phone, chat, and text capabilities.
Behavioral Health Crisis and 988 Coordinating Office.--Of
the funds provided for the 988 Program, the Committee includes
an increase of $5,000,000 for SAMHSA to continue to staff an
office within the Center for Mental Health Services to
coordinate work relating to behavioral health crisis care
across HHS operating divisions, including CMS and HRSA, as well
as with external stakeholders. The office will continue to
support technical assistance, data analysis, and evaluation
functions in order to develop a crisis care system encompassing
nationwide standards with the objective of expanding the
capacity of and access to local crisis call centers, mobile
crisis care, crisis stabilization, psychiatric emergency
services, and rapid post-crisis follow up, provided by the
National Suicide Prevention and Mental Health Crisis Response
System, Community Mental Health Centers, Certified Community
Behavioral Health Clinics and other community mental health and
substance use disorder (SUD) providers.
NSPL-Specialized Services for LGBTQI+ Youth.--Of the funds
provided for the 988 Program, the Committee includes
$30,000,000 for SAMHSA to continue to provide specialized
services for LGBTQI+ youth within the NSPL, including training
for existing counselors in LGBTQI+ youth cultural competency
and the establishment and operation of an Interactive Voice
Response (IVR) and other technical solutions to transfer
LGBTQI+ youth to a specialty organization. SAMHSA shall make
this funding competitively available to an organization with
experience working with LGBTQI+ youth and possessing the
capacity and infrastructure to handle LGBTQI+ youth callers
through an IVR.
Criminal Justice Activities.--The Committee includes an
increase of $10,000,000 for Criminal and Juvenile Justice
Programs to address some of the unmet need for effective
behavioral health services and supports that are accessible
before, during, and after incarceration and continue in the
community for those with a mental disorder. The Committee
recognizes the importance of providing comprehensive services
to those who suffer from severe mental health issues. The
Committee is aware that lack of coordinated and accessible
treatment for individuals with mental health and co-occurring
disorders often results in avoidable arrest and incarceration,
and that these individuals often recidivate in part due to gaps
in addressing their needs. Communities of color are often
disproportionately impacted by these service gaps. The
Committee encourages SAMHSA to prioritize funding for centers
that provide assistance to those with severe mental health
needs who are at risk of recidivism. These mental health
centers can provide, but are not limited to, the following
services: crisis care, residential treatment, outpatient mental
health and primary care services, and community re-entry
supports. The Committee also encourages SAMHSA to prioritize
applications from areas with high rates of uninsured
individuals, poverty, and SUDs.
Garrett Lee Smith Youth Suicide Prevention.--The Committee
includes a total increase of $13,000,000 for Garrett Lee Smith
Youth Suicide Prevention, to develop and implement youth
suicide prevention and early intervention strategies.
Healthy Transitions.--The Committee includes an increase of
$20,000,000 for the Healthy Transitions program, which provides
grants to States and Tribes to improve access to mental
disorder treatment and related support services for young
people aged 16 to 25 who either have, or are at risk of
developing a serious mental health condition.
Homelessness Prevention Programs.--The Committee includes
an increase of $5,000,000 for Homeless Prevention Programs to
help prevent or reduce chronic homelessness by funding services
for individuals and families experiencing homelessness while
living with severe mental illness or co-occurring mental and
substance disorders. The program addresses the need for
treatment and support service provision to individuals and
families.
Infant and Early Childhood Mental Health.--The Committee
recognizes the importance of building mental health services
for children under the age of six and includes an increase of
$20,000,000 for Infant and Early Childhood Mental Health. The
Committee continues to urge SAMHSA to expand grants to entities
such as State agencies, tribal communities, and university or
medical centers that are in different stages of developing
infant and early childhood mental health services. These
entities should have the capacity to lead partners in systems-
level change as well as building or enhancing the basic
components of such early childhood services, including an
appropriately trained workforce. The Committee is pleased with
SAMHSA's use of a portion of funding to provide technical
assistance to existing grantees to better integrate infant and
early childhood mental health into State systems and encourages
that work to continue. The Committee encourages SAMHSA to
increase technical assistance allocations as the number of
grantees increases.
Interagency Task Force on Trauma-Informed Care.--The
Committee includes $3,000,000 for the Interagency Task Force on
Trauma-Informed Care, as authorized by section 7132 of the
SUPPORT Act (P.L. 115-271). The Task Force recommends best
practices to identify, prevent, and mitigate the effects of
trauma on infants, children, youth, and their families.
Mental Health Crisis Response Grants.--The Committee notes
that funding crisis care services can help divert people
experiencing a mental health crisis from the criminal justice
system into mental health treatment. However, the availability
of mental health crisis care remains inconsistent across the
U.S., and first responders are not always trained and equipped
to diffuse a mental health crisis, which can lead to tragic
outcomes. Many communities are implementing model programs
where mental health providers respond to mental health
emergencies, sometimes in partnership with law enforcement. To
make these model programs more widely available, the Committee
includes an increase of $50,000,000 to expand the grant program
for communities to create, or enhance existing, mobile crisis
response teams that divert the response for mental health
crises from law enforcement to behavioral health teams. These
teams may be composed of licensed counselors, clinical social
workers, physicians, EMTs, crisis workers, and/or peers
available to respond to people in crisis and provide immediate
stabilization and referral to community-based mental health
services and supports. The Committee encourages grantees to
partner or co-respond with law enforcement to ensure community
policing meets the needs of everyone in the community. The
Committee looks forward to receiving the report on existing
steps being taken to strengthen partnerships between mental
health providers, behavioral health teams, and first responders
requested in House Report 117-96. The Committee requests a
report not later than one year following the obligation of
awards in fiscal year 2023 for this program, including best
practices and recommendations for subsequent grant cycles.
Minority Fellowship Program.--The Committee provides a
total of $25,169,000, an increase of $9,000,000, across SAMHSA
for the Minority Fellowship Program in order to improve
prevention, wellness, and treatment across the lifespan. As
Congress seeks to better address substance misuse and mental
health disorders across all populations, the Committee
recognizes the critical importance of supporting a diverse
behavioral health workforce and its effectiveness in addressing
SUDs and mental health issues impacting minority and
underserved populations.
National Strategy for Suicide Prevention.--The Committee
includes an increase of $5,000,000 for the implementation of
the National Strategy for Suicide Prevention, including raising
suicide awareness, establishing emergency room referral
processes, and improving clinical care practice standards. In
addition, funding will further support the Zero Suicide model,
a comprehensive, multi-setting approach to suicide prevention
in health care systems. The Committee also includes an increase
of $1,000,000 for the American Indian/Alaska Native (AI/AN)
Suicide Prevention Initiative.
Primary and Behavioral Health Care Integration.--The
Committee includes an increase of $50,000,000 to improve the
coordination and integration of primary care services and
publicly funded behavioral health services.
Project AWARE.--The Committee includes a total increase of
$108,999,000 for Project AWARE, which is designed to identify
children and youth in need of mental health services, to
increase access to mental health treatment, and to promote
mental health literacy among teachers and school personnel, as
set out by the 2013 ``Now is the Time'' plan. This includes an
increase of $102,749,000 for Project AWARE State grants, and an
increase of $6,250,000 for Resilience in Communities after
Stress and Trauma (ReCAST) grants. In addition, the Committee
includes an increase of $20,000,000 for Mental Health Awareness
Training. The Committee encourages SAMHSA to sustain and
strengthen its grant and other programs that support school-
based and campus-based services aimed at preventing and
treating mental health challenges experienced by younger
Americans.
Tribal Behavioral Grants.--The Committee includes an
increase of $4,250,000 to expand efforts to address the high
incidence of substance misuse and suicide among AI/AN
populations.
Certified Community Behavioral Health Clinics
The Committee includes $400,000,000, an increase of
$85,000,000 for the Certified Community Behavioral Health
Clinics (CCHBC) program. The Committee is pleased that the
CCBHC program is expanding access to mental health and SUD
treatment services and significantly reducing hospital
emergency room utilization. CCBHCs are required to partner with
local agencies, and this often includes partnering with law
enforcement to develop safe and effective crisis response. The
Committee directs SAMHSA to continue to make funds available
nationwide and to prioritize resources to entities within
States that are part of section 223(a) of the Protecting Access
to Medicare Act of 2014 (P.L. 113-93) demonstration and to
entities within States that were awarded planning grants.
Children's Mental Health Services
The Committee includes $225,000,000, an increase of
$100,000,000 for Children's Mental Health Services (CMHS),
which support grants and technical assistance for community-
based services for children and adolescents with serious
emotional, behavioral, or mental disorders, and assists States
and local jurisdictions in developing integrated systems of
community care.
Community Violence Pilot.--The Committee recognizes the
crisis of community violence that is devastating families and
claiming the lives of youth--particularly youth in communities
of color--all across this country. Of the funds provided for
CMHS, the Committee includes $50,000,000 for SAMHSA to
establish a pilot program to provide and expand mental health
services for families affected by community violence. The
severe lack of resources for emotional support and wellbeing is
of paramount need in Black and brown communities and this
funding would be a crucial support for the pervasive trauma
that so many families, especially families of color, face in
the aftermath of fatal community violence.
Mental Health Block Grant
The Committee includes $1,357,571,000, an increase of
$500,000,000, for the Mental Health Block Grant (MHBG). The
MHBG 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 10 percent set-aside within the MHBG for
evidence-based programs that address the needs of individuals
with early serious mental illness, including psychotic
disorders.
MHBG Crisis Care Set-Aside.--The Committee increases the
set-aside in the MHBG for evidence-based crisis care programs
to 10 percent to address the needs of individuals with serious
mental illnesses and children with serious mental and emotional
disturbances. The Committee directs SAMHSA to use the set-aside
to fund, at the discretion of eligible States and Territories,
some or all of a set of core crisis care elements including:
local, regional or statewide call centers that have capacity to
address distressed and suicidal callers and deploy mobile teams
or direct persons to accessible crisis receiving centers or
clinics with same day appointments, mobile crisis response
teams and crisis receiving units.
MHBG Prevention and Early Intervention Set-Aside.--The
Committee understands that early intervention is critical if we
are to prevent or mitigate the effects of mental illness and
enable individuals to live fulfilling, productive lives. To
increase access to early intervention and prevention services,
the Committee includes a new 10 percent set-aside within the
MHBG total to support evidence-based programs that address
early intervention and prevention of mental disorders among at-
risk children, including young children and toddlers, and
adolescents. The Committee directs SAMHSA to use the set-aside
to fund, at the discretion of eligible States and Territories,
activities targeted to children and youth such as, but not
limited to, training school-based personnel to identify
children and youth at risk of mental disorders; programs to
promote positive social-emotional development in children from
birth to age five; mental health consultation for child care
programs; collaborating with primary care associations to field
depression and anxiety screening tools in front line primary
care practices; or partnering with local non-profit entities in
low-income and minority communities to implement trauma-
informed early intervention and prevention initiatives.
Statutory State plan and reporting requirements will apply to
early intervention and prevention set-aside programming.
MHBG and Children Ages Zero-Five.--The Committee recognizes
that by investing in early mental health prevention,
identification, and treatment, the need for treatment later in
life when it becomes much more difficult, time intensive, and
expensive can be reduced. The Committee is concerned that there
has not been a sufficient focus on this population. The
Committee urges States to dedicate a portion of their MHBG
funding through the new Prevention and Early Intervention Set-
Aside for services and activities related to infants and
toddlers, such as expanding the infant and early childhood
mental health workforce; improving the quality of services
available to children and families; increasing knowledge of
infant and early childhood mental health among professionals
who see children most; and strengthening systems and networks
for identification and referral to reach more young children in
need. The Committee looks forward to receiving the report on
the portion of MHBG funding that States are allocating to
services and activities for infants and toddlers requested in
House Report 117-96.
MHBG and AANHPIs.--The Committee urges States to ensure a
portion of MHBG funding is allocated to focus on Asian
Americans, Native Hawaiians, and Pacific Islanders (AANHPI).
This focus should include the training of professionals on
effective outreach and engagement with AANHPIs to raise
awareness of these culturally inclusive services, including
those with lived experiences.
Workplace Mental Health Wellness.--The Committee notes that
workforce mental health is an important part of ensuring the
overall mental health of our larger communities. To address
workforce mental health in the community context, the Committee
urges SAMHSA to encourage States to use a portion of their MHBG
funds to work with public and nonprofit organizations to
implement evidence-based programs designed to educate and aid
employers in providing mental health assistance to their
employees to reduce the stigma and encourage the treatment of
mental health illness in the workplace.
National Child Traumatic Stress Initiative
The Committee includes $150,000,000, an increase of
$68,113,000 for the National Child Traumatic Stress Initiative.
The Committee strongly supports the National Child Traumatic
Stress Network (NCTSN), which carries out essential work in
building, evaluating, disseminating, and delivering evidence-
based services and best practices, including through
universities, hospitals, and front-line providers, to prevent
and mitigate the impact of exposure to trauma among children
and families. The Committee directs SAMHSA to ensure that the
NCTSN maintains its focus on collaboration, data collection,
and the provision of direct services and that new grants should
not be awarded as training only. The agreement also provides no
less than $10,000,000 for activities authorized under section
582(d) and (e) of the PHS Act for the National Center for Child
Traumatic Stress.
Projects for Assistance in Transition from Homelessness
The Committee includes $79,635,000, an increase of
$15,000,000 for the Projects for Assistance in Transition from
Homelessness (PATH) program, which supports grants to States
and territories for assistance to individuals suffering from
severe mental illness and/or SUDs and who are experiencing
homelessness 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.
HUD/HHS Collaboration Supportive Housing for People with
Mental Illness Pilot.--The Committee is concerned that
inadequate housing and support opportunities exist for people
with serious mental health illness, which often results in
people with serious mental illness cycling through hospitals
and public institutions like jails, prisons, and homeless
shelters. The Committee recognizes that housing support paired
with wraparound services is a successful model. In fiscal year
2021, the Committee requested a report from the Department of
Housing and Urban Development (HUD) and SAMHSA on the
feasibility of such a program and received agency feedback for
its creation. The Committee directs SAMHSA to work with HUD to
establish a pilot program for PATH grantees to partner with
public housing agencies to provide mental health, SUD, and
other supportive services for people experiencing homelessness,
at imminent risk of becoming homeless, or in HUD-assisted
housing. The Committee directs SAMHSA to use no less than
$5,000,000 of the funds made available for the PATH program for
this pilot.
Protection and Advocacy for Individuals with Mental Illness
The Committee includes $40,000,000, an increase of
$2,000,000, for the Protection and Advocacy for Individuals
with Mental Illness program, which ensures that the rights of
individuals with mental illness 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.
Addressing Access to Firearms and Suicide Prevention
Programs.--The Committee continues to encourage SAMHSA to focus
on suicide prevention policies that limit access to firearms
and other lethal means when an individual is in crisis. The
Committee urges SAMHSA to develop, adapt, and disseminate
training on lethal means safety counseling for health care
providers; to collaborate with the Department of Veterans
Affairs (VA) and NSPL to promote gun storage maps, accessible
by both VA health care providers and Crisis Center counselors,
to facilitate temporary out-of-home firearm storage; and to
encourage the incorporation of tools such as extreme risk laws
into risk mitigation and response plans.
Behavioral Health Intervention Training.--The Committee
continues to encourage SAMHSA to develop school-based and
evidence-based best practices addressing behavioral health
intervention training to support practices that assist children
and youth with behavioral health needs. One potential best
practice is behavioral intervention teams--a team of qualified
mental health professionals who are responsible for
identifying, screening, and assessing behaviors of concern and
facilitating the implementation of evidence-based
interventions. SAMHSA shall also provide technical assistance
to institutions of higher education, elementary schools, and
secondary schools to assist such institutions and schools in
implementing the best practices.
COVID-19 Impact on Communities of Color.--The Committee is
concerned by the enduring impact of the COVID-19 pandemic on
the mental health of communities of color. The pandemic
exacerbated high rates of mental illness in these communities
and highlighted the need for culturally and linguistically
appropriate services. The Committee requests a report not later
than 180 days after the date of enactment of this Act on
SAMHSA's outreach, education, and public engagement strategies,
designed to meet the cultural and language needs of diverse
populations; increase awareness of symptoms of SUD and mental
illness common among the aforementioned populations, taking
into account differences within subgroups such as gender,
gender identity, age, sexual orientation, or disability;
disseminate evidence-based, culturally and linguistically
appropriate and adapted interventions and treatments; ensure
meaningful engagement of people with lived experiences, their
families, and community members in the materials development
and implementation; broaden the perspective among both
individuals in these communities and stakeholders serving these
communities, to use a comprehensive public health approach to
promoting behavioral health that addresses a holistic view of
health by focusing on the intersection between behavioral and
physical health; and address the impact of the COVID-19
pandemic on the behavioral health of such populations.
Impact of COVID-19 on the Mental Health of Older Adults.--
The Committee recognizes the exacerbated impact of the COVID-19
pandemic on older adults, who, being more susceptible to the
virus, have experienced heightened isolation since the onset of
the pandemic, which is linked to higher rates of loneliness,
depression, suicidal ideation, and other mental health issues.
The Committee encourages SAMHSA to work with States to address
the impact of increased isolation of seniors. The Committee
requests a report within 180 days of the date of enactment of
this Act, outlining specific efforts to address seniors' mental
health challenges.
Mental Health Centers of Excellence.--The Committee
continues to be concerned about the growing need for more
effective health care programs and a need to better provide
treatment recommendations to meet the needs of those
experiencing mental illness. The Committee urges SAMHSA to
establish a center of excellence program focused on
comprehensive mental health treatments. The Centers will focus
on the development, evaluation, and distribution of evidence-
based resources regarding comprehensive treatment
recommendations for mental health patients that include
supportive services, wraparound services, and social
determinants of health where applicable. The Centers will also
work to disseminate treatment recommendations to the broader
network of mental health clinicians. Preference should be given
to entities that can demonstrate existing behavioral health
medical home model services, CCBHC implementation, work with
HUD's Housing for Persons with Disabilities (section 811)
program, collaborative care agreements with primary care
practices, and/or programs for supported living and supported
employment. One grantee should be designated as the National
Coordinating Center across the selected centers and provide
technical expertise across all recipients. The Centers should
collaborate with SAMHSA's Mental Health Technology Transfer
Center Network and the Serious Mental Illness advisor in
developing the new program.
Perinatal Suicide Prevention.--The Committee continues to
urge SAMHSA to develop and implement perinatal suicide
prevention programs, including culturally appropriate resources
and programs for Black and other at-risk pregnant and
postpartum individuals.
Reducing Barriers to Transportation.--The Committee notes
that mental health, SUD, and opioid use disorder (OUD) are a
pervasive crisis across the country and have been exacerbated
by the effects of the COVID-19 pandemic. The Committee is also
aware that many seeking treatment lack reliable transportation
which becomes a major barrier for individuals seeking out
treatment or other mental health services. The Committee
encourages SAMHSA to acknowledge funds for State and local
governments can be used to provide reliable, equitable, and
convenient access to transportation for those seeking
treatment. The Committee requests SAMHSA conduct a review
within 180 days of the date of enactment of this Act to measure
the impact of recovery transportation on individuals' ability
to access treatment and provide a summary report.
Rural Mental Health.--The Committee recognizes the unique
challenges faced by those who live in rural and frontier areas
to access regular mental health and substance use services.
These challenges are further complicated when individuals need
timely behavioral health crisis services led by behavioral
health professionals in these areas. Providers in rural areas
also face unique obstacles. They may lack the full staff or
resources to implement evidence-based practices or meet
requirements for grant funding. Given these challenges, the
Committee requests a report not later than one year after the
date of enactment of this Act providing details on strategies
to address the unique concerns of those in rural communities.
The report should address what resources are needed to improve
and sustain access to prevention, treatment, and recovery-
oriented services, including crisis response services, and to
recruit, train, and sustain sufficient workforce in rural and
frontier settings.
Youth Mental Health and Mentoring Initiatives.--The
Committee notes that since the pandemic began, rates of
psychological distress among young people, including symptoms
of anxiety, depression, and other mental health disorders, have
increased. Professional mentoring programs provide evidence-
based mental health and trauma mitigation services to children
and families who experience barriers to accessing mental health
supports, while reducing the burdens on existing systems of
care. The Committee urges SAMHSA to prioritize funds to these
programs to improve access to mental health services for at-
risk youth and their families and to ensure applicable grant
opportunities include these types of professionals as parties
grantees can work with when implementing SAMHSA grants. In
addition, the Committee urges SAMHSA to study underlying causes
of psychological distress in young people.
SUBSTANCE USE SERVICES
Appropriation, fiscal year 2022....................... $3,954,596,000
Budget request, fiscal year 2023...................... 5,574,443,000
Committee Recommendation.............................. 4,826,048,000
Change from enacted level......................... +871,452,000
Change from budget request........................ -748,395,000
Within the total provided for Programs of Regional and
National Significance, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Capacity:
Opioid Treatment Programs and Regulatory $9,724,000
Activities......................................
Screening, Brief Intervention, Referral to 32,840,000
Treatment.......................................
PHS Evaluation Funds ........................ 2,000,000
Targeted Capacity Expansion-General.............. 147,916,000
Medication-Assisted Treatment................ 136,500,000
Tribal Set-aside......................... 16,500,000
Grants to Prevent Prescription Drug/Opioid 18,000,000
Overdose........................................
First Responder Training......................... 61,000,000
Rural Focus.................................. 36,000,000
Pregnant and Postpartum Women.................... 49,931,000
Recovery Community Services Program.............. 5,151,000
Children and Families............................ 30,197,000
Treatment Systems for Homeless................... 37,114,000
Minority AIDS.................................... 66,881,000
Criminal Justice Activities...................... 99,380,000
Drug Courts.................................. 80,000,000
Improving Access to Overdose Treatment........... 1,500,000
Building Communities of Recovery................. 28,000,000
Peer Support Technical Assistance Center......... 2,000,000
Comprehensive Opioid Recovery Centers............ 7,500,000
Emergency Department Alternatives to Opioids..... 10,000,000
Treatment, Recovery, and Workforce Support....... 12,000,000
Youth Prevention and Recovery Initiative......... 4,000,000
Science and Service:
Addiction Technology Transfer Centers............ 9,046,000
Minority Fellowship Program...................... 8,789,000
------------------------------------------------------------------------
Building Communities of Recovery.--The Committee includes
an increase of $15,000,000 to support the development,
enhancement, expansion, and delivery of recovery support
services.
Children and Families.--The Committee includes an increase
of $592,000 for the Children and Families program, which makes
appropriate treatment available to youth and their families or
caregivers to reduce the impact of SUD and/or co-occurring
mental and substance use disorders on communities in the U.S.
Comprehensive Opioid Recovery Centers.--The Committee
includes an increase of $2,500,000 for Comprehensive Opioid
Recovery Centers, as authorized by section 7121 of the SUPPORT
Act (P.L. 115-271), to help ensure that people with SUD can
access proper treatment.
Emergency Department Alternatives to Opioids.--The
Committee includes an increase of $4,000,000 for Emergency
Department Alternatives to Opioids, as authorized by section
7091 of the SUPPORT Act (P.L. 115-271). This program provides
funding to hospitals and emergency departments to develop and
implement alternative pain management protocols and treatments
that limit the prescribing of opioids in emergency departments.
Grants to Prevent Prescription Drug/Opioid Overdose and
First Responder Training.--The Committee includes an increase
of $4,000,000 for Grants to Prevent Prescription Drug/Opioid
Overdose Deaths, and an increase of $15,000,000 for First
Responder Training for Opioid Overdose Reversal Drugs, which
includes an increase of $10,000,000 for a rural set-aside. Of
the funds provided for First Responder Training, the Committee
directs at least $10,000,000 to Rural Emergency Medical
Services Training Grants. The Committee notes strong concerns
about the increasing number of unintentional overdose deaths
attributable to prescription and nonprescription opioids. The
Committee urges SAMHSA to take steps to encourage and support
the use of funds for opioid safety education and training,
including initiatives that improve access for licensed health
care professionals, including paramedics, to emergency devices
used to rapidly reverse the effects of opioid overdoses. Such
initiatives should incorporate robust evidence-based
intervention training and facilitate linkage to treatment and
recovery services.
Improving Access to Overdose Treatment.--The Committee
includes an increase of $500,000 to train and support health
care providers and pharmacists on the prescribing of FDA
approved drugs or devices for the emergency treatment of opioid
overdose.
Minority AIDS Initiative.--The Committee includes a total
of $119,275,000, an increase of $3,276,000, across SAMHSA to
expand access to effective, culturally competent, HIV/AIDS-
related mental health services in racial and ethnic minority
communities, for people living with an SMI and who are living
with or are at high risk for HIV/AIDS.
Peer Support Technical Assistance Center.--The Committee
includes an increase of $1,000,000 to provide technical
assistance to recovery community organizations and peer support
networks.
Pregnant and Postpartum Women program.--The Committee
includes an increase of $15,000,000 for the Pregnant and
Postpartum Women program and recognizes SAMSHA for its work
managing this program, which utilizes a family-centered
approach to provide comprehensive residential SUD treatment
services for pregnant and postpartum women, their minor
children and other family members.
Recovery Community Services Program.--The Committee
includes an increase of $2,717,000 for the Recovery Community
Services Program (RCSP) to help recovery communities strengthen
their infrastructure and provide peer recovery support services
to those in or seeking recovery from SUD. These funds will also
support the Recovery Community Services Program Statewide
Network (RSCP-SN) program to strengthen the relationships
between recovery community organizations and their statewide
networks of recovery stakeholders as key partners in the
delivery of State and local treatment and recovery support
services (RSS), as well as allied health systems through
collaboration, systems improvement, public health messaging,
and training conducted for (or with) key recovery stakeholder
organizations. RCSP-SN grantees collaborate with traditional
SUD treatment providers and other purchasers of PRSS to
strengthen and embed these critical service elements as
fixtures on the Recovery Oriented Systems of Care landscape.
Screening, Brief Intervention, and Referral to Treatment.--
The Committee includes an increase of $3,000,000 for Screening,
Brief Intervention, and Referral to Treatment (SBIRT). The
Committee urges SAMHSA to continue working to ensure SBIRT
screening is more widely adopted by health providers, and
directs this increase be used for implementing grants to
pediatric health care providers in accordance with the
specifications outlined in section 9016 of P.L. 114-255, Sober
Truth in Preventing Underage Drinking Reauthorization. Training
grants should focus on screening for underage drinking, opioid
use, and other drug use, and be managed by the Center for
Substance Use Services within the existing SBIRT program.
Grantees would train providers in screening children and
adolescents for and offering brief interventions to discourage
alcohol and other substance use; educating parents; diagnosing
and treating alcohol use and other SUDs; and referring patients
to other appropriate care, when necessary.
Targeted Capacity Expansion-Medication Assisted
Treatment.--The Committee includes an increase of $35,500,000
for Medication Assisted Treatment (MAT) for Prescription Drug
and Opioid Addiction; an increase of $4,500,000, for grants to
Indian Tribes, tribal organizations, or consortia; and an
increase of $224,000 for general Targeted Capacity Expansion
activities. The Committee urges SAMHSA to require opioid
treatment program applicants submit with their certification
application, a description of outreach displaying that the
applicant has properly notified the community of the treatment
center location. The Committee recommends that outreach shall
include community stakeholders including community board(s),
tenant associations, residential and outpatient treatment SUD
providers, health care providers, community-based organizations
who provide opioid prevention services.
Treatment Systems for Homeless.--The Committee includes an
increase of $728,000 to support services for people with
alcohol or another SUD and who are experiencing homelessness,
including youth, veterans, and families.
Treatment, Recovery, and Workforce Support.--The Committee
includes an increase of $2,000,000 for Treatment, Recovery, and
Workforce Support, as authorized by section 7183 of the SUPPORT
Act (P.L. 115-271). This program will help implement evidence-
based programs to support individuals in SUD treatment and
recover to live independently and participate in the workforce.
Youth Prevention and Recovery Initiative.--The Committee
includes $4,000,000 for the Youth Prevention and Recovery
Initiative, as authorized by section 7102 of the SUPPORT Act
(P.L. 115-271), to create a competitive grant program for
health care providers and other entities to create SUD
treatment and prevention programs that include the appropriate
use of medications for opioid use disorder (MOUD) for
adolescents and young adults. The Committee notes access to
treatment for individuals experiencing SUD is critical. The use
of MOUD has been shown to be a safe and effective treatment for
SUD. However, access to MOUD for adolescents and young adults
remains low. In order to provide MOUD to those who need it,
adolescent health care providers must have the ability to
prescribe these drugs and must also have access to the latest
resources and training to be able to dispense MOUD safely and
effectively.
State Opioid Response Grants
The Committee includes $1,775,000,000 for State Opioid
Response (SOR) grants, an increase of $250,000,000. The
Committee further directs SAMHSA to ensure that these resources
continue to be managed by State alcohol and drug agencies
defined as the agency that manages the Substance Use Prevention
and Treatment Block Grant under part B of title X of the PHS
Act. This approach will ensure continuity of funding, effective
coordination of efforts, and decrease fragmentation within each
State system. The Committee supports efforts from SAMHSA
through SOR grants to expand access to SUD treatments in rural
and underserved communities, including through funding and
technical assistance. The Committee encourages SAMHSA to
continue to focus on expanding access to evidence-based MOUD in
counties that lack providers who are actively dispensing or
prescribing MOUD.
SOR Funding Cliff.--The Committee remains concerned that
longstanding guidance to the Department to avoid a significant
cliff between States with similar mortality rates was
overlooked in the award for fiscal year 2020 funds. When the
determination of new award amounts is made in fiscal year 2023,
the Committee urges the SAMHSA to award funds to avoid funding
cliffs between States with similar mortality rates.
Substance Use Prevention and Treatment Block Grant
The Committee includes a program level of $2,408,079,000
for the Substance Use Prevention and Treatment Block Grant
(SUBG), an increase of $500,000,000. SUBG provides funding to
States to support alcohol and drug use prevention, treatment,
and rehabilitation services. The Committee recognizes the
critical role the block grant plays in State systems across the
country, giving States the flexibility to direct resources to
address the most pressing needs of localities across the State.
The Committee also recognizes that the 20 percent prevention
set-aside within the SUBG is a vital source of funding for
primary prevention. The prevention set-aside represents an
average of 62 percent of all State alcohol and drug agency's
budget for primary prevention and is essential to ending the
substance misuse crisis. In addition, the Committee includes
new language to use HIV cases, as opposed to AIDS cases, to
calculate the HIV set-aside in the SUBG.
SUBG Recovery Set-Aside.--The Committee establishes a 10
percent set-aside within total SUBG funding for the provision
of evidence-informed SUD non-clinical recovery supports and
services. The Committee directs SAMHSA to ensure that this set-
aside shall support programs that: 1) develop local recovery
community support institutions including but not limited to
recovery community centers, recovery homes, and recovery
schools or programs to mobilize resources within and outside of
the recovery community, to increase the prevalence and quality
of long-term recovery from SUD; 2) provide peer-based recovery
coaching, individual or group supports, to individuals and
families led by those with lived experience with SUD, delivered
in person or using technology; 3) provide ancillary community-
based supports necessary to sustain recovery, including access
to transportation, job training, and educational services; 4)
provide activities to reduce SUD recovery-related stigma and
discrimination at the local level; and 5) provide technical
assistance to organizations principally governed by people in
recovery from SUD through facilitating financing, business
functions and cross-training on evidence informed practices
within the recovery community. The Committee directs SAMHSA to
prioritize programs for underserved populations, to promote
health equity, and to support community-based strategies to
increase recovery capital and support individuals to sustain
long-term recovery, as identified at the local, regional and/or
State level by the recovery community. Funds from the recovery
set-aside will help support operating costs for organizations
that provide the above services, prioritizing those with
leadership, staffing, and governance structures that include
representation from those identified as in long-term recovery
and impacted family members who reflect the community served.
Block Grant Reporting Requirements.--The Committee
acknowledges the important role of the Mental Health and
Substance Use Prevention and Treatment Block Grants in
supporting States' efforts to provide resources for expanded
mental health and SUD treatment and prevention services. The
Committee is concerned with the lack of transparency and
information that is provided to Congress and the public about
how States are distributing those funds and what programs or
services they are going toward. The Committee continues to
encourage SAMHSA to implement public reporting on their
existing block grants. The Committee looks forward to receiving
the report on data collection and reporting barriers requested
in House Report 117-96.
Fentanyl Awareness Education.--The Committee notes that the
SUBG may be used to develop educational materials related to
the dangers of fentanyl, including the lethalness of small
quantities.
Contingency Management.--The Committee is aware that
contingency management, also known as motivational incentives,
is an evidence-based treatment method for individuals with SUD,
particularly for substances such as stimulants that currently
have no FDA-approved pharmacological intervention. Current
interpretation of Federal laws and regulations constrain the
ability of individuals and entities to use Federal funding for
appropriate contingency management program incentives. The
Committee urges SAMHSA, in coordination with the Office of
Inspector General, to reevaluate the limitations on the use of
cash and cash-equivalent payments offered as part of
contingency management in the treatment of SUD to better align
them with current research.
Data Collection for SUD Grants to States.--The Committee is
aware that in November 2020, the GAO issued a report (GAO-21-
96) recommending that school-based drug prevention programs
under SUBG and SOR better report how their activities
contribute to the National Drug Control Strategy's prevention
education goals. A GAO report issued in December 2021 (GAO-22-
104520) recommends further analysis and clarification of data
collected through the SOR program. The Committee encourages
SAMHSA to fully adopt the recommendations in these reports and
requests an update in the fiscal year 2024 Congressional Budget
Justification on the implementation of these recommendations.
Evidence-Based Practices To Combat the Opioid Crisis.--The
Committee directs SAMSHA to encourage States to use grant funds
provided to combat the SUD crisis to prioritize evidence-based
best practices exemplified by the States, including but not
limited to: MAT, Overdose Education and Naloxone Distribution,
Warm Handoff Protocols for Overdose Survivors Discharged from
Emergency Rooms, and peer recovery support groups. The
Committee directs that SAMHSA-funded SUD treatment and recovery
activities shall include evidence-based, self-empowering,
mutual aid recovery support programs that expressly support
MAT.
Evidence-Based Programs for People Experiencing
Homelessness.--The Committee recognizes the importance of
access to SUD treatment for individuals experiencing
homelessness. The Committee encourages SAMHSA to prioritize
disseminating evidence-based programs and treatments
specifically tailored for those with SUD(s) and who are at a
high risk of becoming homeless, and to consider grant
applications that include targeting resources to address SUD
within the homeless population.
Medications for Opioid Use Disorder.--The Center for
Substance Use Services is urged to include as an allowable use
of funds (all FDA approved) medications for opioid use disorder
(MOUD) and other clinically appropriate services to treat
opioid use disorder.
Opioid Use Disorder Relapse.--The Committee recognizes that
return to use (or recurrence of symptoms) might occur after OUD
treatment. The Committee appreciates SAMHSA's efforts to
address this by emphasizing the importance of adherence to
evidence-based practices that have been demonstrated to reduce
the risk of return to use (or recurrence of symptoms) and
encourages SAMHSA to disseminate and emphasize implementation
of these practices in all settings where treatment is offered,
including rehabilitation and criminal justice settings.
Recovery Housing.--The Committee recognizes the importance
of recovery housing, in which individuals abstain from use of
non-prescribed substances in a supportive environment. In order
to increase the availability of high-quality recovery housing,
the Committee encourages SAMHSA to collaborate with other
Federal agencies, including HUD, the Department of Labor, the
Department of Justice, and the Bureau of Indian Affairs, to
coordinate activities across the Federal government and develop
recommendations to improve policies on recovery housing and
support services spanning the continuum of care.
SUD Response in Rural America.--The Committee encourages
SAMHSA to support initiatives to advance SUD objectives in
rural areas, specifically focusing on addressing the needs of
individuals with SUD in rural and medically-underserved areas,
and programs that stress a comprehensive community-based
approach involving academic institutions, health care
providers, and local criminal justice systems.
SUBSTANCE USE PREVENTION SERVICES
Appropriation, fiscal year 2022....................... $218,219,000
Budget request, fiscal year 2023...................... 311,912,000
Committee Recommendation.............................. 248,434,000
Change from enacted level......................... +30,215,000
Change from budget request........................ -63,478,000
Within the total provided for Programs of Regional and
National Significance, the Committee provides the following
amounts:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Strategic Prevention Framework................... $137,484,000
Strategic Prevention Framework Rx............ 15,000,000
Federal Drug-Free Workplace...................... 4,894,000
Minority AIDS Initiative......................... 43,170,000
Sober Truth on Preventing Underage Drinking...... 14,500,000
National Adult-Oriented Media Public Service 2,000,000
Campaign....................................
Community Based Coalition Enhancement Grants. 11,500,000
Interagency Coordinating Committee to Prevent 1,000,000
Underage Drinking...........................
Tribal Behavioral Health Grants.................. 25,000,000
At-Home Prescription Drug Disposal Demonstration. 5,000,000
Science and Service:
Center for the Application of Prevention 11,993,000
Technologies....................................
Science and Service Program Coordination......... 4,072,000
Minority Fellowship Program...................... 2,321,000
------------------------------------------------------------------------
At-Home Prescription Drug Disposal Demonstration and
Evaluation.--The Committee is aware that many unused and
unwanted prescription opioids and other powerful medications
remain in homes and are subject to diversion. The Committee
includes $5,000,000 for an at-home drug deactivation and
disposal demonstration and evaluation initiative and urges
SAMHSA to make a diverse selection of grantees including urban,
rural, and tribal government partners. The initiative will
assess the effectiveness of drug disposal technologies that
meet the standard in section 3032 of the SUPPORT for Patients
and Communities Act (21 U.S.C. 355-1(e)(4)(B)).
Center for the Application of Prevention Technologies.--The
Committee includes an increase of $4,500,000 for the Center for
the Application of Prevention Technologies. The Committee
encourages SAMHSA to ensure eligibility for private, non-
profit, and regional organizations, including faith-based
organizations for the Center for the Application of Prevention
Technologies. The broad coalitions orchestrated by these
regional organizations are uniquely positioned to supplement
the work already being done by the State, tribal, and community
organizations currently authorized for such grants.
Eliminating Racial Disparities in Overdose Deaths.--The
Committee is concerned with the rising rates of overdose deaths
in communities of color, specifically among Black people. These
racial disparities are made worse by the fact that access to
treatment is often dependent on race, income, geography, and
insurance status, rather than individual preferences, or
medical or psychiatric indicators and needs. The Committee
urges SAMHSA to scale programs in communities of color,
including increased outreach capacity, to help eliminate racial
disparities in overdose deaths and improve access to prevention
and treatment services.
PTSD in First Responders.--The Committee looks forward to
receiving the report requested in House Report 117-96 that
examines post-traumatic stress disorder (PTSD) in individuals
working in civilian first responder disciplines of law
enforcement, fire services, and emergency medical services.
Sober Truth on Preventing Underage Drinking Act.--The
Committee includes an increase of $2,500,000 for the Sober
Truth on Preventing Underage Drinking (STOP) Act. Of this
amount, the Committee includes an increase of $2,500,000 for
the Community Based Enhancement Grant Program to help community
coalitions address underage drinking.
Strategic Prevention Framework.--The Committee provides an
increase of $10,000,000 for the Strategic Prevention Framework
(SPF). Of this amount, the Committee includes an increase of
$5,000,000 for SPF for Prescription Drugs (SPF Rx).
Tribal Behavioral Grants.--The Committee includes an
increase of $4,250,000 to expand efforts to address the high
incidence of substance misuse and suicide among AI/AN
populations.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
Appropriation, fiscal year 2022....................... $291,658,000
Budget request, fiscal year 2023...................... 181,073,000
Committee Recommendation.............................. 288,707,000
Change from enacted level......................... -2,951,000
Change from budget request........................ +107,634,000
The Committee provides the following amounts for Health
Surveillance and Program Support:
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Health Surveillance.................................. $53,295,000
PHS Evaluation Funds............................. 30,428,000
Program Support...................................... 85,000,000
Public Awareness and Support......................... 13,260,000
Performance and Quality Information Systems.......... 10,200,000
Drug Abuse Warning Network........................... 15,000,000
Behavioral Health Workforce.......................... 1,000,000
PHS Evaluation Funds............................. 1,000,000
------------------------------------------------------------------------
Community Project Funding.--Within the funds included in
this account, $110,952,000 shall be used for the projects, and
in the amounts, specified in the table titled ``Labor, HHS,
Education Incorporation of Community Project Funding Items'' at
the end of this report.
State Opioid Response Network-Technical Assistance.--The
Committee directs SAMHSA to continue funding the State Opioid
Response Network-Technical Assistance grant that funds the
Opioid Response Network to provide locally based technically
assistance teams within the administrative portion of the
appropriated amounts for SOR grants. The Committee recognizes
the essential work currently being done by the Opioid Response
Network in delivering technical assistance to SOR grantees,
sub-recipients and others addressing opioid use disorder and
stimulant use disorder in their communities.
Agency for Healthcare Research and Quality
HEALTHCARE RESEARCH AND QUALITY
Appropriation, fiscal year 2022....................... $350,400,000
Budget request, fiscal year 2023...................... 415,891,000
Committee Recommendation.............................. 385,000,000
Change from enacted level......................... +34,600,000
Change from budget request........................ -30,891,000
The Committee includes $385,000,000 for the Agency for
Healthcare Research and Quality (AHRQ), $34,600,000 above the
fiscal year 2022 enacted level.
AHRQ's mission is to produce evidence to make health care
safer, higher quality, more accessible, equitable, and
affordable, and to work within HHS and with other partners to
make sure that the evidence is understood and used. AHRQ
conducts, supports, and disseminates scientific and policy-
relevant research on topics such as promoting high-quality
care, eliminating health care disparities, using information
technology, and evaluating the effectiveness of clinical
services.
Within the total for AHRQ, the House includes the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Scientific Support for the US Preventive Services 11,542,000
Task Force..........................................
Digital Health Care Research......................... 16,349,000
Patient Safety Research.............................. 99,615,000
Health Services Research, Data, and Dissemination.... 110,312,000
Medical Expenditure Panel Survey..................... 71,791,000
Program Management................................... 75,391,000
------------------------------------------------------------------------
Antimicrobial Resistance.--The Committee continues to
provide no less than $10,000,000 for activities related to
combating antibiotic-resistant bacteria.
Center for Primary Care Research.--The Committee includes
no less than $5,000,000 for the Center for Primary Care
Research authorized at 42 USC 299b-4(b).
Improving Maternal Morbidity and Mortality State and Local
Data.--The Committee supports efforts described in the fiscal
year 2023 budget request to improve the provision of timely and
accurate data about maternal health and the health care system
to policymakers, health care providers, and the public.
Long COVID.--The Committee supports efforts described in
the fiscal year 2023 budget request regarding health systems
research on how to organize and deliver patient-centered care
for people living with long COVID, including the use of digital
and telehealth, providing needed mentoring and support to
smaller communities to establish multidisciplinary clinics to
care for people with complex cases of long COVID, and enhancing
the ability of primary care practices to use emerging evidence
to care for millions of Americans with long COVID.
Diagnostic Safety.--The Committee includes no less than
$20,000,000, a $10,000,000 increase above the fiscal year 2022
enacted level and the fiscal year 2023 budget request, to fund
AHRQ research, testing, and solutions to avoid diagnostic error
and to support Diagnostic Safety Centers of Excellence to
disseminate related findings. Funding provided will support
eight centers, with each center focusing on specific
conditions, populations, or settings of diagnostic safety as
noted in the fiscal year 2023 budget request.
Person-Reported Experience of Care Quality Maternal Health
Measures.--The Committee is concerned that the U.S. spends
significantly more per capita on childbirth than any other
high-income nation, with costs estimated to be well over $50
billion annually, and yet despite this expenditure ranks far
behind almost all other high-income countries in birth outcomes
for both mothers and babies, including high and deeply
inequitable rates of preterm birth, low birth weight, and
maternal and infant mortality. Quality measures are important
drivers of quality improvement in health care, and their
significance is growing in the context of increasing
alternative payment model mechanisms for accountability. The
portfolio of nationally-endorsed maternity care quality
measures is small and includes no person-reported measures of
the experience of receiving maternal-newborn care. Given
widespread reports, especially among of people of color, of
experiencing disrespectful maternity care, and of persistent
inequitable health outcomes, the need for nationally-endorsed
person-reported measures of maternity care to discern, track
and improve maternal-newborn care experiences is crucial. The
Committee strongly encourages AHRQ to develop maternity
adaptations of the generic Consumer Assessment of Healthcare
Providers and Systems surveys and other evidence-based
assessment tools as necessary for facilities, health plans, and
individual/group clinicians to fill these crucial gaps in
maternal and newborn health measures. The Committee requests
that the measures be designed to capture and reduce inequities
and measure care across the continuum of maternity care
providers and care settings, as well at the health plan level.
Such measures will elevate birthing people's voices in
standardized ways that foster accountability and quality
improvement.
Statewide Surgical Quality Initiatives.--The Committee is
aware that several States have moved aggressively to combine
the knowledge, skills, and resources of diverse hospitals
across the State with the expertise of foundations, hospital
associations, and other outside stakeholders to identify and
disseminate best practices in surgical care. The goals of the
collaborative are to improve surgical outcomes, improve the
value (quality/cost) of surgical care, and decrease disparities
in care. The Committee urges AHRQ to prioritize grants to
States that have developed such collaborations and intend to
expand by adding more hospitals and incorporate telehealth and
mobile solutions into higher-value care.
Trafficking Awareness Training for Health Care.--The
Committee strongly encourages AHRQ to support activities
authorized under the Trafficking Awareness Training for Health
Care Act to award, on a competitive basis, grants or contracts
to eligible entities to train health care professionals to
recognize and respond to victims of a severe form of
trafficking for purposes authorized under the Trafficking
Awareness Training for Health Care Act. Medical professionals
are in a unique position to identify abuse and help victims of
trafficking, and this program will support training to enable
them to do so.
United States Preventive Services Task Force (USPSTF).--In
fiscal year 2022, the Committee expressed its initial concerns
about significant deficiencies in the process and structure of
the USPSTF, as illustrated by its recommendations concerning
screening mammography and cervical cancer screening. The
Committee addressed the need for comprehensive USPSTF reform to
ensure that its recommendations further public health for all
Americans and address health inequities by outlining several
recommendations. Within 120 days of enactment of this Act, the
Committee requests an update from USPSTF on its implementation
of the recommendations identified to reform its process for
developing recommendations.
The Committee also is concerned about the ability of the
USPSTF to keep pace with medical innovation. Emerging and
innovative screening modalities can further public health for
all Americans and address health inequities by increasing
access to and compliance with USPSTF recommended screenings.
The Committee encourages USPSTF to utilize the Early Topic
Update process described in the USPSTF procedure manual to
review a recommendation on an enhanced timeframe upon a showing
of new evidence. The Committee also encourages USPSTF to
prioritize review of any new screening test or preventive
medication approved or cleared by the FDA that is a preventive
strategy or modality pertaining to but not included in a
previous Task Force recommendation. In addition to
prioritization, the Committee encourages the Task Force to act
on such prioritization in a timely manner. Within 120 days of
enactment of this Act, the Committee requests an update from
USPSTF on its use of the Early Topic Update process.
Centers for Medicare & Medicaid Services
GRANTS TO STATES FOR MEDICAID
Appropriation, fiscal year 2022................... $368,666,106,000
Budget request, fiscal year 2023.................. 367,357,090,000
Committee Recommendation.......................... 367,357,090,000
Change from enacted level..................... -1,309,016,000
Change from budget request.................... - - -
Medicaid provides health coverage to eligible populations,
including eligible low-income adults, children, pregnant women,
elderly adults, and people with disabilities. Medicaid is
administered by States, according to Federal requirements. The
program is funded jointly by States and the Federal government.
This amount does not include $165,722,018,000, which was
provided as advance funding for the first quarter of fiscal
year 2023. In addition, the Committee recommends an advance
appropriation of $197,580,474,000 for program costs in the
first quarter of fiscal year 2024, to remain available until
expended.
The Committee continues bill language providing indefinite
budget authority for unanticipated costs in fiscal year 2023.
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
Appropriation, fiscal year 2022................ $487,862,000,000
Budget request, fiscal year 2023............... 548,130,000,000
Committee Recommendation....................... 548,130,000,000
Change from enacted level.................. +60,268,000,000
Change from 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
Appropriation, fiscal year 2022....................... $4,024,744,000
Budget request, fiscal year 2023...................... 4,346,985,000
Committee Recommendation.............................. 4,346,985,000
Change from enacted level......................... +322,241,000
Change from budget request........................ - - -
Note: The fiscal year 2022 appropriation includes funding
provided in section 227 of P.L. 117-103.
Program Operations
The Committee includes $2,957,300,000 for Program
Operations, an increase of $122,477,000. This appropriation
includes funding for Research, Demonstration, and Evaluation,
which was previously funded on its own line. This office
administers the programs under the Centers for Medicare &
Medicaid Services (CMS), funds beneficiary outreach and
education, maintains information technology infrastructure
needed to support various claims processing systems, and
supports other programmatic improvements.
Access to Buprenorphine.--The Committee is concerned by
reports of patients not being able to fill buprenorphine
prescriptions at pharmacies. The Committee requests a briefing
from CMS and OIG within 180 days of the date of enactment of
this Act on the results of the current audits examining access
to and use of medications for opioid use disorder (MOUD) and
CMS's intended response.
Advancements in Breast Reconstruction.--The Committee notes
that reconstruction after mastectomy can have a significant,
positive impact on the quality of life for breast cancer
survivors. For this reason, the Women's Health and Cancer
Rights Act (WHCRA) was enacted in 1998 to provide insurance
protections to women choosing breast reconstruction after a
mastectomy. The number of breast reconstructions performed in
the U.S. has steadily increased over the past two decades. Over
the same timeframe, significant technological procedure
advancements have shifted the focus beyond cosmetic-only
results to include the restoration of typical breast functions,
such as sensation. Sensory restoration as a part of breast
reconstruction can ultimately improve the overall physical and
emotional health, safety, and quality of life for breast cancer
survivors. The Committee directs CMS, in collaboration with
other HHS agencies with necessary expertise, to study the
landscape of surgical techniques and other procedures for
breast reconstruction, and whether gaps exist in the insurance
coverage provided by the WHCRA. The Committee requests an
update in the fiscal year 2024 Congressional Budget
Justification on this study.
Adverse Childhood Experiences.--The Committee is aware that
childhood trauma and toxic stress have been linked to negative
health outcomes through adulthood, including higher rates of
diabetes, stroke, depression, lapses in cognitive abilities,
and developmental delays, suicide, and substance misuse, among
other negative outcomes. Low-income children are particularly
vulnerable to the impacts of adverse childhood experiences
(ACEs). The Committee directs CMS to comply with the language
included in House Report 116-450 which requires the agency to
work with the National Child Traumatic Stress Network and the
CDC to provide a report, no later than 180 days after the date
of enactment of this Act, that evaluates how Medicaid could be
further leveraged to screen, diagnose, and provide evidence-
based interventions to children ages 0-21 suffering from ACEs.
Biosimilars.--The Committee is concerned about the lack of
access to lower cost biosimilars to beneficiaries within the
Medicare Part D program. The Committee encourages CMS to
examine existing barriers to biosimilar adoption and to explore
the development of policies that incentivize and facilitate the
adoption of biosimilar to reduce prescription drug costs to
patients and Medicare. The Committee urges CMS to provide
beneficiary focused education on the availability, safety, and
efficacy of biosimilars and the potential for lower out-of-
pocket costs. CMS should include this information in Medicare
Plan Finder and in Real Time Benefit tools. CMS should also
prioritize policies to accelerate the adoption of all
biosimilars on Medicare Advantage and Part D formularies.
Cardiac Computed Tomography.--The Committee notes that
unstable and low Medicare payment for cardiac computed
tomography (CT) services is contributing to significant
disparity in access to this vital service among minority
populations. The Committee requests a report within 90 days of
the date of enactment of this Act on actions being taken by the
agency to address this inequity.
Certified Registered Nurse Anesthetists.--The Committee is
aware that during the COVID-19 pandemic, Certified Registered
Nurse Anesthetists (CRNAs) have been working under a waiver
that expanded access to care for CRNA services. With the
current workforce shortages in the healthcare industry, the
Committee urges HHS to consider options to permanently extend
waivers that will help best utilize the current workforce to
improve access to care before the end of the COVID-19 public
health emergency.
Children's Mental Health.--The Committee is aware of
reporting in recent years on trends in behavioral health
services for children insured by Medicaid, including increased
reliance on psychotropic medications without accompanying
behavioral health services, a lack of home- and community-based
services options, and children in Medicaid from racially/
ethnically diverse backgrounds being less likely than white
children to use behavioral health services. The Committee
requests a report within 180 days of the date of enactment of
this Act on Medicaid spending for children, youth, and young
adolescents on behavioral health, disaggregated by race and
ethnicity. This report should include data on the settings in
which children and youth receive services, the use of
psychotropic medications in this population, a breakdown of
mental health services and substance use services, and whether
children who received outpatient treatment received care in
their state of residence.
Colorectal Cancer Screenings.--The Committee commends CMS
for removing cost sharing requirements for patients for the
removal of potential precancerous or cancerous polyps during a
screening colonoscopy. However, the Committee urges CMS to
explore options to fully remove any barrier to access to
colonoscopies by also waiving cost-sharing requirements for
beneficiaries that select a covered non-invasive colorectal
screening test who receive a positive test result and require a
colonoscopy. At home colorectal cancer screening tests are an
important tool to encourage increased adoption of colorectal
cancer screenings and should be treated equal to a screening
colonoscopy under CMS's reimbursement policy.
Compounded Medications.--The Committee continues to request
a report, within 120 days of the date of enactment of this Act,
assessing Medicare's current policy for Part D coverage of
medications compounded using bulk drug ingredients.
Consensus on Assessing Mobility.--The Committee encourages
CMS and other stakeholders to promote development of consensus
around a mobility assessment that is validated and clinically
meaningful to providers and patients. In addition, CMS should
evaluate feasibility of a mobility quality measure to
incentivize providers to actively intervene to prevent mobility
loss among hospitalized older adults.
Contraceptive Access under the Affordable Care Act.--The
Committee is concerned about access to care for patients
seeking preventive services, including contraceptive services.
The Committee directs CMS to engage in patient education to
ensure patients understand their rights under the Affordable
Care Act (ACA) to access (without cost sharing) the
contraceptive product that is determined best for the patient,
in consultation with their health care provider. In addition,
the Committee directs CMS to engage with health care providers
to disseminate the latest guidance on contraceptive access for
patients, as well as how to help patients seek access to
contraceptive services (without cost sharing) through a health
insurance plan's exceptions process.
Consumer Assistance Program.--The Committee encourages the
Secretary to allocate up to $400,000,000 derived from ACA user
fees to restore Consumer Assistance Program grants under
section 1002 of the ACA.
Cost-Sharing for Vaccines.--The Committee notes that
minimizing cost sharing with Medicare Part D is critical to
ensuring that Medicare beneficiaries have access to vaccines
that can prevent serious disease. Studies have shown a direct
correlation between cost sharing and increased abandonment
rates of vaccines. To help reduce these barriers, the Committee
encourages CMS to update the Medicare plan finder to clearly
designate to consumers the plans that cover vaccines at no
cost.
Dementia Care Management Model.--The Committee urges the
Center for Medicare & Medicaid Innovation (CMMI) consider how
best to test a Medicare dementia care management model. The
Committee encourages CMMI to continue working with stakeholders
to find a way to test a value-based dementia care management
model that could reach dementia patients across the stages and
include coordinated care management and caregivers. The
Committee requests an update not later than one year after the
date of enactment of this Act on the progress for this model.
Diabetes Self-Management Training Benefit.--The Committee
is concerned that barriers to accessing the Medicare diabetes
self-management training benefit, particularly among
communities of color, have resulted in utilization by only five
percent of newly diagnosed Medicare beneficiaries. The
Committee looks forward to receiving the report addressing the
barriers to accessing the diabetes self-management training
benefit, as requested in House Report 117-96.
Disability Clinical Care.--The Committee is aware of a
recent National Council on Disability (NCD) report entitled
``Enforceable Accessible Medical Equipment Standards--A
Necessary Means to Address the Health Care Needs of People with
Mobility Disabilities,'' which identified inaccessible medical
equipment among the reasons for the susceptibility of people
with disabilities to experience substandard health care, citing
numerous studies documenting access barriers involving medical
equipment and the health disparities experienced by millions of
people with disabilities. NCD raised concerns that people with
physical disabilities often postpone or delay care due to the
inability to get onto exam tables and other diagnostic
equipment and have to search for facilities that have such
equipment. Relatedly, NCD has recently advised Congress and the
Administration regarding the nexus between the lack of
disability clinical care training for health care professionals
and the well-documented health disparities experienced by
people with disabilities. The Committee encourages CMS to
examine including disability clinical care training and the
availability of accessible medical and diagnostic equipment in
its conditions of participation for Part A and Part B
providers.
Disproportionate Share Hospitals.--The Committee again
encourages CMS to compile publicly available information on
hospitals that receive payments under Medicaid as
disproportionate share hospitals. Such information shall
include the Medicaid inpatient utilization rate and low-income
utilization rate. Within each category, CMS should further
identify such hospitals by rural or urban status, number of
beds, and status as a major teaching hospital.
Domestic Manufacturing.--The Committee recognizes the
importance of ensuring a robust U.S. manufacturing base and
domestic supply chain to support Federal health programs.
Therefore, the Committee urges CMS to develop and implement a
pilot or demonstration program to identify innovative payment
and reimbursement policies within Federal health care programs,
including Medicare, Medicaid, and CHIP, to support the
utilization of U.S. manufactured generic and biosimilar
medications to ensure increased access and utilization of life-
saving and life-changing drugs.
Drug Quality.--The Committee continues to be concerned
about the discovery of dangerous levels of carcinogens in
frequently prescribed medications, including angiotensin II
receptor blockers (ARBs) like losartan and valsartan,
ranitidine, and metformin. As two of the country's largest
payers for prescription medication, Medicare and Medicaid have
a responsibility to help ensure the safety and quality of
prescribed therapies. The Committee reiterates its request for
a report on the amount that the Medicare and Medicaid programs
spent on medication in the previous three fiscal years that was
subsequently recalled by manufacturers, as requested in House
Report 117-96. The Committee also requests that CMS consider
the potential value of increased chemical testing of medication
in the U.S. supply chain and quality rating systems for drug
manufacturers.
Enhancing Access to Recommended Vaccines.--The Committee is
concerned that current regulations implementing the Public
Health Service Act's (PHSA) provisions regarding vaccine
coverage and cost-sharing have caused uneven access to CDC-
recommended vaccines. The Committee encourages HHS, Department
of Labor (DOL), and Department of the Treasury (Treasury) to
act to ensure that its regulations fully implement section 2713
of the PHSA, which ensures broad-based coverage of all CDC-
recommended vaccines without cost-sharing, including
occupational and travel vaccines, regardless of whether the
vaccine is recommended for routine use or placed on the CDC's
Immunization Schedules.
Ensuring Access to Lifesaving COVID-19 Oral Medications
from Pharmacists.--The Committee is concerned with CMS's
guidance ``Permissible Flexibilities Related to Oral Antiviral
Drugs for Treatment of COVID-19 that May Receive U.S. Food and
Drug Administration Emergency Use Authorization and are
Procured by the U.S. Government,'' which only encourages, but
does not require, Part D ``sponsors to consider paying a
dispensing fee for these drugs that may be higher than a
sponsor's usual negotiated dispensing fees given the unique
circumstances during the public health emergency.'' The
Committee is concerned about patients' access to these
lifesaving medications and encourages CMS to review policy
options for Part D sponsors to cover all the necessary services
to ensure the safe pharmacy dispensing of COVID-19 oral
medications.
GAO Report on Health Care Consolidation.--The Committee
recognizes the need for more research on consolidation in
health care markets. As such, the Committee directs GAO to
study the extent health care consolidation is taking place
across Medicare and Medicaid, and how the involvement of
private equity in healthcare could be contributing to
consolidation. The Committee requests a briefing, including GAO
and CMS, within 90 days of the date of enactment of this Act to
discuss the scope and requirements of the study, and expects to
receive regular updates from GAO about the status of the report
and any initial critical findings.
Geographic Practice Cost Index.--The Committee encourages
CMS to publish its work on a rationale for current methodology
for the Geographic Practice Cost Index so that the various
inputs can be better understood. In addition, the Committee
requests a briefing from the GAO within 90 days of the date of
enactment of this Act on the results from the recent GAO report
on geographic adjustments to Medicare physician payments (GAO-
22-103876).
Graduate Medical Education.--The Committee notes that in
section 126 of P.L. 116-260, Congress provided an additional
1,000 new graduate medical education (GME) slots eligible for
Medicare payment. In section 126, Congress specified four
categories of hospitals eligible for additional GME slots:
hospitals located in rural areas; hospitals currently training
over their caps; hospitals located in States with new medical
schools; and hospitals serving Health Professional Shortage
Areas; however, when CMS released their final plan for the
distribution of the 1,000 new slots, a ``super prioritization''
based on location of resident training was created that is not
found in the statute. The Committee urges CMS to prioritize
applications in fiscal year 2023 from any hospitals seeking to
establish or expand residency training in certain needed
specialties, such as primary care, geriatrics, and general
surgery, as had been the priority with previous GME slot
distribution programs.
Hospitals in the U.S. Virgin Islands.--The Committee
remains concerned that Medicare payments for hospitals in the
U.S. Virgin Islands are calculated using out-of-date payment
data and formulas under the Tax Equity and Fiscal
Responsibility Act of 1982 (TEFRA). The two hospitals in the
U.S. Virgin Islands are reimbursed based on 1982 and 1996
costs. As a result, patients are forced to travel outside the
territory for necessary services, including total joint
replacements and chemotherapy, often at great expense and
personal hardship. The Committee encourages CMS to update the
TEFRA base period for these hospitals to more accurately
reflect current conditions and costs.
IMD Exclusion Pilot Program.--The Committee is aware that
although HHS allows waivers to States allowing short-term stays
in Institutions for Mental Disease (IMD) for mental health
treatment, there are IMDs that provide care to thousands of
individuals in acute psychiatric distress located in States
without waivers. The Committee continues to urge CMS to pursue
a pilot program, as outlined in House Report 117-96.
IMD Exclusion Report.--The Committee continues to request a
report, as included in House Report 117-96, examining how
repealing Medicaid's IMD exclusion could affect access to and
quality of mental health services, including mental health
services for nonelderly, Medicaid-eligible adults. The report
should include a cost estimate for repealing the exclusion.
Infectious Disease Outbreaks.--The Committee requests a
briefing within 90 days of the date of enactment of this Act on
policy and administrative options, including a modifier to
current evaluation and management (E/M) codes for infectious
disease physicians and other types of clinicians, that CMS
could take to reimburse clinicians for critical activities
associated with managing infectious disease outbreaks that
would automatically initiate payment to clinicians under the
Physician Fee Schedule for services associated with these
unanticipated events.
Language Access.--The Committee recognizes the need to
ensure that translated materials are culturally competent and
written in a manner that can be adequately understood by
limited English proficient populations (LEP). The Committee
urges CMS to improve the quality and quantity of such
materials, and consult community based organizations to help
vet translated consumer-facing materials produced by CMS in at
least the top 15 languages spoken by LEP people living in the
United States. The Committee also encourages CMS to develop
translation glossaries of common terms used within CMS programs
in at least the top 15 languages spoken by LEP people.
Limited Wraparound Coverage.--The Committee continues to
remain concerned that the previous Administration allowed the
limited wraparound coverage pilot program to expire. This
failure has caused significant uncertainty for patients who
depended on this program for several years. The Committee looks
forward to receiving the report outlining a plan to ensure that
participants impacted by the expiration of the pilot program
will receive benefits equivalent to those of the limited
wraparound coverage program as requested in House Report 117-
96. This report should include an analysis of the outcomes of
the pilot program and an explanation for the decision by HHS,
DOL, and Treasury not to extend it. The Committee continues to
recommend this pilot program be made permanent and encourages
the HHS, DOL, and Treasury to restore the program.
Lowering the Cost of Care.--The agreement continues to
encourage CMMI to consider creative pilot projects that lower
the cost of care among older Americans and enable individuals
who retire overseas to retain and utilize their Medicare
primary healthcare benefits. The pilot should consider
potential cost savings involving international collaborations
where the quality of care is comparable and less expensive. The
Committee requests an update on this effort in the fiscal year
2024 Congressional Budget Justification.
Maximizing Deceased Donor Organ Recovery, Acceptance, and
Utilization.--The Committee supports full implementation of the
CMS final rule for Organ Procurement Organizations (OPOs)
Conditions for Coverage (CMS-3380-F), including efforts to
decertify underperforming OPOs in advance of 2026 given the
lives, Medicare costs, and urgent equity issues at stake. OPO
failures are disproportionately borne by patients of color,
which means OPO reform is an urgent health equity issue. This
fact further emphasizes the need for effective implementation
of the Final Rule, and to ensure effective and equitable OPO
performance, the Committee encourages CMS to require OPO
process data to be publicly available, in line with
international best practice.
Medicaid Dental Audits.--The Committee has previously
raised concerns that failure to use professional guidelines or
established State Medicaid manual parameters in the auditing
process can result in inaccurate Medicaid dental audits,
negatively impacting dentist participation in the program and
impeding patient access to care. While State Medicaid agencies
(SMA) have significant responsibility in managing provider
audits, the Committee believes that as part of CMS oversight of
the Medicaid program, it is appropriate to issue guidance to
SMAs concerning best practices in dental audits and offer
training in such practices. The Committee again urges CMS to
develop such guidance for SMAs and looks forward to receiving
the report on steps taken to develop such guidance as requested
in House Report 117-96.
Medicaid Parity in Territories.--The Committee supports the
Administration's proposal to eliminate the Medicaid allotment
caps for U.S. Territories and to align the territories' Federal
matching rate to that of the States.
Medicare Advantage and Long-Term Acute Care Hospitals
(LTCHs).--The Committee is aware there is concern there are
more barriers to LTCHs and Inpatient Rehabilitation Facilities
(IRFs) in Medicare Advantage (MA) plans as compared to
traditional Medicare. The Committee requests CMS review whether
MA plan pre-authorization requirements and their use of
proprietary or home-grown algorithms or admission criteria are
consistent with current Medicare Part A coverage policy to
protect MA enrollees' statutory right to comparable benefits.
The review should also determine the validity of Medicare
Advantage Plans denials of admissions to LTCH and IRF based on
not offering the benefit of a Medicare approved level of care;
verify that personnel being utilized by MA plans for pre-
authorizations and denials have the necessary specialized
rehabilitation education and training when requests from LTCHs
and IRFs are being reviewed; review MA plans' process to
provide pre-authorization review and appeals for denials within
reasonable amount of time of planned discharge, including
weekends, to allow for accelerated transfer to LTCHs and IRFs
when necessary; review transparency of MA plans on how they
determine medical necessity, as well as the specific standards
and guidelines that lead to a denial; review transparency of MA
Plans with regard to medical necessity, the number of initial
pre-authorization denials, the number of initial denials
overturned, and the number of second level appeals for pre-
authorization for LTCHs and IRFs.
Medicare Advantage Coverage of Substance Use Services.--The
Committee is aware that enrollees of Medicare Advantage (MA)
plans may face barriers to accessing timely and appropriate
care for substance use disorder (SUD) compared to enrollees of
other insurers. The Committee urges CMS to review how MA plans
can improve access to care for SUD, including by measuring
provider availability as part of network adequacy standards,
such as by maintaining sufficient networks of providers for SUD
and mental health care. The Committee also urges CMS to review
how MA plans can improve access to care for SUD, including
through reviewing level of care assessment tools that reflect
generally accepted standards of care and informing
beneficiaries of the plan's responsibility to arrange for
medically necessary care outside of the network, but at in-
network cost sharing, if the covered service is not provided in
network. The Committee requests a report in the fiscal year
2024 Congressional Budget Justification on updates since the
October 2020 report required by P.L. 115-271 on SUD treatment
services that are provided by MA plans as supplemental
benefits.
Medicare Advantage Overpayments.--The Committee is
concerned about the accuracy of CMS's payments to Medicare
Advantage (MA) plans. The Committee urges CMS to consider
making the following adjustments to MA plan payments: use the
Demographic Estimate of Coding Intensity (DECI) model to
evaluate the relationship of fee-for-service and MA risk scores
for the overall system and plan sponsors; develop a Coding
Intensity Adjustment (CIA) factors applied to MA payments using
the DECI model; calculate the CIA factor to be used in MA
Payments; set limits on the use of select factors and data for
risk adjustment systems and risk score calculations; and use
social determinants of health data in a potential new risk
adjustment model. The Committee requests a report within 180
days of the date of enactment of this Act analyzing the impact
of these potential adjustments on the accuracy of payments to
MA plans.
Medicare Coverage of Behavioral Health Services.--The
Committee is concerned there is insufficient Medicare coverage
of community-based behavioral health services for individuals
in crisis. The Committee requests a report in the fiscal year
2024 Congressional Budget Justification on addressing the scope
of Medicare coverage of behavioral health services for
outpatient behavioral and mental health services. This report
should include information on the total amount of Medicare
spending on behavioral and mental health services in calendar
years 2019 through 2021 by site of service, the amount spent on
each code for services that could be furnished to individuals
in behavioral or mental health crisis, and the provider types
that billed for these services.
Medicare Coverage of Home-based Extended Care Services.--
The Committee encourages CMS to consider options to improve
extended care services for Medicare beneficiaries, such as
through home-based extended care by home health agencies.
Medicare Coverage of Medicines to Treat Obesity.--The
Committee notes that access to obesity treatment, including
anti-obesity medication is an important part of the
Administration's effort to combat chronic disease, reduce
health care costs and improve care. Obesity is associated with
over 200 comorbid conditions and is a driver of health care
costs and poor health outcomes for patients with heart disease,
Alzheimer's, diabetes, cancer, among many others, and is a top
modifiable risk factor for serious COVID-19 outcomes.
Furthermore, consistent with the President's Executive Order on
Advancing Racial Equity, the Committee acknowledges that
obesity is a chronic disease that disproportionately impacts
communities of color. Therefore, consistent with the
Administration's priorities, the Committee believes and that it
is a matter of health equity and key to reducing modifiable
risk factors for cancer and Alzheimer's disease, to ensure that
seniors have access to obesity treatments under Medicare Part D
to complement coverage of intensive behavioral therapy and
bariatric surgery under Medicare Part B. The Committee
encourages CMS to ensure access to treatments for obesity in
Part D by clarifying that an agent for ``weight loss'' does not
include an FDA-approved anti-obesity agent as classified by the
United States Pharmacopeia Drug Classification system.
Mental Health Parity.--The Committee was pleased to see the
2022 Mental Health Parity and Addiction Equity Act (MHPAEA)
Report to Congress from HHS, DOL, and Treasury implementing
section 203 of Division BB of P.L. 116-260. The report points
out, however, that several health insurance plans and issuers
failed to accurately and timely submit comparative analyses on
nonquantitative treatment limits (NQTLs). This has resulted in
HHS, DOL, and Treasury being unable to issue final
determinations of non-compliance, thus limiting enforcement of
MHPAEA. The Committee urges the Secretary of HHS, jointly with
DOL and Treasury, to complete its determinations of non-
compliance and make public the findings related to NQTLs found
to be in violation of MHPAEA. While it is encouraging that
plans and issuers chose to remove problematic provisions
voluntarily, the report suggests there has been sufficient
denial of mental health services through the use of NQTLs.
Navigators.--The Committee strongly supports the Navigators
program, which helps consumers understand their health coverage
options and sign up for health insurance coverage during
enrollment periods. The Committee urges CMS to return to
providing robust funding for Navigator activities.
Neonatal Opioid Withdrawal Syndrome.--The Committee
recognizes the increasing incidence of neonatal opioid
withdrawal syndrome (NOWS) in the United States, including
increasing hospital stays and rates of NOWS among Medicaid-
covered births. The Committee is concerned there are currently
no quality measures for NOWS and prenatal opioid exposure, and
requests a report within 180 days of the date of enactment of
this Act on recommendations for quality measures to be
implemented for improving the quality, safety, value, and
consistency of care for newborns with opioid-exposure,
including NOWS. In developing these recommendations, CMS should
consider how they can be used to advance health equity and
promote person-centered care. The Committee encourages CMS to
consider these recommendations in the next Child Core Set
annual update.
Nuclear Medicine Quality Improvement.--The Committee is
aware of evidence demonstrating the occurrence and consequence
of extravasations in nuclear medicine procedures. These events
can harm patients through compromised imaging that negatively
affects care, repeated or additional procedures, increased
costs, and unintended irradiation to patient tissue. The
Committee supports CMS engagement with outside stakeholders on
the issue.
Obesity and Comorbidities.--The Committee notes obesity is
a disease, and it leads to serious and costly health issues,
including diabetes, heart disease, stroke, certain chronic
liver diseases like nonalcoholic steatohepatitis, and some
types of cancer. Comprehensive management of obesity requires
both lifestyle changes and physician-guided support including
access to innovative pharmacological treatments. The Committee
requests additional information in the fiscal year 2024
Congressional Budget Justification on how policies in Medicare
could be improved to help reduce obesity and its comorbidities
for those Americans who require clinical interventions and
reduce the racial and ethnic disparities in health care
outcomes for beneficiaries suffering from obesity.
Ovarian Cancer Testing.--The Committee recognizes that
ovarian cancer is the only gender-specific cancer with greater
than 50 percent mortality rate, and accounts for more deaths
than any other cancer of the female reproductive system,
especially among women of color. African American women have a
62 percent five-year mortality rate compared to 54 percent for
Caucasian women. The most commonly used detection method may
miss ovarian cancer 37 to 67 percent of the time in African
American women. Asian Pacific Islanders have a higher risk of
developing ovarian clear cell cancer, Hispanic women are
diagnosed with ovarian cancer at an earlier age than non-
Hispanic groups, and there are significant regional differences
in the incidence and mortality of ovarian cancer among Native
American women in the United States. FDA-cleared medical
innovations that use multi-marker testing for ovarian cancer
can improve early detection in women, and especially women of
color, but are not universally reimbursed. The Committee
recommends CMS cover and pay for multi-marker testing related
to ovarian cancer for Medicare beneficiaries. In addition, the
Committee requests a report not later than 180 days after the
date of enactment of this Act with the status and timeline for
a national coverage determination for multi-marker tests for
ovarian cancer.
Patient Access to Home Health Care.--The Committee supports
the intent of the network adequacy rules of CMS for Medicare
Advantage organizations and for Medicaid managed care
organizations under 42 C.F.R. 438 and 457 to maintain a network
of qualified providers sufficient to provide adequate access
for covered services to meet the health care needs of the
patient population served. The Committee requests a report
within 180 days of the date of enactment of this Act on
regulatory actions related to network adequacy.
Patient Advocate Program.--The Committee is concerned about
barriers hospitalized patients face during time of discharge
and the subsequent coordination of care at discharge. Patients
from historically underserved racial and cultural groups suffer
the greatest challenges in terms of care coordination. While
some patients are able to contribute to the decision making
process regarding healthcare, there are other patients who are
unable to fully comprehend the coordination of care at
discharge, including: access to nurse case managers, social
workers, and/or mental health care providers. The number of
patients assigned to a nurse case manager or social worker is
high. Therefore, an additional level of patient advocacy and
support is critical to the ongoing coordination of safe patient
care at discharge from acute care and/or acute rehabilitation
facilities. The Committee recommends $10,000,000 for the
development of a patient advocacy program to support improved
coordination of care and improve patient care outcomes for all
patients discharged from acute care or acute rehabilitation
settings. The Committee also requests a report within 180 days
of the date of enactment of this Act to assess barriers to
coordination of care for hospitalized patients, address
disparities by race, ethnicity, and culturally responsive care.
In addition, the Committee makes these recommendations to
improve patient access to care within a hospital and/or acute
rehabilitation setting.
Pediatric ESRD Services.--The Committee recognizes that
children with end stage renal disease (ESRD) have unique care
needs and require services that are not typically required by
adult ESRD patients, including specialized nursing care,
nutritional support, social workers, and child life
specialists. The Committee commends CMS for focusing on
pediatric case-mix adjustment in its December 2020 technical
expert panel and requesting information on the adequacy of
reimbursement for pediatric services in the request for
information included in the calendar year 2022 End Stage Renal
Disease Prospective Payment System Proposed Rule. The Committee
requests an update in the fiscal year 2024 Congressional Budget
Justification on progress towards establishing adequate bundled
payments for pediatric ESRD services.
Peripheral Artery Disease.--The Committee is aware that an
estimated 20 million Americans have peripheral artery disease
and about 200,000 of them, disproportionately people of color,
suffer avoidable amputations every year as a result. The
Committee urges CMS to raise public awareness in Medicare
beneficiaries and providers of racial disparities in
amputations due to peripheral artery disease, diabetes, and
related comorbidities through a nationwide awareness and
education campaign. Further, the Committee encourages the
Secretary to establish an interagency working group in
coordination with CMS, the Indian Health Service (IHS), and the
Department of Veterans Affairs (VA) and to study the
implementation of a comprehensive amputation reduction program
within CMS and IHS based on the VA Preventing Amputations in
Veterans Everywhere Program. The Committee directs the
Secretary to provide recommendations not later than one year
after the date of enactment of this Act on how to reduce
amputations.
Pharmacists and Patient Care Services.--The Committee is
aware that certain Medicare Part B services and care frameworks
have provisions to include pharmacists and their patient care
services. However, CMS has few mechanisms to identify and
evaluate the contributions of pharmacists to patient care and
outcomes or to identify barriers within current service
requirements that prevent scalable involvement of pharmacists.
The Committee encourages CMS to create a mechanism to provide
greater visibility into the scope and outcomes of the Medicare
services currently provided by pharmacists.
Pharmacist-Provided Incident to Physician Services.--The
Committee is pleased with CMS's recognition in the calendar
year 2021 physician fee schedule (PFS) final rule (FR 84583)
that ``pharmacists could be considered QHPs [qualified health
care professionals] or clinical staff, depending on their role
in a given service,'' and that ``new coding might be useful to
specifically identify these particular models of care.''
However, the Committee remains concerned with current CMS PFS
requirements restricting physicians' and nonphysician
practitioners' (NPPs) utilizing pharmacists under incident to
models to bill at the lowest E/M code (99211), with an
estimated time commitment of 7 minutes. The Committee
understands this restriction has diminished providers'
engagement with pharmacists in team-based care models across
the country. CMS should consider how to ensure physicians and
NPPs can optimize the use of pharmacists. The Committee
encourages CMS identify mechanisms to attribute, report, and
sustain pharmacists' patient care contributions to
beneficiaries in the Medicare Part B program.
Programs of All-Inclusive Care for the Elderly.--The
Committee notes during the COVID-19 pandemic, Programs of All-
Inclusive Care for the Elderly (PACE) have been effective in
keeping their medically complex, nursing home eligible
population safe at home. PACE organizations furnish all
Medicare and Medicaid covered services, long term care and
supports, meals and other services as needed by participants,
principally in participants homes. PACE participants have had
one-third the COVID-19 cases and deaths as compared to the
rates of nursing home residents. The Committee urges CMS to
consider moving forward on PACE-specific pilots in fiscal year
2023, so this community-based model of care may be evaluated as
to whether it increases access and affordability for Medicare
or Medicaid beneficiaries.
Psychosocial Rehabilitation Model.--The Committee is
concerned about the high prevalence of loneliness and social
isolation among Americans with severe mental illness (SMI),
especially given the body of research indicating that these
factors, along with other social determinants of health, can
strongly affect mental and physical health outcomes for this
population. The Committee encourages CMS to explore alternative
payment models that better reflect the significant health,
economic, and overall societal benefits associated with
alleviating social isolation among people with SMI. The
Committee encourages CMS to consider how CMMI could integrate
the value associated with reducing social isolation for people
with SMI in current and future value-based models; how the
Center for Clinical Standards of Quality could identify
patient-reported outcome measures related to social isolation
and loneliness that could be included in current and future
value-based models; and how the Center for Medicaid and CHIP
Services (CMCS) could encourage State Medicaid agencies to
contract with payers that offer comprehensive psychosocial
rehabilitation services that reduce social isolation and
improve quality of life for people with SMI.
Radiation Oncology Model.--Despite the delay in
implementation, the Committee is concerned that the radiation
oncology (RO) model as currently proposed could potentially
reduce access to certain types of radiation therapy and
negatively affect patient outcomes. The Committee looks forward
to the report on the RO model requested in House Report 116-
450. In addition, the Committee encourages CMS to work with
stakeholders to develop a RO model that supports patients
access to care, patient quality, and the Medicare trust funds.
Rare Diseases.--The Committee recognizes patients with rare
and ultra-rare diseases experience significant challenges, and
such challenges are likely to impact marginalized communities
and communities of color disproportionately. The Committee
requests a report within 180 days of the date of enactment of
this Act on barriers to accessing treatments, diagnostics,
clinicians, especially specialists, in both conditions
affecting fewer than 20,000 patients, and in communities of
color affected by diseases with fewer than 200,000 patients.
The report should include an assessment of any legal, improper
payment, and fraud implications of any denials of care for
these patients, as well as recommendations for addressing any
barriers to accessing treatments for such patients.
Robotic Stereotactic Radiosurgery.--The Committee continues
to support robotic stereotactic radiosurgery (SRS) and robotic
stereotactic body radiation therapy (SBRT). The Committee urges
CMS to maintain sufficient payment for SRS and SBRT to ensure
viability in both the freestanding and hospital outpatient
setting, including in both traditional fee-for-service Medicare
as well as in the context of any alternative payment models
developed by CMS.
Rural Pharmacies.--The Committee recognizes the importance
of rural pharmacies in dispensing medications, providing care,
educating patients, ensuring patient safety, and responding to
the COVID-19 pandemic. The Committee is concerned that
insufficient reimbursement and payments, increasing costs of
operation, and narrowing profit margins threatens the viability
of pharmacies in rural areas. The Committee requests a report
within 180 days of the date of enactment of this Act that
includes a review and assessment of the reimbursement and
payment options for rural pharmacies.
Saline Shortage.--The Committee notes the FDA has
recognized a shortage of saline solution since at least 2013,
when it was included on the FDA drug shortage list. Saline
solution is delivered to patients through intravenous (IV)
pumps. The shortage of saline highlights a potential risk for
routine health care delivery and critical care during trauma
events. The Committee encourages CMS to coordinate with the FDA
and complete its coverage and payment reviews of products
related to new classes of resuscitation fluids as expeditiously
as possible.
Site Neutral Reimbursement.--The Committee remains
concerned with the financial impact of the Site Neutral Payment
Rule on access to care, health disparities, and hospital
finances for Sole Community Hospitals and other hospitals in
underserved areas. The Committee encourages CMS to consider
restoring payment rates for Sole Community Hospitals with
excepted off-campus provider-departments.
Social Determinants of Health.--The Committee is aware that
social determinants of health are critical drivers of health
outcomes and health care costs and that early childhood
development is affected by social factors. The Committee
commends CMS for the guidance on social determinants issued to
States in January 2021 and encourages CMS to continue to
clarify and disseminate strategies that States can implement
under current Medicaid and Children's Health Insurance Program
(CHIP) authority, or through waivers, to address social
determinants of health (SDOH) in the provision of health care,
including strategies specifically targeting the pediatric
population. This should include guidance on how States can
encourage and incentivize managed care organizations to address
SDOH through contracts.
Social Determinants of Health Analytics.--The Committee is
encouraged that Medicare Advantage (MA) and Medicaid Managed
Care Organizations (MCOs) have stated an intent to employ
strategies to address SDOH, and the Committee supports work on
SDOH given historic inequities that have existed among at-risk
populations like communities of color and rural communities.
However, in constructing SDOH-based recommendations for
beneficiaries, many health plans are regularly using what is
described as ``consumer data,'' which includes clinical,
social, economic, behavioral, and environmental data that is
individually identified, sometimes combining or allowing other
entities to combine it with protected medical information
governed by Health Insurance Portability and Accountability Act
of 1996. The Committee requests a report within 180 days of the
date of enactment of this Act on efforts by CMS to ensure the
transparency by MA and MCO plans in the use of data of
beneficiaries in addressing SDOH, how CMS ensures that MA and
MCO plans notify beneficiaries of the use of protected or
consumer data, and how ongoing CMS work with MA and MCOs around
SDOH and the use of consumer data and protected medical
information aligns with and improves health equity as per the
goals of Executive Order 13985 and the HHS's Equity Action
Plan.
Sole Community Hospitals.--The Committee appreciates that
CMS, during the COVID-19 public health emergency (PHE), waived
distance requirements to ensure Sole Community Hospitals were
able to focus on maintaining access to needed health care
services for Medicare beneficiaries. The Committee encourages
CMS to consider utilizing its regulatory flexibilities to
provide a transition period for hospitals that may have fallen
out of compliance with Sole Community Hospital requirements
during the PHE.
State All Payer Claims Databases.--The Committee includes
sufficient funding to support grants of $1,000,000 to up to 25
eligible States under section 320B of the PHS Act for the first
year of activities to establish a State All Payer Claims
Database (APCD) or improve an existing State APCD. These grants
will support the work the Agency for Healthcare Research and
Quality and the Assistant Secretary for Planning and Evaluation
are currently conducting on APCD infrastructure.
STI Screening and Treatment Initiative.--The Committee
continues to be concerned with the high rates of sexually
transmitted infections (STIs) among young adults and pregnant
women. As STIs continue to rise, reaching this vulnerable
population is critical to curb the spread of these diseases.
The Committee urges CMS to collaborate with the CDC's Division
of STD Prevention to develop a screening, treatment, and
education initiative under the Medicaid program.
Supplemental Liquid Oxygen.--The Committee notes reports of
ongoing supplemental oxygen shortage exacerbated by the
increase in patients with COVID-19 and long COVID. The
Committee is concerned about reports of Medicare beneficiary
barriers to liquid oxygen for home and community use. The
Committee encourages HHS to evaluate options to ensure the
long-term availability of supplemental liquid oxygen.
Supportive Services through Medicaid.--The Committee
recognizes the importance of supportive services for
individuals with a substance use or mental health disorder.
Supportive services, like peer support workers, help people
stay in treatment or recovery and avoid recurrence of substance
use. The Committee urges CMS to continue working with States to
incorporate support services, including peer support services,
supportive employment services, and tenancy support services,
into State Medicaid plans or waivers of such plans in a way
that promotes sustainability of services and aligns with the
best available evidence and contributes to supporting the full
spectrum of treatment and recovery support services for
behavioral health conditions.
Telehealth and Health Care Access.--The Committee requests
a report in the fiscal year 2024 Congressional Budget
Justification on the impact of telehealth on health care
access, utilization, cost, and outcomes, broken down by race,
ethnicity, sex, age, disability status, and zip code under the
Medicaid program and CHIP.
Transportation for Dialysis.--The Committee continues to
strongly urge CMS to delay further implementation of the Prior
Authorization of Repetitive, Scheduled Non-Emergent Ambulance
Transport model until it ensures appropriate alternative
transportation to dialysis services and diabetes-related wound
care for low-income beneficiaries who have no other means of
transportation. The Committee further requests a plan within 90
days of the date of enactment of this Act to provide
alternative transportation to the low-income Medicare-Medicaid
full and partial dual eligibles who have no alternative
transportation to dialysis and diabetes wound care services.
Utilization Management for MOUD.--The Committee recognizes
that frontline medical provider experience and research
increasingly indicate that individuals who take oral
buprenorphine for opioid use disorder (OUD) may benefit from
doses higher than 24mg. The population of individuals who may
need higher doses of buprenorphine to prevent cravings is
expected to increase as fentanyl continues to proliferate the
illicit opioid market. The Committee is aware that State
Medicaid programs may have in place utilization management
practices, including those that require a prior authorization
before prescribing oral buprenorphine above 16mg or 24mg daily.
The Committee requests that CMS examine State utilization
management requirements related to oral buprenorphine, and
whether such requirements unnecessarily delay access to
treatment.
Utilization of Z Codes for Social Determinants of Health.--
The Committee commends CMS for publishing a report on the
Utilization of Z codes for SDOH among Medicare FFS
beneficiaries. As the report notes, the COVID-19 pandemic has
disproportionately affected underserved communities. The
Committee is concerned about whether the current Z codes
definitions are expansive and specific enough to track the SDOH
impacting underserved communities. To help reduce these
barriers, the Committee encourages HHS to update the current Z
code definitions and establish a national standard to review
SDOH to ensure physicians nationwide use the same tools to
analyze SDOH. The Committee requests a briefing within 180 days
of the date of enactment of this Act on the current utilization
of Z codes, how HHS suggests the Z codes definitions could be
updated to better track SDOH impacting underserved communities
and recommendations on how to increase the utilization of Z
codes.
Whole Child Health.--The Committee recognizes that SDOH
influence health outcomes, particularly for children. The
Committee further recognizes that the COVID-19 pandemic has
placed additional social stressors on children and their
families and has negatively impacted pediatric mental health.
The Committee commends CMS for testing the Integrated Care for
Kids Model and for its guidance on social determinants issued
to States in January 2021. The Committee urges the CMCS to
establish a whole child health demonstration program to address
the health and social factors impacting children served by
Medicaid and CHIP and to improve health equity. This
demonstration program should include pediatric value-based care
models and locally driven strategies to align financial
incentives and resources across Medicaid and other public and
private programs and resources. The Committee requests a report
within 180 days of the date of enactment of this Act on the
plan to establish the demonstration program, including cost
estimates for implementation.
Whole Genome Sequencing Guidance for Medicaid and CHIP
Programs.--The Committee understands there is a growing body of
evidence that whole genome sequencing (WGS), whole exome
sequencing, and gene panel testing can save lives and save
money when used to diagnose infants and children who are
suspected of having a rare genetic disease. Under ``Project
Baby Bear,'' a pilot program in California's Medicaid program,
the use of rapid WGS helped physicians more accurately identify
the exact cause of rare genetic diseases. The Committee also
understands that other States are pursuing or considering
similar initiatives. The Committee encourages CMS to develop
guidance for State health officials on best practices for
incorporating WGS, whole exome sequencing, and gene panel
testing into their Medicaid and CHIP programs as a first-line
diagnostic for infants and children who are suspected of having
rare genetic diseases in the inpatient setting. This guidance
should also include advice for States on how to encourage
managed care organizations to cover WGS, whole exome
sequencing, and gene panel testing for this population. The
Committee requests a report within 180 days of the date of
enactment of this Act on steps taken to develop such guidance.
In addition, the Committee understands there are undiagnosed
diseases that do not require hospital inpatient care.
Therefore, the Committee encourages CMS to issue guidance on
the Early and Periodic Screening, Diagnostic and Treatment
(EPSDT) Benefit on the usage of WGS, whole exome sequencing,
and gene panel testing.
State Survey and Certification
The Committee provides $494,261,000 for State Survey and
Certification activities, an increase of $96,927,000. State
Survey and Certification supports certifications of Medicare
and Medicaid certified health care facilities to ensure that
beneficiaries receive care at facilities that meet health,
safety, and quality standards required by CMS.
Federal Administration
The Committee provides $895,424,000 for Federal
Administration activities related to the Medicare and Medicaid
programs, an increase of $122,891,000. Federal Administration
funding supports CMS staff, along with operating and
administrative expenses for information technology,
communication, utilities, rent and space requirements, as well
as administrative contracts.
Quality Improvement Organizations.--The Committee does not
support the Administration's proposal to shift personnel costs
to the Federal Administration account that have previously been
funded by a mandatory appropriation.
Health Care Fraud and Abuse Control Account
Appropriation, fiscal year 2022....................... $873,000,000
Budget request, fiscal year 2023...................... 899,000,000
Committee Recommendation.............................. 899,000,000
Change from enacted level......................... +26,000,000
Change from budget request........................ - - -
The Health Care Fraud and Abuse Control Account (HCFAC)
funds support activities conducted by CMS, the HHS Office of
Inspector General, and the Department of Justice (DOJ). This
appropriation includes a base amount of $323,000,000 and an
additional $576,000,000 through a discretionary budget cap
adjustment provided to meet the terms of H. Res. 1151. This is
$26,000,000 above the fiscal year 2022 enacted level.
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 related to these programs
carried out by the DOJ.
Care Denials.--The Committee strongly encourages CMS to
increase investigations of inappropriate care denials by
private insurance companies.
Senior Medicare Patrol.--The Committee includes $35,000,000
for the Senior Medicare Patrol program. The Committee continues
to include modified bill language to enable the Secretary to
fund the Senior Medicare Patrol program, which is administered
by the Administration for Community Living, from either
discretionary or mandatory funds provided to this account.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriation, fiscal year 2022....................... $2,795,000,000
Budget request, fiscal year 2023...................... 2,883,000,000
Committee Recommendation.............................. 2,883,000,000
Change from enacted level......................... +88,000,000
Change from budget request........................ - - -
The Committee also recommends $1,300,000,000 in advance
funding, as requested, for the first quarter of fiscal year
2024 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
Appropriation, fiscal year 2022....................... $3,800,304,000
Budget request, fiscal year 2023...................... 3,975,304,000
Committee Recommendation.............................. 4,000,000,000
Change from enacted level......................... +199,696,000
Change from budget request........................ +24,696,000
The Committee recommends $4,000,000,000 for the Low Income
Home Energy Assistance program, which is $199,696,000 above the
fiscal year 2022 enacted level and $24,696,000 above the fiscal
year 2023 budget request. The Low Income Home Energy Assistance
Program (LIHEAP) supports eligible families and households
through programs providing assistance with energy costs.
In addition to funding made available in this bill, the
Committee notes that the Infrastructure Investment and Jobs Act
(P.L. 117-58) provided $500,000,000 in LIHEAP funding over five
fiscal years, with $100,000,000 made available each fiscal year
through September 30, 2026, to support eligible families with
home energy costs.
Hold Harmless.--While the Committee recognizes that
progress has been made in recent years to limit annual
decreases in State allocations to no more than three percent of
what a State received in the previous year, the Committee
continues to believe that all States have unmet needs and that
all States benefit from the consistency of annual
appropriations when the overall account is unchanged or
increased. To correct this volatility and hold States,
territories, and Tribes (funded through the States) harmless
from annual reductions, the bill includes language directing
the Administration for Children and Families (ACF) to
distribute, at a minimum, no less than the amount of funding to
each State, territory, and Tribe as was appropriated in the
Consolidated Appropriations Act, 2022.
Technical Assistance.--The Committee recommends a
$1,700,000 increase for HHS to establish a system to automate
the formulation process to enable ACF staff to provide
estimates more readily when requested by the Committee.
REFUGEE AND ENTRANT ASSISTANCE
Appropriation, fiscal year 2022....................... $6,425,214,000
Budget request, fiscal year 2023...................... 6,327,843,000
Committee Recommendation.............................. 7,979,346,000
Change from enacted level......................... +1,554,132,000
Change from budget request........................ +1,651,503,000
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 children
in Federal custody and survivors of torture.
Funding for several of the programs within this account is
highly dependent on estimates and as such, it is critical that
ORR communicate changes to estimated numbers of arrivals and
costs as they become available. The Committee directs ORR to
provide monthly updates of arrivals each month by category,
including refugees, asylees, Cuban and Haitian entrants,
Special Immigrant Visas, and unaccompanied children, to include
any updates in estimated funding needs as a result of changes
in trends in those categories.
Within the total, the Committee includes the following:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Transitional and Medical Services................... $760,000,000
Victims of Trafficking............................... 35,000,000
Refugee Support Services............................. 450,000,000
Unaccompanied Children............................... 6,714,346,000
Survivors of Torture................................. 20,000,000
------------------------------------------------------------------------
Transitional and Medical Services
The Committee includes $760,000,000, which is $196,000,000
above the fiscal year 2022 enacted level. The Transitional and
Medical Services (TAMS) program provides grants to States and
nonprofit organizations to provide refugees and other eligible
populations with up to eight months of cash and medical
assistance.
Victims of Trafficking
The Committee includes $35,000,000 for the Victims of
Trafficking program, which is $5,245,000 above the fiscal year
2022 enacted level. The recommendation includes $5,500,000 for
the National Human Trafficking Hotline.
The Committee appreciates that the Office on Trafficking in
Persons (OTIP) has integrated legal services into its
comprehensive case management grant programs and encourages ACF
to continue to increase access to legal services for both
foreign national victims and U.S. citizen and legal permanent
resident victims, consistent with demonstrated need.
Refugee Support Services
The recommendation includes $450,000,000, which is
$142,799,000 above the fiscal year 2022 enacted level. The
Refugee Support Services (RSS) program provides formula and
competitive grants to States and nonprofit organizations to
address barriers to employment and help refugees become self-
sufficient.
The Committee urges ORR to engage with the Department of
Housing and Urban Development and Department of State on ways
to align Federal efforts and reduce administrative costs across
refugee support programs to maximize the efficient provision of
safe housing and other services for eligible populations.
Unaccompanied Children
The Committee includes $6,714,346,000 for the Unaccompanied
Children (UC) Program, which is equal to the amount requested
in the fiscal year 2023 budget request (including both
discretionary and contingency funding). The Committee notes
that the request is approximately $1,300,000,000 below the
amount that was provided for the program in fiscal year 2022,
despite the continued impacts of COVID-19 and the high numbers
of children seeking refuge at the Southern border. The
Committee provides the funding requested for fiscal year 2023
with the understanding that the reduction of funding (compared
to fiscal year 2022) is the result of strategic improvements
ORR is making to plan for additional capacity when there are
surges in arrivals, and the sustained focus on efforts to
discharge children safely and expeditiously to vetted sponsors.
The Committee recommends this funding level with the
understanding that ORR will continue its commitment to invest
in a network of licensed beds to the greatest extent possible,
increase oversight and monitoring of all shelters, expand
services for children while they are in care and post-release,
and importantly, to maintain the closure of emergency intake
sites.
The Committee continues to stress the critical importance
of increased services to children, and provides not less than
$650,000,000, an increase of $92,000,000 over the fiscal year
2022 enacted level, for legal services, post-release services,
and child advocates. The Committee directs ORR to report
regularly the number of referrals from CBP, and to continue to
provide quarterly reports on the number of children receiving
services from legal service providers, the number receiving
post-release legal and social services, and the number who are
appointed child advocates, including the number of children on
the waitlist for any of these services, in accordance with the
directive in House Report 116-450. The Committee expects ORR to
set targets for the number and percentage of children that will
be provided such services so that the Committee can ensure that
the number of children with access to such services
significantly increases over fiscal year 2022.
Age-Outs.--The Committee continues to direct ORR to develop
tangible post-18 plans for every 17-year-old unaccompanied
child in ORR care at least two weeks in advance of their 18th
birthday to ensure that an appropriate non-secure placement,
along with any necessary social support services, has been
identified for the child prior to discharge from ORR.
Case Management and Community Support Services.--The
Committee expects HHS to coordinate with DHS to provide an
analysis of existing case management programs, including the
Alternatives to Detention Case Management pilot program being
administered by the DHS Office of Civil Rights and Civil
Liberties, and to promptly brief the Committee within 180 days
of enactment of P.L. 117-103. The Committee remains concerned
that case management programs accountable only to U.S.
Immigration and Customs Enforcement may negatively impact the
ability and willingness of community-based organizations to
directly contract for community-based support services, and
encourages HHS to evaluate which agencies or offices within HHS
may be well-positioned to ensure that individuals and families
receiving short term assistance upon entry can receive
referrals for longer term community-based case management
services through HHS when requested.
Child Advocates.--The recommendation includes $12,000,000
for ORR to expand Child Advocate services and to ensure that
child advocates are appointed to particularly vulnerable
children, including victims of abuse or trafficking, children
12 years old and younger, children in residential treatment
centers, children seeking review of their release or placement,
pregnant and parenting children, children with disabilities or
complex medical conditions, and children who are expected to
remain in ORR custody for prolonged periods of time. The
Committee encourages ORR to ensure that child advocates are
able to communicate and share information essential to
protecting a child's best interests with the child and the
child's attorney. The recommendation continues language waiving
matching requirements, and provides an increase in funding for
the program to more than offset previous matching requirements.
To ensure that child advocates have the visibility and
capacity to be appointed to the most pressing cases in ORR
custody, the Committee strongly urges ORR to proactively share
census data from each facility with child advocates on a
consistent basis. Such census should list the names, ages,
countries of origins, languages, and lengths of stay of each
child in the program, which will help child advocates identify
the children in greatest need.
Children with Prolonged Stays.--The Committee continues to
direct ORR to submit a report every six months on the number of
children who have been in ORR custody longer than a year. Such
report should include how long each child has been in ORR
custody and a status update on their case, including whether
the child has any family or other potential sponsor(s) in the
United States and a summary of ORR's efforts to place the child
with a sponsor or in a long-term foster care setting. The
Committee directs ORR to ensure that a care provider is taking
all steps necessary to place every child in a home as
expeditiously as possible and that no child is unaccounted for,
resulting in prolonged detention.
Communicating With Congress.--The Committee expects HHS to
notify the Committee prior to making any administrative or
policy changes expected to impact the number of children in ORR
custody; shelter operations; the placement of children with
sponsors; or any post-release services.
Community-Based Facilities.--The Committee directs ORR to
prioritize new grant or contract funding to small-scale,
community-based residential care placements. As ORR adds State-
licensed capacity to its network, the Committee expects that no
less than 50 percent of beds added to the network be in small-
scale shelters, transitional foster care, small group homes, or
long-term foster care. The Committee further directs ORR to
ensure there is an adequate supply of long-term foster care
beds in the network to minimize the time it takes for a child
to be moved to this least restrictive placement.
In addition, ORR is directed to notify the Committee prior
to all new funding opportunity announcements, grant or contract
awards, or plans to release or acquire property. Further, the
Committee strongly encourages ORR to post funding opportunity
announcements more consistently and predictably, and to provide
training and technical assistance to potential new providers.
Legal Services.--The Committee supports the continued
expansion of independent legal services for unaccompanied
children and notes that services provided by independent and
qualified legal counsel to unaccompanied children increase the
efficiency, effectiveness, and fairness of immigration
proceedings, significantly reduce the failure-to-appear rate of
children who are released from HHS custody, and help relieve
the immigration court backlog. The recommendation includes
funding and direction for ORR to ensure in-person ``Know Your
Rights'' and legal screenings for every child in custody, and
for the continued expansion of direct representation for
released unaccompanied children. The Committee emphasizes the
vital importance of legal services for unaccompanied children
both during ORR custody and following release and expects post-
release direct representation to be made available to children
up to funded capacity, without restrictions related to age
while in ORR care; release date; estimated time to conclude a
case; or other characteristics, provided the representation is
initiated while the individual is still a minor.
The Committee expects legal services to be in person absent
exigent circumstances, such as for a public health emergency,
and expects ORR to ensure that there is sufficient confidential
space available for legal services at all facilities, including
emergency or influx facilities. When services must be provided
remotely, ORR shall make sufficient technology and confidential
space available for communication via video whenever possible,
or via telephone if necessary.
In addition, the Committee strongly encourages ORR to work
with legal service providers to develop a strategy to minimize
the risks of any child having to go to immigration court
without independent legal counsel. Within the amount for
services for children, the recommendation includes up to
$8,300,000 for legal service providers to recruit and train
additional attorneys for the purposes of building the capacity
necessary to provide independent representation to
unaccompanied children with pending immigration cases.
Mental Health Services.--The Committee appreciates the
steps that ORR has taken to improve mental health services for
children in its custody and urges ORR to further expand mental
health services and the use of other interventions, and to
provide in-person and continuous training to ORR-contracted
staff on the specialized needs of children in ORR's care. The
Committee directs ORR to work with residential care service
providers, child welfare experts, and other stakeholders with
relevant expertise to ensure compliance with Federal, State and
local codes related to the standards of care or the well-being
of young children and children with disabilities, and to
develop policy guidelines regarding residential care and
specialized, trauma-informed practices for the aforementioned
groups of children, including regarding appropriateness of
residential treatment centers as a form of residential care.
The Committee directs ORR to include in its fiscal year 2024
Congressional Budget Justification information on these
efforts, including details and metrics on the types of training
offered to staff to ensure appropriate care is available for
young children, children with disabilities, and children with
mental health needs.
Non-Parental Relatives.--The Committee strongly supports
efforts to reduce the amount of time a child may be separated
from a family member when referred from CBP as unaccompanied
even though the child arrived at the border with a non-parental
relative. The Committee further supports ORR's efforts to
improve efficiency, including by deploying HHS staff to DHS
facilities for the purposes of verifying relationships and
initiating the sponsor suitability process for adult family
members claiming a Category 2a or 2b relationship with the
child (or children) with whom they arrived.
Office of the Ombudsperson.--The Committee continues to
support efforts to increase and improve independent oversight
of the UC program through the establishment of an Office of the
Ombudsperson. The Committee expects the briefing required in
accordance with the Joint Explanatory Statement that
accompanied P.L. 117-103 to include a strategy for
establishment of the Office, including estimates of the
resources necessary to do so. The Committee includes up to
$10,000,000 for establishment of the Office.
Post-Release Services.--The Committee includes an increase
in funding for post-release services to enhance and extend case
management services to more children to assist them with school
enrollment; access to legal services, health care, mental
health and community services; and to provide counseling to the
child and families in the initial period after release. The
Committee urges ORR to engage with current family reunification
service providers, post-release service providers, and recently
released children and sponsors to discuss needed services, the
length of services, and how to improve coordination between
shelters, providers and other community services providers, to
help evaluate the current program, to identify new risks and
opportunities for improvement.
In addition to children already designated under law or
policy to receive such services, the Committee encourages ORR
to ensure that all pregnant or parenting teens, children whose
primary language is neither English nor Spanish, as well as
children who faced separation from a parent or legal guardian
at the U.S.-Mexico border, are referred for post-release
services. ORR should arrange for such services to be provided
by non-governmental organizations with experience and expertise
in working with these children. The Committee urges ORR to
develop and make public on its website the criteria for how
children are prioritized for post-release services, and the
number of children receiving services in each fiscal year.
Protection of Genetic Information.--The Committee continues
to prohibit any governmental agency or private entity from
accessing, using, or storing any genetic material, data, or
information collected in this reunification effort, including
for the purpose of criminal or immigration enforcement. Any
genetic material, data, or information obtained by a government
agency or private entity should be destroyed after testing and
the probability of a genetic relationship is calculated. The
entities conducting DNA testing shall obtain the consent of any
individual over age 18 prior to testing, and shall make every
effort to obtain the consent of a guardian prior to testing
anyone under age 18. The Committee requests ORR continue to
include in its annual Congressional Budget Justification the
steps it is taking to protect the privacy and genetic material
and data of individuals who are being tested as part of
reunification efforts.
Spend Plan.--The bill includes a general provision
requiring the Secretary of HHS to continue to submit a
comprehensive spend plan to the Committee every 60 days. The
plan should continue to include a report on facilities, by
facility type, including facility-specific data including
number of licensed beds; operating status (open or not yet
open); whether a facility is operated by a for-profit or non-
profit company; and the availability of such facilities to
legal, medical and social service resources.
Tender Age Children.--The Committee directs ORR to include
in the fiscal year 2024 Congressional Budget Justification
information on efforts to ensure developmentally appropriate
care is available for tender age children. The justification
should detail how placement options, services, and staff
training are tailored for tender age children, as well as an
assessment of the circumstances under which very young children
are referred to ORR.
Unlicensed Facilities.--The Committee understands the
challenges facing HHS in ensuring sufficient State-licensed
shelter capacity amid the ongoing COVID-19 pandemic and high
numbers of children seeking protection at the Southern border.
The Committee recognizes and shares HHS's commitment to
ensuring that unaccompanied children are not subject to
prolonged detention in U.S. Customs and Border Protection (CBP)
facilities--however, the Committee strongly supports the
medical, psychological, and child welfare advocacy communities
in their compelling arguments against, and well-founded reasons
to limit, the use of any unlicensed facilities, especially
large-capacity temporary shelters where large numbers of
children reside in the same space and where access to services
may be limited. The Committee acknowledges that ORR has
discontinued the use of emergency intake sites--including by
expanding services at some of those sites to meet influx
standards--but continues to have concerns about how ORR will
ensure that influx facilities maintain standards that are
robust and comprehensive. The Committee directs ORR to submit,
within 120 days of enactment of this Act, a report detailing
plans to ensure independent, third-party monitoring of all
unlicensed facilities to verify their compliance with required
standards, as well as a plan for licensure for all unlicensed
facilities, or a comparable plan for how ORR can independently
verify that each such facility has satisfied requirements
equivalent to applicable State licensing standards while such
facilities are in use.
In addition, the Committee is aware of actions recently
taken by certain States that remove, exempt, or threaten to
strip ORR facilities of State licenses and important safety and
monitoring mechanisms. The Committee urges HHS to ensure State
actions do not undermine the safety and well-being of
unaccompanied children, and the Committee expects ORR to take
steps to ensure third-party oversight and monitoring of
affected ORR facilities, commensurate with State-licensed
monitoring and oversight requirements and timelines. As part of
the report requested above, the Committee directs ORR to
include a section on the actions it is taking to appropriately
monitor and oversee operations of any facilities affected by
such State actions.
Survivors of Torture
The Committee includes $20,000,000 for the Survivors of
Torture program, which is $2,000,000 above the fiscal year 2022
enacted level. The program funds non-profit organizations
providing healing and support services to refugees, asylees and
asylum seekers, who need help overcoming the effects of
torture.
PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT
Appropriation, fiscal year 2022....................... $6,165,330,000
Budget request, fiscal year 2023...................... 7,562,000,000
Committee Recommendation.............................. 7,165,330,000
Change from enacted level......................... +1,000,000,000
Change from budget request........................ -396,670,000
The Committee recommends $7,165,330,000 for the Child Care
and Development Block Grant (CCDBG) program, which is
$1,000,000,000 above the fiscal year 2022 enacted level. The
Committee strongly supports the commitment in the budget to
allot three percent for Indian Tribes, in addition to the set-
aside of $184,960,000 included in this Act. The CCDBG 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.
Child Care Facilities Needs Assessment.--The Committee
appreciates that ACF has been conducting a feasibility study to
determine how States could conduct needs assessments of their
child care and early education facilities and requests a
briefing within 30 days of enactment of this Act on the results
of that analysis, including an estimate of the resources
necessary to fund such Statewide needs assessments.
Early Childhood Educator Workforce Pipeline.--The Committee
encourages the Department of Health and Human Services to work
with the Department of Education and the Department of Labor to
develop and implement a strategy for strengthening the early
educator workforce pipeline, including in the child care
sector.
Home-Based Providers.--The Committee recognizes the value
of home-based providers to the field of child care, and directs
ACF to develop and disseminate guidance clarifying authorities
under existing law for use of CCDBG funds to support home-based
child care providers, including relative providers, and offer
examples of initiatives currently underway in States to do so.
Homelessness Data.--The Committee encourages OCC to provide
technical assistance to and conduct monitoring of States to
improve the quality and completeness of the data States are
required to collect on the homelessness status of children
receiving childcare subsidies. The Committee expects OCC to
annually publish on its website data gathered regarding
homelessness status and related demographic data.
SOCIAL SERVICES BLOCK GRANT
Appropriation, fiscal year 2022....................... $1,700,000,000
Budget request, fiscal year 2023...................... 1,700,000,000
Committee Recommendation.............................. 1,700,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Social Services Block Grant provides grants to States
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
Appropriation, fiscal year 2022....................... $13,438,343,000
Budget request, fiscal year 2023...................... 15,311,822,000
Committee Recommendation.............................. 15,167,344,000
Change from enacted level......................... +1,729,001,000
Change from budget request........................ -144,478,000
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 2023
Budget Activity Committee
------------------------------------------------------------------------
Programs for Children, Youth, and Families
Head Start....................................... $12,396,820,000
Preschool Development Grants..................... 350,000,000
Runaway/Homeless Youth........................... 133,000,000
Abuse of Runaway Youth Prevention................ 22,000,000
State Child Abuse Prevention..................... 110,000,000
Discretionary Child Abuse Prevention............. 41,000,000
Community-based Child Abuse Prevention........... 75,000,000
Child Welfare Services........................... 273,735,000
Child Welfare Training........................... 38,984,000
Adoption Opportunities........................... 50,000,000
Adoption Incentives.............................. 75,000,000
Social Services Research and Demonstration....... 101,679,000
Native American Programs......................... 63,762,000
Community Services
Community Services Block Grant................... 800,000,000
Community Economic Development................... 22,383,000
Rural Community Facilities....................... 12,000,000
Domestic Violence Hotline............................ 27,360,000
Family Violence/Battered Women's Shelters............ 300,000,000
Chafee Education and Training Vouchers............... 45,257,000
Disaster Human Services Case Management.............. 2,364,000
Program Direction.................................... 227,000,000
------------------------------------------------------------------------
Head Start
The Committee recommends $12,396,820,000 for the Head Start
program, which is $1,360,000,000 above the fiscal year 2022
enacted level and $193,366,000 above the fiscal year 2023
budget request. Head Start and Early Head Start promote school
readiness of children under 5 from low-income families through
education, health, social and other services.
Cost-of-Living Adjustment.--The Committee recommends
$596,000,000 for a cost-of-living adjustment.
Early Head Start (EHS) Expansion and Early Head Start-Child
Care (EHS-CC) Partnerships.--The Committee includes
$500,000,000 to expand Head Start and Early Head Start programs
for eligible children and families. The Committee understands
that the EHS-CC Partnership grant program was designed to
enhance the quality of child care to better meet the needs of
working families, and supports the program's appreciation for
how Head Start can be critically helpful to meeting those
needs. However, the Committee is aware of certain communities
for which there are significant barriers to establishing the
EHS-CCP model and expects grants for EHS expansion or EHS-CC
partnerships to be awarded based on the unique needs of each
community with due consideration of local feasibility. The
Committee requests a briefing within 30 days of enactment of
this Act, on how the Office of Head Start (OHS) can promote the
EHS-CCP model without awarding funding based on a predetermined
spending level, and in a way that does not disadvantage
communities where EHS-CCP is infeasible. The Committee urges
OHS to ensure that the program is not expanded in a way that
excludes children and babies whose parents do not qualify for
child care, or pregnant women.
The Committee continues to direct ACF to include in the
fiscal year 2024 Congressional Budget Justification and each
Congressional Budget Justification thereafter, the actual and
estimated number of funded slots for each of the following:
Head Start, EHS, and EHS-CC Partnerships.
Migrant and Seasonal Head Start.--The Committee is
concerned by reports that an increasing number of farmworker
families with young children are finding it difficult to
qualify for Migrant and Seasonal Head Start (MSHS) services
despite regulatory flexibilities available to the program in
the Head Start Act. The Committee is concerned that 2019
enrollment data indicates that MSHS programs may not be
utilizing these flexibilities to the maximum extent allowable
and urges the Secretary to continue to work with individual
MSHS programs to maximize flexibilities related to income
eligibility where under-enrollment is an issue. Within 120 days
of enactment of this Act, the Committee directs OHS to provide
a comprehensive list of the MSHS programs reporting under-
enrollment in fiscal years 2021 and 2022 and to include program
specific data on the percent of enrollees determined eligible
by the allowable flexibilities (as outlined in the Report to
Congress on Head Act Eligibility, April 2022), so that the
Committee can better understand the eligibility issues facing
MSHS programs and can continue to discuss any further actions
that may be necessary.
Quality Improvement Funding.--The Committee includes
$262,000,000 in quality improvement funding. The Committee
strongly believes the flexibility provided by this funding is
necessary for Head Start programs to meet the local needs of
programs, and expects funding to be prioritized for recruiting
and retaining quality staff and improving facilities and
classroom environments to support high quality program
services, and address the rise of adverse childhood
experiences.
Tribal Colleges and Universities-Head Start Partnership
Program.--The Committee includes $8,000,000 for the Tribal
Colleges and Universities (TCU)-Head Start Partnership Program.
Preschool Development Grants
The Committee recommends $350,000,000 for Preschool
Development Grants, which is $60,000,000 above the fiscal year
2022 enacted level. 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.
The Committee encourages ACF to continue to support States
that choose to use a portion of their renewal grant funding to
award sub-grants to programs in a mixed delivery system across
the State, particularly for low-income and disadvantaged
children prior to entering kindergarten, or to improve the
quality of local programs through the enhancement of early
childhood systems.
Runaway and Homeless Youth
The Committee recommends $155,000,000 for the Runaway and
Homeless Youth (RHY) program, which is $14,717,000 above the
fiscal year 2022 enacted level and $4,951,000 above the fiscal
year 2023 budget request.
The Committee supports the ability of grantees to provide
prevention services regardless of enrollment in residential
services, and urges the program to remind grantees that they
are not required to enroll a young person in shelter or
residential services, nor require the young person to
physically travel to the grantee's location, in order for the
young person who is deemed at risk of running away or becoming
homeless to be eligible to receive prevention and supportive
services, including counseling and case management.
The program is encouraged to notify applicants if grant
applications were successful at least 30 days before the grant
is to begin, or no less than 30 days before an existing grant
is set to end.
The Committee strongly urges the program to ensure that
service delivery and staff training comprehensively address the
individual strengths and needs of youth, as well as be language
appropriate, gender appropriate (interventions that are
sensitive to the diverse experiences of male, female, and
transgender youth and consistent with the gender identity of
participating youth), and culturally sensitive and respectful
of the complex social identities of youth (e.g., race,
ethnicity, nationality, age, religion/spirituality, gender
identity/expression, sexual orientation, socioeconomic status,
physical or cognitive ability, language, beliefs, values,
behavior patterns, or customs). The Committee strongly believes
that no runaway youth or homeless youth should be excluded from
participation in, be denied the benefits of, or be subject to
discrimination under, any program or activity funded in whole
or in part under the Runaway and Homeless Youth Act, based on
any of the conditions outlined in this paragraph.
State Child Abuse Prevention
The Committee recommends $110,000,000 for Child Abuse
Prevention and Treatment Act (CAPTA) State Grants, which is
$14,909,000 above the fiscal year 2022 enacted level.
Child Abuse Discretionary Activities
The Committee recommends $41,000,000 for Child Abuse
Discretionary Activities, which is $5,000,000 above the fiscal
year 2022 enacted level.
Child Abuse Hotline.--The recommendation includes
$2,000,000 for ongoing support for a national child abuse
hotline to provide resources and intervention in all
modalities, including chat, text, and call, to provide
comprehensive capabilities to serve both youth and concerned
adults facing child abuse and neglect.
The Committee encourages ACF to continue evaluating and
sharing text and chat best practices in appropriate
communication, identity verification, privacy protection, and
resource sharing with other national hotlines.
National Child Abuse and Neglect Data System (NCANDS).--The
Committee continues to encourage HHS to explore the feasibility
of adding--to the caregiver characteristics and environmental
factors fields in NCANDS--a category of animal abuse as an
additional factor that could place a child at risk for
maltreatment.
Preventing Maltreatment in Youth Residential Facilities.--
The Committee is concerned by reports of youth being maltreated
by staff employed at residential facilities and urges HHS, in
consultation with the Department of Education, to share
information with States on promising practices for preventing
and addressing maltreatment in residential facilities for
youth.
Trauma-Informed Interventions.--The Committee includes
$5,000,000 for a demonstration project related to the
implementation of a new and innovative approach to serving
children in foster care by providing trauma-informed
interventional programming, including evidence-based clinical
services, foster parent training and curriculum, volunteer
support services for foster parents, positive biological and
birth family engagement to enhance family reunification,
enrichment activities for the children and trauma-informed
systems work. Eligible applicants should be nonprofit
organizations with a demonstrated experience working with
children in foster care who have experienced severe trauma.
Applicants shall include Institutional Review Board-approved
research supported by content area and epidemiological experts.
The project should report regularly to ACF on findings,
outcomes, and recommendations regarding sustainable funding and
replicable programmatic models.
Community-Based Child Abuse Prevention
The Committee recommends $75,000,000 for Community-Based
Child Abuse Prevention, which is $9,340,000 above the fiscal
year 2022 enacted level. These formula grants support
community-based approaches to child abuse and neglect
prevention.
The Committee believes that communities can help build
strong families and improve their capacity to nurture the
healthy development of their children by providing ready access
to online information about the full range of public and
private resources available to them. The Committee encourages
ACF to continue providing technical assistance to State lead
agencies on how they may use funds provided under this account
to help local governments and communities to develop (or
maintain) websites that provide current and regularly updated
information on family, youth, and community resources,
including programs and services provided through nonprofits;
community organizations; the Federal Government; and State and
local governments.
Child Welfare Research, Training and Demonstration
The Committee recommends $38,984,000 for the Child Welfare
Research, Training and Demonstration program, which is
$20,000,000 above the fiscal year 2022 enacted level. This
program awards competitive grants to entities that prepare
personnel for work in the child welfare field and those engaged
in research around child welfare issues.
The Committee recognizes the need for reforms in the child
welfare system and includes $20,000,000 for a new competitive
grant program to address racial inequity in the child welfare
field and reorient systems towards a prevention-first model.
Adoption Opportunities
The Committee recommends $50,000,000 for the Adoption
Opportunities program, which is $2,000,000 above the fiscal
year 2022 enacted level and $3,900,000 above the fiscal year
2023 budget request. This program funds competitive grants and
contracts to public and private organizations to remove
barriers to adoption and to provide permanent homes for
children who would benefit from adoption, particularly children
with special needs.
The Committee includes $2,000,000 for the National Adoption
Competency Mental Health Training Initiative to provide States,
Tribes and territories technical assistance to ensure that
training curriculums are available and appropriately used by
State child welfare and mental health professionals, and to
initiate the development of derivative trainings for courts and
continuing medical education for medical professionals to
ensure consistency across disciplines. The Committee continues
to encourage the program to institutionalize its curriculums as
the standard for consistent training in all State child welfare
agencies.
Social Services Research and Demonstration
The Committee recommends $101,679,000 for the Social
Services Research and Demonstration program.
Community Project Funding.--Within the funds included in
this account, $69,167,000 shall be used for the projects, and
in the amounts, specified in the table titled ``Labor, HHS,
Education Incorporation of Community Project Funding Items'' at
the end of this report.
Diaper Distribution Grant Demonstration.--The Committee
includes $20,000,000, a $10,000,000 increase above the fiscal
year 2022 enacted level, for the diaper distribution grant
program first funded in P.L. 117-103, for grants to social
service agencies or other non-profit organizations for diaper
and diapering supply needs.
Medical-Legal Partnerships.--The Committee recognizes the
value that medical-legal partnerships (MLPs) provide to
underserved communities by combining health and legal services
at a single site of care. The recommendation includes
$2,000,000 for an MLP grant program to assist individuals with
health-harming legal needs, including in the areas of housing
stability, income supports, family stability, civil rights,
immigration, and environmental health. The Committee directs
ACF to award grants to multidisciplinary teams that will work
together to address medical and social/legal problems that have
an impact on overall health and expects the program to award
grants with preference to Minority-Serving Institutions and
university-affiliated safety-net non-profit hospitals that have
long-standing Medical-Legal Partnerships that primarily serve
Native and underserved populations.
Support Services at Affordable Housing.--The Committee
includes $3,000,000 for a demonstration program to provide
funding to owners of affordable housing properties to offer
supportive services for their residents, including after-school
programs for children and teenagers; education opportunities
for youth and adult residents; mental health, alcohol and
addiction treatment; self-sufficiency resources; resources on
future home ownership; financial literacy training; elderly
care; assistance to residents with disabilities; and other
community services. The Committee requests a report one year
after award of such grants on the findings of this
demonstration program.
Native American Programs
The Committee recommends $63,762,000 for Native American
Programs, which is $5,000,000 above the fiscal year 2022
enacted level and $1,263,000 above the fiscal year 2023 budget
request. These programs assist tribal and village governments
and Native American institutions and organizations in their
efforts to support and develop stable, diversified local
economies. Tribes and non-profit organizations use funds to
develop and implement sustainable community-based social and
economic programs and services to improve the well-being of
Native people.
Within the total, the recommendation includes no less than
$18,000,000 for Native American language preservation
activities, including no less than $8,000,000 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 of 2006.
Community Services Programs
Community Services Block Grant.--The Committee recommends
$800,000,000 for the Community Services Block Grant (CSBG),
which is $45,000,000 above the fiscal year 2022 enacted level
and $45,781,000 above the fiscal year 2023 budget request. The
CSBG provides funds to alleviate the causes and conditions of
poverty in communities.
The Committee is concerned about a lack of supportive
services in low-income housing areas, and urges the Office of
Community Services (OCS) to coordinate with the Department of
Housing and Urban Development (HUD), and State and local
housing authorities to expand supportive services at low-income
housing communities to leverage Federal funding sources to
increase self-sufficiency and improve low-income individuals'
living conditions.
Community Economic Development.--The Committee recommends
$22,383,000 for Community Economic Development, which is
$1,000,000 above the fiscal year 2022 enacted level. Community
Economic Development is a grant program which funds Community
Development Corporations seeking to address the economic needs
of low-income individuals and families through the creation of
sustainable business development and employment opportunities.
Rural Community Facilities Development.--The Committee
recommends $12,000,000 for the Rural Community Facilities
Development program, which is $1,000,000 above the fiscal year
2022 enacted level and equal to the fiscal year 2023 budget
request. Rural Community Development is a grant program that
works with regional and Tribal organizations to manage safe
water systems in rural communities.
Domestic Violence Hotline
The Committee recommends $27,360,000 for the Domestic
Violence Hotline, which is $11,860,000 above the fiscal year
2022 enacted level and equal to the fiscal year 2023 budget
request. The Hotline provides 24-hour, toll-free and
confidential services immediately connecting callers to local
service providers.
Within the recommendation, the Committee includes
$1,000,000 for a pilot project to explore best practices,
intervention, and prevention methods, including establishment
of a hotline for those who choose to cause harm, to reduce
incidents of domestic violence.
In addition, the Committee recognizes the unique challenges
experienced by individuals in religious communities, especially
populations underserved because of religion, in accessing
appropriate domestic violence services and support, and
includes $250,000 for the Domestic Violence Hotline to evaluate
and expand its list of resources for contacts from religious
communities.
Family Violence Prevention and Battered Women's Shelters
The Committee recommends $300,000,000 for the Family
Violence Prevention and Battered Women's Shelters programs,
which is $100,000,000 above the fiscal year 2022 enacted level.
The Family Violence Prevention and Services Act (FVPSA)
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).
Addressing Domestic Violence in Religious Communities.--The
Committee recognizes the unique challenges experienced by
individuals in religious communities, especially populations
underserved because of religion, in accessing appropriate
domestic violence services and supports. The Committee supports
the work that FVPSA Resource Centers are doing to improve
outreach to faith-based communities. The Committee encourages
the Resource Centers to continue to provide training and
technical assistance to faith-based communities, especially
populations underserved because of religion and requests a
report within 180 days of enactment of this Act on the ways
Resource Centers provide training and technical assistance to
religious communities.
Culturally Specific Services for Domestic Violence and
Sexual Assault.--The Committee recognizes that current public
health and social pandemics have disproportionally impacted
communities of color, leaving women and girls of color more
vulnerable to incidents of domestic violence and sexual
assault, and recommends no less than $20,000,000 for culturally
specific organizations to develop or enhance appropriate
services that are specific to their community.
Native Hawaiian Resource Center on Domestic Violence.--
Within the recommendation, the Committee includes $2,000,000
for the Native Hawaiian Resource Center on Domestic Violence 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 in Native Hawaiian communities.
Sexual Assault Technical Assistance Initiative.--The
Committee provides $5,000,000 for the program to support the
Federal administrative costs to monitor grants for survivors of
sexual assault and grants to support culturally specific
populations, and to provide grants for technical assistance
providers with extensive knowledge of and demonstrated
expertise in the problem and solutions to sexual assault, as
well as experience in the anti-sexual assault field.
Chaffee Education and Training Vouchers
The Committee recommends $45,257,000 for the Chafee
Education and Training Voucher (CETV) program, which is
$2,000,000 above the fiscal year 2022 enacted level. The CETV
provides vouchers to youth who are, or were formerly, in foster
care for expenses related to post-secondary education
assistance and vocational training.
Program Direction
The Committee recommends $227,000,000 for Program
Direction, which is $14,500,000 above the fiscal year 2022
enacted level.
PROMOTING SAFE AND STABLE FAMILIES
Appropriation, fiscal year 2022....................... $427,515,000
Budget request, fiscal year 2023...................... 451,000,000
Committee Recommendation.............................. 427,515,000
Change from enacted level......................... - - -
Change from budget request........................ -23,485,000
The Committee recommends $345,000,000 in mandatory funds
and $82,515,000 in discretionary funds for the Promoting Safe
and Stable Families program. 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
Appropriation, fiscal year 2022....................... $6,963,000,000
Budget request, fiscal year 2023...................... 7,606,000,000
Committee Recommendation.............................. 7,606,000,000
Change from enacted level......................... +643,000,000
Change from budget request........................ - - -
The Committee also recommends an advance appropriation of
$3,200,000,000 for the first quarter of fiscal year 2024 to
ensure timely completion of first quarter grant awards.
Mental Health Services for Foster Youth.--The Committee
appreciates that the Children's Bureau complies with the
statutory requirement to conduct periodic Child and Family
Services Reviews (CFSR) to ensure that State child welfare
systems' practices are in compliance with State plan
requirements in title IV-B and IV-E of the Social Security Act
in order to direct corrective action if outcomes do not meet
Federal benchmarks. The Committee urges the Department to use
the CFSR case file reviews and stakeholder interviews to verify
that States are ensuring that foster children receive mental
health screenings, follow-up mental health assessments, and are
referred for mental health services, as required by title IV-B,
and looks forward to receiving data on the number of children
in out-of-home care who received a diagnosis of a behavioral or
mental health condition when the AFCARS 2020 data is available
for analysis.
Administration for Community Living
AGING AND DISABILITY SERVICES PROGRAMS
Appropriation, fiscal year 2022....................... $2,264,927,000
Budget request, fiscal year 2023...................... 2,930,491,000
Committee Recommendation.............................. 2,860,008,000
Change from enacted level......................... +595,081,000
Change from budget request........................ -70,483,000
Created in 2012, the Administration for Community Living
(ACL) brings together the efforts and achievements of the
Administration on Aging, the Administration on Intellectual and
Developmental Disabilities, and the HHS Office on Disability to
serve as the Federal agency responsible for increasing access
to community supports, while focusing attention and resources
on the unique needs of older Americans and people with
disabilities across the lifespan.
The Committee continues to fund the Senior Medicare Patrol
Program through the Health Care Fraud and Abuse Control
Account.
Home and Community-Based Supportive Services
The Committee recommends $450,000,000 for Home and
Community-Based Supportive Services, which is $51,426,000 above
the fiscal year 2022 enacted level. 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 $27,500,000 for Preventive Health
Services, which is $2,652,000 above the fiscal year 2022
enacted level and $1,161,000 above the fiscal year 2023 budget
request. This program funds activities that help seniors remain
healthy and avoid chronic diseases. Funding supports a variety
of healthy aging programs aimed to reduce disease and prevent
injuries, including evidence-based programs to address the risk
of falls, chronic diseases, mental health, and medication
management.
Protection of Vulnerable Older Americans
The Committee recommends $41,944,000 for activities to
protect vulnerable older Americans, which is $17,286,000 above
the fiscal year 2022 enacted level and equal to the fiscal year
2023 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. Within the recommendation, the Committee provides a
$17,000,000 increase to the Long-Term Care Ombudsman program.
Family Caregiver Support Services
The Committee recommends $230,000,000 for the National
Caregiver Support program, which is $36,064,000 above the
fiscal year 2022 enacted level. This program offers a range of
support services to family caregivers, including assistance in
accessing services such as respite care, counseling, support
groups, and caregiver training.
GAO Study on Caregiving Youth.--The Committee is concerned
with reports that there may be 3 to 5 million youths serving as
a primary or secondary caretaker for a family member and
believes there is insufficient data on this population. The
Committee directs GAO to complete a study examining what is
known about the number and characteristics of caregiving youth;
to what extent the substance abuse crisis and COVID-19 pandemic
has increased this population; what challenges caregiving youth
face; what additional resources are needed to address these
challenges; what Federal programs could be expanded to serve
this population; and how HHS coordinates with other programs to
support caregiving youth.
Native American Caregiver Support Services
The Committee recommends $13,806,000 for the Native
American Caregiver Support program, which is $2,500,000 above
the fiscal year 2022 enacted level. 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 $1,260,069,000 for
senior nutrition. The recommendation includes: $700,000,000 for
Congregate Nutrition Services; $400,000,000 for Home-Delivered
Meal Services; and $160,069,000 for the Nutrition Services
Incentives program. 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 $41,264,000 for Native American
Nutrition and Supportive Services, which is $5,000,000 above
the fiscal year 2022 enacted level. 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 $36,961,000 for Aging Network
Support Activities, which is $18,500,000 above the fiscal year
2022 enacted level and $14,015,000 above the fiscal year 2023
budget request. This program supports activities that expand
public understanding of aging and the aging process.
Care Corps.--The recommendation includes $5,500,000 for the
Care Corps program. The Committee recognizes the success of
local programs that are increasing seniors' access to non-
emergency medical services by offering transportation with
trained volunteers to serve as aides and advocates for those
with accessibility challenges, and includes a $1,500,000
increase for ACL to award grants to programs capable of
building a network of screened and trained volunteer chaperones
to accompany older adults and adults with disabilities in need
to and from non-emergency medical appointments and outpatient
procedures.
Direct Care Workforce Demonstration.--The Committee
provides $3,000,000 for a Direct Care Workforce Demonstration
project, to reduce barriers to entry for a diverse and high-
quality direct care workforce, including providing wages,
benefits, and advancement opportunities needed to attract or
retain direct care workers.
Holocaust Survivor's Assistance and Person-Centered,
Trauma-Informed Care (PCTI).--The Committee provides
$10,000,000 for the Holocaust Survivor's Assistance program,
which provides supportive services for aging Holocaust
survivors and their families, and to other older adult
populations that have been exposed to and impacted by traumatic
events, including aging military veterans, first responders,
victims of childhood and domestic violence, and survivors of
man-made or natural disasters.
Interagency Coordinating Committee on Healthy Aging and
Age-Friendly Communities.--While numerous Federal agencies and
programs support older Americans and aim to reduce falls and
provide safe and accessible living environments, interagency
coordination is critical to ensure these programs are effective
and cohesive. The Committee provides $1,000,000 for the
coordination of healthy aging programs across HHS, the
Department of Housing and Urban Development, the Department of
Transportation, and other agencies as appropriate, with a focus
on falls prevention programs and safe living environments, and
with a goal of informing the 2025 White House Conference on
Aging.
Research, Demonstration, and Evaluation Center for the
Aging Network.--The Committee includes $10,000,000 to create a
Research, Demonstration, and Evaluation Center for the Aging
Network, as authorized in the 2020 OAA Reauthorization. Funding
should be used to hire staff, and invest in research,
demonstration, and evaluation of falls prevention programs. The
Committee expects the Center to research best practices on
falls prevention and distribute the most promising practices in
the field of falls prevention to the aging network. Within
funding provided, the Committee expects the Center to offer
demonstration and evaluation programs through competitive
grants to be innovative and respond to evolving evidence about
what works to prevent and reduce risk of falls, and equip the
Network with funding to implement those models.
Alzheimer's Disease Program
The Committee recommends $30,060,000 for the Alzheimer's
disease program, which is $560,000 above the fiscal year 2022
enacted level and equal to the fiscal year 2023 budget request.
This program provides competitive matching grants to a limited
number of States to encourage program innovation and
coordination of public and private services for people with
Alzheimer's disease and their families.
The recommendation includes $2,000,000 for the National
Alzheimer's Call Center.
Respite Care
The Committee recommends $14,220,000 for Respite Care,
which is $6,110,000 above the fiscal year 2022 enacted level
and equal to the fiscal year 2023 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.
Falls Prevention
The Committee recommends $10,000,000 for the Falls
Prevention program, which is $5,000,000 above the fiscal year
2022 enacted level and $5,000,000 above the fiscal year 2023
budget request. Falls prevention grants support the promotion
and dissemination of prevention tools delivered in community
settings.
Chronic Disease Self-Management Program
The Committee recommends $8,000,000 to be transferred from
the PPH Fund to ACL for the Chronic Disease Self-Management
program, which is equal to the fiscal year 2022 enacted level
and the fiscal year 2023 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 $100,000,000 for Elder Rights
Support Activities, which is $81,126,000 above the fiscal year
2022 enacted level and $22,600,000 above the fiscal year 2023
budget request. This program supports efforts that provide
information, training, and technical assistance to legal and
aging services organizations working to prevent and detect
elder abuse and neglect.
The recommendation includes $80,000,000 to continue the
nationwide Adult Protective Services formula grant program
authorized in 2012 by the Elder Justice Act.
Aging and Disability Resource Centers
The Committee recommends $9,119,000 for Aging and
Disability Resource Centers (ADRCs), which is $1,000,000 above
the fiscal year 2022 enacted level. These centers provide
information, counseling, and access for individuals to learn
about the services and support options available to seniors and
the disabled so they may retain their independence.
State Health Insurance Assistance Program
The Committee recommends $58,115,000 for the State Health
Insurance Assistance Program, which is $5,000,000 above the
fiscal year 2022 enacted level and $2,873,000 above the fiscal
year 2023 budget request. The State Health Insurance Assistance
Program provides Medicare beneficiaries with information,
counseling, and enrollment assistance.
Paralysis Resource Center
The Committee recommends $10,185,000 for the Paralysis
Resource Center (PRC), and directs not less than $9,400,000 to
the National PRC. 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 $4,200,000 for the Limb Loss
Resource Center, which is $200,000 above the fiscal year 2022
enacted level and equal to the fiscal year 2023 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 $13,118,000 for the Traumatic
Brain Injury program, which is $1,297,000 above the fiscal year
2022 enacted level and equal to the fiscal year 2023 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 $85,000,000 for State Councils on
Developmental Disabilities, which is $5,000,000 above the
fiscal year 2022 enacted level. The Developmental Disabilities
State Councils work to develop, improve, and expand the system
of services and supports for people with developmental
disabilities. The Committee recommends not less than $700,000
for technical assistance and training for the State Councils on
Developmental Disabilities.
In addition, the Committee encourages ACL to consult with
the appropriate Developmental Disabilities Act stakeholders
prior to announcing opportunities for new technical assistance
projects and to notify the Committee prior to releasing new
funding opportunity announcements, grants, or contract awards
with technical assistance funding.
Developmental Disabilities Protection and Advocacy
The Committee recommends $50,000,000 for Developmental
Disabilities Protection and Advocacy, which is $7,216,000 above
the fiscal year 2022 enacted level. 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 notes that the Supreme Court decision in
Olmstead v. L.C. (1999) held that the Americans with
Disabilities Act (ADA) does not 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. The Committee notes that actions
to close intermediate care facilities for individuals with
intellectual disabilities may impact some individuals who do
not meet the criteria for transfer to a community-based
setting. The Committee urges HHS to ensure that 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.
Voting Access for Individuals With Disabilities
The Committee recommends $12,414,000 for the Voting Access
for Individuals with Disabilities program, which is $3,951,000
above the fiscal year 2022 enacted level and equal to the
fiscal year 2023 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, accessing polling
places, and casting a vote.
Developmental Disabilities Projects of National Significance
The Committee recommends $13,750,000 for Developmental
Disabilities Projects of National Significance, which is
$1,500,000 above the fiscal year 2022 enacted level. This
program funds grants and contracts that develop new
technologies and demonstrate innovative methods to support the
independence, productivity, and integration of those living
with a disability into the community.
University Centers for Excellence in Developmental Disabilities
The Committee recommends $42,119,000 for University Centers
for Excellence in Developmental Disabilities, which is equal to
the fiscal year 2022 enacted level. The University Centers for
Excellence in Developmental Disabilities Education, Research,
and Service are a nationwide network of independent but
interlinked centers, representing a national resource for
addressing issues, finding solutions, and advancing research
related to the needs of individuals with developmental
disabilities and their families.
Independent Living
The Committee recommends $140,000,000 for the Independent
Living program, of which $27,195,000 is for the Independent
Living State Grants program and $112,805,000 is for the Centers
for Independent Living program. This funding level is
$21,817,000 above the fiscal year 2022 enacted level.
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 $117,470,000 for the National
Institute on Disability, Independent Living, and Rehabilitation
Research (NIDILRR), which is $1,000,000 above the fiscal year
2022 enacted level. NIDILRR generates knowledge and promotes
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.
The Committee notes the potential of emerging technologies,
like distributed ledger technologies or blockchain, to expand
voting access for individuals with disabilities. The Committee
encourages NIDILRR to consider a feasibility analysis into the
use of emerging technologies to assist with voting access for
individuals with disabilities, that includes but is not limited
to, the particular voting challenges faced by individuals with
disabilities, and how emerging technologies could be utilized.
Assistive Technology
The Committee recommends $44,000,000 for Assistive
Technology, which is $5,500,000 above the fiscal year 2022
enacted level and equal to the fiscal year 2023 budget request.
Assistive Technology (AT) supports programs providing grants to
States for addressing assistive technology needs of individuals
with disabilities. The goal is to increase awareness of and
access to assistive technology devices and services that may
help with education, employment, daily activities, and
inclusion of people with disabilities in their communities.
The Committee continues to provide $2,000,000 for
competitive grants to support existing and new alternative
financing programs that provide for the purchase of AT devices.
Program Administration
The Committee recommends $52,063,000 for Program
Administration, which is $10,000,000 above the fiscal year 2022
enacted level. This funding supports Federal administrative
costs associated with administering ACL's programs.
Community Project Funding
Within the funds included in this account, $30,446,000
shall be used for the projects, and in the amounts, specified
in the table titled ``Labor, HHS, Education Incorporation of
Community Project Funding Items'' at the end of this report.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
Appropriation, fiscal year 2022....................... $571,122,000
Budget request, fiscal year 2023...................... 665,067,000
Committee Recommendation.............................. 639,622,000
Change from enacted level......................... +68,500,000
Change from budget request........................ -25,445,000
Of the funds provided, $75,728,000 shall be derived from
evaluation set-aside transfers available under section 241 of
the Public Health Service (PHS) Act, which is $10,900,000 above
the fiscal year 2022 enacted level.
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 (HHS).
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.
Advertising Contracts for Small Business Owners.--The
Committee understands that, as the largest advertiser in the
United States, the Federal government should work to ensure
fair access to its advertising contracts, including outdoor
advertising, for small disadvantaged businesses and businesses
owned by minorities and women. The Committee directs each
department and agency to include the following information in
its fiscal year 2024 Congressional Budget Justification:
expenditures for fiscal year 2022 and expected expenditures for
fiscal year 2024 for (1) all contracts for advertising
services; and (2) contracts for the advertising services of (I)
socially and economically disadvantaged small businesses
concerns (as defined in section 8(a)(4) of the Small Business
Act (15 U.S.C. 637(a)(4)); and (II) women- and minority-owned
businesses.
Bereaved Children.--The Committee is concerned with the
impact of the COVID-19 pandemic on bereaved children. The
consequences of losing a caregiver include higher risk of
experiencing substance abuse and mental health problems,
including anxiety, depression, and post-traumatic stress
disorder, as well as higher risk of reduced employment and
housing instability. Bereaved children also experience lower
rates of academic attainment and higher dropout rates. The
COVID-19 pandemic created the additional stressor on bereaved
children by reducing or limiting their access to critical
social support systems commonly provided through consistent
school or community. The Committee acknowledges the President's
efforts to identify these children and families and make
resources available to them and encourages HHS to coordinate
with Congress and relevant agencies to establish a taskforce to
ensure the social and emotional development of bereaved
children.
Blood Donation Education.--The Committee includes
$1,000,000 for outreach and education to individuals who become
newly eligible to donate blood due to evidence-based updates to
FDA's deferral guidelines. The Committee directs HHS to conduct
such community outreach in consultation with community
stakeholders.
Brain Aneurysms.--The Committee recognizes that although
one in 50 Americans has a brain aneurysm, there are typically
no warning signs or symptoms unless the aneurysm ruptures. Up
to 50 percent of patients will not survive such a hemorrhage.
Even when an aneurysm has ruptured, the symptoms are not widely
known among health care professionals. The Committee reiterates
the language included in House Report 115-862 directing the
Secretary, in consultation with appropriate stakeholders--
including health care providers, brain aneurysm patient
advocacy foundations, brain aneurysm survivors, and
caregivers--to facilitate the development of best practices on
brain aneurysm detection and rupture for first responders,
emergency room physicians, primary care physicians, nurses, and
advanced practice providers. The Committee encourages the
Secretary to consider incorporating topics including, but not
limited to, the symptoms of brain aneurysms, evidence-based
risk factors for brain aneurysms, appropriate utilization of
medical testing and diagnostic equipment, and screening
recommendations. The Secretary shall continue to consult with
appropriate stakeholders to develop a strategy for
disseminating information about the best practices and begin
implementing this strategy within one year after the date of
enactment of this Act. The Secretary shall review research on
brain aneurysm detection and diagnosis and update the best
practices every three years, as appropriate. In addition, the
Committee requests an update in the fiscal year 2024
Congressional Budget Justification outlining the Department's
expenditures over the last five fiscal years on research and
other activities related to brain aneurysms.
Breastfeeding Services and Supplies.--The Committee
acknowledges that HRSA updated its Women's Preventive Services
Initiative (WPSI) Breastfeeding Services and Supplies
recommendation which serves as the basis for insurer decisions
around coverage of related services and supplies especially for
Medicaid beneficiaries in expansion States. Concerns have been
raised that the WPSI recommendation's lack of consideration for
quality in its coverage recommendations will lead insurers to
cover only the most inexpensive supplies without regard to the
needs of individual infants and mothers. HHS is directed to
provide, within 120 days of the date of enactment of this Act,
the information first requested by the Committee in House
Report 115-862 detailing how health insurers have implemented
comprehensive lactation services, the standards insurers use to
set reimbursement rates for breastfeeding supplies and
services, and the current best practices used to provide
coverage to help women breastfeed. HHS also is directed to
respond to the request in House Report 115-244 to 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.
Cardiovascular Disease Patients.--The Committee notes the
growing prevalence of cardiovascular disease (CVD) and the
economic burden this deadly disease has on the health care
system. The Committee further notes that lipid-panel
(cholesterol) screenings, diagnosis and appropriate treatment
and management of CVD is vital to prevent major cardiac events
and hospitalizations. Various disease prevention and
progression therapies are widely available, including statins
and modern biologic treatments that have demonstrated efficacy
against certain types of CVD. However, such therapies often
face barriers including prohibitive utilization management
practices by health plans, which limit adoption. The Committee
requests a report within 180 days of the date of enactment of
this Act on challenges facing healthcare providers and patients
with a specific focus on healthcare costs incurred related to
postponed, delayed, or suboptimal treatments associated with
CVD.
Children's Interagency Coordinating Council.--The Committee
notes that the COVID-19 pandemic has contributed to a further
decline in the economic standing, education, and physical and
mental health status of low-income children, particularly among
children in Hispanic, African American, Asian American, Native
Hawaiian, Pacific Islander, and American Indian/Alaska Native
families. Data shows that the COVID-19 pandemic is causing more
children to experience poverty and resulting in additional
hardships including educational gaps and negative mental health
impacts. The Committee supports collaboration amongst HHS, the
Department of Energy, the Department of Justice, the Department
of Agriculture (USDA), United States Agency for International
Development, and other Federal agencies to address these
pressing problems. To foster greater coordination,
collaboration, and transparency on child policy across agency
lines, the Committee again directs the Secretary to establish a
Children's Interagency Coordinating Council. Among other tasks,
the Council shall enter into an agreement with the National
Academy of Sciences to provide an annual report to Congress
analyzing and monitoring how existing and emerging Federal
policies have affected child poverty using the U.S. Census
Bureau Supplemental Poverty Measure. In addition, the Council
will examine and periodically report on a broad array of
comprehensive and cross-cutting issues affecting child well-
being.
Combating Opioid Overdoses.--The Committee commends NIDA
for funding studies on kratom based on promising results that
unadulterated kratom may provide help for some Americans
struggling with addictions, given its analgesic and less
addictive properties as compared to opioids.
Contraceptive Deserts.--The Committee notes that an
estimated 19 million women in need of publicly funded
contraception live in contraceptive deserts, counties in which
there is no reasonable access to the full range of
contraceptive options. A recent study found that contraceptive
deserts vary across States, with between 17 and 53 percent of
the State population living in a desert. Furthermore, it found
that low-income people and people of color are more likely to
live in contraceptive deserts. The Committee requests the
Secretary undertake a study of contraceptive deserts and
examine the extent to which Federal policy changes and
resources can improve access to the full range of contraceptive
options. The Committee requests this report within 180 days of
the date of enactment of this Act, along with the Department's
policy recommendations.
Contraceptive Access Under the Affordable Care Act.--The
Committee is concerned about access to care for patients
seeking preventive services, including contraceptive services.
The Committee directs the Secretary, in collaboration with the
Departments of Labor (DOL) and Treasury, to engage in patient
education to ensure patients understand their rights under the
Affordable Care Act to access (without cost sharing) the
contraceptive product that is determined best for the patient,
in consultation with their health care provider. In addition,
the Committee directs the Secretary to engage with health care
providers to disseminate the latest guidance on contraceptive
access for patients, as well as how to help patients seek
access to contraceptive services (without cost sharing) through
a health insurance plan's exceptions process. The Committee
urges the Secretary to take action against health insurance
plans that are not meeting their obligations to patients under
the law.
Cosmetic Safety.--The Committee encourages the Secretary of
HHS to establish and maintain an interagency council for the
purpose of sharing data, promoting collaboration on cosmetic
safety, and generating solutions to address negative impacts on
the health of women and girls of color, professional nail,
hair, beauty, and salon workers, and other vulnerable
populations caused by exposure to unsafe chemicals in cosmetic
products. The interagency should include, but not be limited
to, representatives from the Office of the Secretary FDA, NIH,
CDC, the Assistant Secretary of Labor for Occupational Safety
and Health (or the Administrator's designee), the Administrator
of the Environmental Protection Agency (or the Administrator's
designee), the Administrator of the Small Business
Administration (or the Administrator's designee), and the
Secretary of Labor (or the Secretary's designee).
Chronic Fatigue Syndrome Advisory Committee.--The Committee
looks forward to reviewing the HHS plan regarding myalgic
encephalomyelitis/chronic fatigue syndrome (ME/CFS) which was
requested in House Report 116-62 and was required within 180
days of the date of enactment of that Act. In the interim, the
Committee encourages HHS to foster interagency and stakeholder
collaboration in addressing the related crisis in post-acute
COVID-19 syndrome (PACS) and ME/CFS by forming an Infection-
Associated Chronic Illnesses Advisory Committee that includes,
but is not limited to relevant agency representatives, patient
representatives from long COVID, ME/CFS, and other infection-
associated chronic illnesses communities, medical care
providers, and disease experts.
Decentralized Trials.--The Committee notes the COVID-19
pandemic has shown the possibility of conducting remote and
decentralized clinical trials. In parallel, decentralized
trials can foster greater participation, including by promoting
increased diversity in clinical trial participants. The
Committee directs the Secretary, in collaboration with NIH,
FDA, ONC, CMS, and HRSA to evaluate policy options across the
department to ensure health care providers and patients have
tools to identify and participate in decentralized and remote
clinical trials. This assessment should include steps to foster
greater data sharing, including related to electronic health
records, genomics, and imaging. The Committee requests a report
not later than two years after the date of enactment of this
Act, with findings from the assessment and proposals to
accelerate decentralized clinical trials and foster trial
diversity.
Embryo Adoption Awareness Campaign.--The Committee includes
$1,000,000 for the Embryo Adoption Awareness Campaign 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.
Food as Medicine.--The Committee directs the Secretary, in
consultation with other Federal agencies, to develop and
implement a Federal strategy to reduce nutrition-related
chronic diseases and food insecurity and improve health and
racial equity in the U.S., including diet-related research and
programmatic efforts that increase Americans' access to food as
medicine, and healthy, nutritious, organic, and affordable
foods, especially in at-risk communities. The Committee
includes $2,000,000 in the Office of the Secretary to establish
a Food As Medicine pilot program, an integrative model for
healthcare, that addresses food insecurity, social isolation,
and chronic disease to advance health and racial equity. The
model shall include the following as defined by the Secretary:
a produce prescription of pesticide-free regenerative or
regenerative organic produce; clinical nutrition training for
healthcare providers; and nutritional and behavioral support
for patients to integrate food interventions into daily habits.
The Secretary may enter into competitively awarded contracts or
cooperative agreements with, or provide grants to, public or
private organizations or agencies within varying States.
Additionally, the Committee requests a report within two years
of the date of enactment of this Act on the implementation of
the Federal strategy and an examination of the status of each
pilot project; the results of the evaluation completed during
the previous fiscal year; and to the maximum extent practicable
the impact of the pilot project on appropriate health,
nutrition, and associated behavioral outcomes among patients
participating in the pilot project baseline information
relevant to the stated goals and desired outcomes of the pilot
project; and equivalent information about similar or identical
measures among control or comparison groups that did not
participate in the pilot project.
Genetic Counseling Inequity.--The Committee recognizes that
genetic counseling and testing provide individuals the
opportunity to learn if they have an inherited genetic
mutation, enabling them--and their families--to better
understand their risk of developing breast (and other) cancers,
help tailor future screening plans, and guide decision making
about ways to reduce the risk of breast cancer. However, access
and utilization of genetic counseling and testing are not the
same for all communities; Black people in the U.S. do not
participate in genetic testing at the same rate as Americans of
European ancestry. The Committee encourages the Secretary to
examine opportunities to increase utilization of genetic
counseling and testing associated with breast cancer for Black
women and requests an update in the fiscal year 2024
Congressional Budget Justification addressing barriers to
increasing access to and utilization of genetic counseling and
testing for all populations, including how to increase health
equity in this area.
Global Health Research.--The Committee requests an update
in the fiscal year 2024 Congressional Budget Justification on
how the Office of Global Affairs (OGA), CDC, FDA, BARDA, and
NIH--including the Fogarty International Center--jointly
coordinate global health research activities with specific
measurable metrics used to track progress and collaboration
toward agreed upon health goals.
Health Attaches.--The Committee includes $3,000,000 to
expand OGA's Health Diplomacy program to fund health attache
offices in Africa, Asia, and Europe.
Health Benefits of Proper Nutrition.--The Committee
continues to recognize the value of proper nutrition and
understands that many chronic medical conditions can be managed
cost effectively by improved nutrition. The Committee again
encourages the Secretary to establish an interagency
collaboration with the Department of Education and the USDA to
enhance nutritional education in K-12 schools and urges the
Secretary to be proactive in promoting disease prevention by
providing a plan to expand nutritional education and to
increase access to nutritional foods for students. The
Committee also requests a strategic plan, led by HHS in
partnership with the USDA, on how culturally appropriate, food-
based solutions can improve health outcomes and save money.
Health Care Providers, Including Pregnancy Help Centers,
Safety.--The Committee includes $5,000,000 for the Secretary to
award grants to health care providers, including Pregnancy Help
Centers, to pay for security services or otherwise to enhance
the security of their facilities, personnel, and patients to
ensure safe access. A health care provider, including a
pregnancy help center, receiving a grant may use the grant to
pay the costs of necessary security services or enhancements to
physical access and cyber security, including video
surveillance camera systems, data privacy enhancements, and
structural improvements.
Home Health Aides.--The Committee recognizes that home
health aides (HHAs) are the foundation of professional home-
based caregiving, and that the growing population of disabled,
chronically ill, and elderly Americans receiving home-based
care requires a skilled and highly trained HHA workforce
prepared to manage complex care needs. The Committee encourages
HHS to explore how HHAs are meeting clinical competencies
necessary to provide high-quality home-based care.
KidneyX.--The Committee continues to include a total of
$5,000,000 for KidneyX to support a public private partnership
to accelerate innovation in the prevention, diagnosis, and
treatment of kidney diseases. An estimated 850 million people
worldwide are living with kidney disease. KidneyX exit
disclaimer icon seeks to improve their lives by accelerating
the development of drugs, devices, biologics, and other
therapies across the spectrum of kidney care.
Local News Media.--The Committee encourages the Department
to utilize local broadcasters and local newspapers, including
those in small communities, in their public affairs Federal
advertising campaigns. The Committee requests an update in the
fiscal year 2024 Congressional Budget Justification on the
Department's public affairs advertising campaigns by percentage
of Federal funding spent on social media, national media, local
news media, and outdoor advertising during fiscal years 2021
and 2022. In addition, the Committee encourages the
Department's Office of the Assistant Secretary for Public
Affairs, in consultation with other relevant offices, to
consider a pilot project focusing on Federal advertising
effectiveness in rural communities--with populations under
40,000 individuals or fewer than 20,000 households--utilizing
local news media, including broadcast, radio, and non-daily
newspapers, whose involvement in advertising campaigns and
message delivery can assist in reaching under-served rural
areas.
LymeX Innovation Accelerator.--The Committee commends the
Office of the Secretary and its Chief Technology Officer for
the Lyme Innovation Initiative, launched November 2018, and the
LymeX Innovation Accelerator announced in October 2020. LymeX
is a $25,000,000 public-private partnership between HHS and the
Steven & Alexandra Cohen Foundation to accelerate innovation in
prevention, diagnostics, and treatments for Lyme and other
tick-borne diseases.
Medication Abortion.--The Committee urges the Department of
Health and Human Services to use every tool at its disposal to
ensure that medication abortion care is accessible, affordable,
covered, and convenient for patients including through access
to telehealth.
Mental Health Parity.--The Committee continues to be
concerned that after 12 years since enactment of the Mental
Health Parity and Addiction Equity Act (MHPAEA), there is still
a lack of oversight and compliance among insurance companies
and health plans not adequately covering mental and behavioral
health services and providers. In December 2019, the GAO
reported that this lack of compliance extends beyond plans
investigated by the DOL and includes plans over which HHS has
oversight authority. The Committee urges the HHS Secretary,
jointly with the Secretary of Labor and the Secretary of the
Treasury, to comply with language included in House Report 117-
96 to establish a process through which employer-sponsored
health plans and health insurance issuers subject to MHPAEA may
submit a public report regarding nonquantitative treatment
limitations while ensuring that any personal or confidential
consumer information is protected. The Committee looks forward
to receiving the report requested in House Report 117-96 on any
auditing and enforcement of all plans and issuers within the
jurisdiction of the respective Department.
National Center on Antiracism and Health Equity.--The
Committee continues to strongly support the Secretary's efforts
to advance health equity and reduce disparities for communities
of color. The Committee looks forward to reviewing the
Secretary's plan to establish a National Center on Antiracism
and Health Equity within the Department to lead efforts to
identify and understand the policies and practices that have a
disparate impact on the health and well-being of communities of
color as requested in House Report 117-96. The Committee
includes $10,000,000 for the Office of the Secretary to
establish a grant program to support public and nonprofit
entities, including community-based organizations, to build and
strengthen coalitions focused on addressing structural racism
in public health and activities that counter the disparate
impact on the health and well-being of communities of color.
The Committee requests a report not later than 180 days after
the date of enactment of this Act on the progress of this pilot
program.
Newborn Screening.--The Committee includes $1,000,000 for
HHS to commission a study with the National Academy of Medicine
to examine the current status of Newborn Screening systems,
processes, and research and make recommendations for future
improvements that would include: the recommended uniform
screening panel review and recommendation process; the barriers
and support to add new Recommended Uniform Screening Panel
conditions to State screening panels; assessments of State
capacity to strengthen current screening processes and
implement screening for new conditions; recommendations for
optimizing federally and privately funded newborn screening
research; new and emerging technologies that would permit
screening for new categories of disorders and how technology
impacts States; technological and other infrastructure needs to
improve diagnosis, follow-up and public health surveillance;
communication and educational needs for stakeholders; data
collection on disease prevalence and improved long term
outcomes; and the impacts of newborn screening efforts on
newborn morbidity and mortality.
Pharmacists and COVID-19 Authorities.--The Committee
appreciates HHS's recognition under the Public Readiness and
Emergency Preparedness (PREP) Act declaration authorities for
pharmacists to order, treat, immunize, and provide other
patient care services, including the ordering and
administration of time-sensitive COVID-19 therapeutics. The
Committee requests a report within 180 days of the date of
enactment of this Act on the impact of these authorities on
public health and proposed actions and recommendations on
whether to make these authorities permanent.
Population Health Task Force.--The Committee notes that the
world's most advanced and innovative hospitals, clinics,
pharmacies, research institutions, healthcare professional
schools, managed care organization, and medical therapies are
addressing social determinants of health by implementing
population health management strategies and value-based care
approaches to improve health outcomes, lower cost of care and
optimize experience of care. The Committee includes $1,000,000
for the Secretary to establish and maintain a report on best
practices of population health management through the creation
of a population health task force. The task force should be
comprised of representatives from, but not limited to, the
Office of the Secretary, CMS, CDC, population health providers,
experts on health equity, health technology, and value-based
care. The Committee requests a report within a year of the date
of enactment of this Act from the task force on population
health, including the task force's initial recommendations.
Prohibition on Contractors with Nondisclosure Agreements.--
The Committee recognizes that harassment, including sexual
harassment and assault, continue to be pervasive in the
workplace, and that the use of predispute nondisclosure and
nondisparagement clauses as conditions of employment can
perpetuate illegal conduct by silencing survivors and shielding
perpetrators. The Committee directs the Department to include
proposals in its fiscal year 2024 Congressional Budget
Justification to eliminate the use of grants and contracts to
employers that use this practice.
Rare Kidney Diseases in Health Equity Initiatives.--The
Committee recognizes the work across HHS to implement practices
and policies to eliminate healthcare disparities in America,
particularly for communities of color. Rare kidney diseases are
underreported and understudied, especially among Black
Americans. The Committee requests an update in the fiscal year
2024 Congressional Budget Justification on disparities in
kidney care and the inclusion of rare kidney diseases in
policies and programs aimed at eliminating health disparities
in communities of color.
Regional Councils and Councils of Governments.--The
Committee encourages the Department to list regional councils
and councils of governments as eligible entities in
competitions for Federal funding whenever local governments or
non-profit agencies are eligible entities. Furthermore, the
Committee encourages the Department to seek opportunities for
regional councils and councils of governments to serve as lead
applicants and grantees to encourage and expand greater
regional collaboration.
Sickle Cell Interagency Working Group.--The Committee notes
approximately 100,000 Americans are living with sickle cell
disease, an inherited blood disorder that causes pain,
infection, and stroke. This disease disproportionately affects
Black Americans. The National Academies of Sciences,
Engineering, and Medicine (NASEM) report ``Addressing Sickle
Cell Disease: A Strategic Plan and Blueprint for Action''
provides important recommendations for improving the health and
quality of life for sickle cell disease patients, including a
hub and spoke ``Centers of Excellence'' care model. The
Committee urges HHS to encourage the Sickle Cell Interagency
Working Group to utilize the NASEM report to develop a plan for
treatment centers address the unmet care needs for patients
with sickle cell disease, sickle cell trait and other heritable
hemoglobinopathies. The Committee requests a report within 180
days of the date of enactment of this Act on the working
group's progress.
Social Determinants of Health.--The Committee directs the
Social Determinants Council created by House Report 116-450 to
continue to provide technical assistance to jurisdictions in
this program. The Committee requests a report within 90 days of
the date of enactment of this Act on the status of the
selection of all Council members.
Stillbirth Task Force.--The Committee provides an
additional $1,000,000 for the Secretary to bolster the work for
the Stillbirth Task Force. The task force should continue to
include the CDC, NIH, outside specialty organizations, and
maternal and fetal medicine specialists. The task force should
work through the Office of the Secretary to identify current
knowledge on stillbirth and prevention, areas of improvement
for data collection, current resources for families impacted by
stillbirth, and next steps to gather data and lower the rate of
stillbirth in the United States. The Committee directs the
Secretary to provide a report within 120 days of the date of
enactment of this Act on the progress of the task force.
Strategy to Reduce Nutrition Related Chronic Diseases.--The
Committee encourages the Secretary, in consultation with other
Federal agencies, to work through the Office of Disease
Prevention and Health Promotion to develop and implement a
Federal strategy to reduce nutrition-related chronic diseases
in the U.S., including diet-related research and programmatic
efforts that increase Americans' access to food as medicine,
and healthy, nutritious, organic, and affordable foods,
especially in at-risk communities. The Committee requests a
report within one year of the enactment of this Act on the
implementation of the Federal strategy and its effectiveness in
reducing nutrition related chronic diseases in the U.S. In
developing the strategy, HHS shall reference the recommendation
of the Government Accountability Office in its September 2021
report entitled ``Chronic Health Conditions: Federal Strategy
Needed to Coordinate Diet-Related Efforts.''
Supporting Community Violence Intervention Programs.--The
Committee notes HHS and its agencies, including CDC and SAMHSA,
have a critical role to play in supporting community violence
intervention, including by providing grant funding to eligible
programs and technical assistance to grant recipients, and
through evaluating the implementation of community violence
intervention programs. The Committee urges the Department to
evaluate its existing grant programs to determine which
programs can be used to support community-based violence
intervention activities and ensure that relevant funding
opportunity announcements clearly articulate that they can fund
community violence interventions. The Committee also urges the
Department to conduct outreach to raise awareness about the
funding available for community violence intervention programs,
provide technical assistance to grant recipients and conduct
research into program efficacy and implementation.
Technology's Role in Healthcare Workforce.--The Committee
recognizes the important role that HHS continues to provide to
support and protect the public health workforce during the
COVID-19 pandemic. The Committee requests an update in the
fiscal year 2024 Congressional Budget Justification on the
challenges associated with hiring, recruiting, and retaining
the Federal, State, local, tribal and territorial public health
workforce. This update should include a specific analysis of
how technology, especially hands-free technology, could help to
protect clinicians' physical safety and ease the burden of
patient care, thereby increasing retention of the public health
workforce.
Telehealth Data.--The Committee recognizes that demand for
telemedicine increased in 2020 in response to the COVID-19
pandemic. In addition, the Committee notes disparities in
telehealth exist between and within racial and ethnic groups,
rural and urban locations, and geographic regions as detailed
in a December 2021 report by the Assistant Secretary for
Planning and Evaluation. The Committee urges the Secretary,
working with CMS and HRSA, to categorize telehealth usage data,
including for audio-only services, by Health Professional
Shortage Areas. The Committee further urges the Secretary to
work across agencies to ensure that improvements to broadband
availability are prioritized in those areas with lowest
telehealth usage, highest audio-only usage, and a known health
professional shortage. The Committee requests an update within
120 days of the date of enactment of this Act on this
categorization and broadband availability.
U.S.-Mexico Border Health Commission.--The Committee
recognizes the important role the U.S.-Mexico Border Health
Commission plays in promoting solutions to health issues unique
to the Southern border. The Committee includes $2,500,000 for
the Commission, an increase of $500,000.
U.S.-Mexico Border Health Commission Vaccine Deployment
Strategy.--The Committee notes the U.S. must work with Mexico
to implement a binational COVID-19 strategy to ensure a full
economic recovery both in border communities and nationally.
The Committee encourages the U.S. section of the U.S.-Mexico
Border Health Commission to engage with their Mexican
counterparts to develop a COVID-19 vaccine deployment strategy
for communities on both sides of the border. The Committee
requests a report within 180 days of the date of enactment of
this Act on these efforts.
White House Initiative on Asian Americans, Native
Hawaiians, and Pacific Islanders (AANHPI).--The Committee
includes funding to support the White House Initiative on Asian
Americans, Native Hawaiians, and Pacific Islanders, led by the
Secretary of HHS, to advance health equity and economic justice
for AANHPI communities that continue to face racism, nativism,
and xenophobia.
Minority HIV/AIDS Fund
The Committee includes $60,000,000 for the Minority HIV/
AIDS Fund (MHAF), which is $3,100,000 above the fiscal year
2022 enacted level, and encourages the Secretary to prioritize
MHAF grants to HIV-based agencies that are minority led with
preference given to organizations led by women, men, and
transgender persons who identify as African American/Black,
Latino, American Indian/Alaskan Native, Asian American, and/or
Native Hawaiian/Pacific Islander.
Tribal Set-Aside.--The Committee notes that according to
the CDC, HIV-positive status among Native Americans is
increasing and nearly one-in-five HIV-positive Native Americans
is unaware of their status. In addition, only three-in-five
receive care and less than half are virally suppressed. To
increase access to HIV/AIDS testing, prevention, and treatment,
the Committee includes $5,000,000 as a tribal set-aside within
the MHAF.
Office of the Assistant Secretary for Health
Commissioned Corps of the United States Public Health
Service.--The Committee is aware that as of October 1, 2021,
the Commissioned Corps of the U.S. Public Health Service (USPHS
Commissioned Corps) is issuing a ``Certificate of Release or
Discharge from Active Duty'' (DD Form 214) to USPHS
Commissioned Corps officers who are released from active duty.
The Committee requests a report within 90 days of the date of
enactment of this Act on the feasibility of issuing a DD Form
214 to each USPHS Commissioned Corps Officer who retired or
separated from USPHS Commissioned Corps service prior to
October 1, 2021 and received a different statement of service.
Hepatitis B Adult Vaccination.--The Committee encourages
the Office of the Assistant Secretary for Health (OASH) to host
an interagency summit to discuss dissemination and
implementation of the Advisory Committee Immunization Practices
(ACIP) recommendation that all adults between 19 and 59 be
vaccinated for hepatitis B. The Committee is also aware that
CDC is actively considering a complimentary universal hepatitis
B vaccine screening policy and encourages OASH to support this
process, as appropriate.
Office of Climate Change and Health Equity.--The Committee
includes $3,000,000 in funding for the Office of Climate Change
and Health Equity (OCCHE) within OASH. HHS established OCCHE to
enhance overall population health by serving at the
intersection of social determinants of health and climate
resiliency.
Teen Pregnancy Prevention.--The Committee strongly supports
the Teen Pregnancy Prevention (TPP) Program and provides
$130,000,000, an increase of $29,000,000 above the enacted
level. The TPP Program has been widely cited as a high-quality
evidence-based program, including by the bipartisan Commission
on Evidence-Based Policymaking.
Teen Pregnancy Prevention Program Evidence Review.--The
Committee includes $900,000 for the TPP Evidence Review, for a
total of $7,700,000 in PHS Act section 241 evaluation set-aside
transfers. The Evidence Review is an independent, systematic,
rigorous review of evaluation studies that inform grantmaking
and provide a clearinghouse of evidence-based programs for
other Federal, State, and community initiatives.
Office of Minority Health
The Committee includes $80,835,000 for the Office of
Minority Health (OMH), which is $16,000,000 above the fiscal
year 2022 enacted level. 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.
Center for Indigenous Innovation and Health Equity.--The
Committee continues to recognize the importance of advancing
Indigenous solutions to achieve health equity. The Committee
includes $4,000,000, an increase of $2,000,000 to support the
work of the Center for Indigenous Innovation and Health Equity.
The Committee continues to urge HHS to consider partnering with
universities with a focus on Indigenous health research and
policy among Native Americans and Alaska Natives, as well as
universities with a focus on Indigenous health policy and
innovation among Native Hawaiians/Pacific Islanders.
Community Health Worker Workgroup.--The Committee provides
an additional $1,000,000 for the Community Health Worker
Workgroup within OMH specifically to focus on increasing
cultural competency in educational campaigns on public health
vaccines and prevention, including but not limited to influenza
and COVID-19.
Healthcare Delivery and Faith-Based Organizations.--The
Committee notes the emerging partnerships with faith-based
organizations to deliver healthcare in underserved communities,
including recent successful efforts to address the COVID-19
pandemic. The Committee understands that community partners and
faith-based organizations can take on an expanded role and
support efforts to address health disparities and promote
health equity. HHS and OMH are encouraged to continue to pursue
new and expanded opportunities.
Language Access Services.--The Committee includes
$3,000,000 to research, develop, and test methods of informing
limited English proficient (LEP) individuals about their right
to and the availability of language access services, including
considerations related to literacy levels of LEP populations,
the needs of older adults and speakers of indigenous languages,
readability, and the usage of symbols, taglines, translated
materials and other methodologies. OMH shall consult external
experts and organizations with knowledge on or connections to
LEP communities and partner with nonprofit community-based
organizations to test solutions and solicit feedback from LEP
populations. The goal of this research would preferably be to
develop a universal symbol that, accompanied by a phone number
or similar information, could be prominently placed on
consumer-facing documents, websites and notices, about the
availability of language access services. In addition, the
Committee notes that the HHS language access plan has not been
updated since 2013. The Committee requests a report not later
than 180 days after the date of enactment of this Act, on HHS's
plan to update its language access plan, including a timeline
for publication on lep.gov.
Minority Leaders Development Program.--The Committee
provides a $1,000,000 increase for the Minority Leaders
Development Program which aims to enhance skills and
competencies necessary for Federal leadership service among
participants through a curriculum focused on health care
policy, leadership skill-building, and cultural competence. The
initiative will fill a gap in Federal fellowship opportunities
for individuals interested in working at HHS to advance health
equity and address the social determinants of health through
health policies, programs, and practices.
National Lupus Training, Outreach, and Clinical Trial
Education Program.--The Committee continues to support the
National Lupus Training, Outreach, and Clinical Trial Education
Program at $2,000,000. The Committee commends efforts by OMH to
increase outreach, education, and awareness of opportunities to
participate in lupus clinical trials among minority populations
nationally.
Shortage of Healthcare Providers.--The Committee is
concerned about the growing shortage of providers including
both primary and specialty healthcare providers that threatens
the foundation of the health care system and health equity. A
coordinated national strategy is needed to diversify the health
care workforce and address shortages in rural and urban
communities. The findings of The Roundtable on Black Men and
Black Women in Science, Engineering, and Medicine outline
racism and bias as significant reasons for this disparity in
science, engineering, and medicine, with detrimental
implications on individuals, health care organizations, and the
nation as a whole. The Committee directs the Secretary to
include a multi-year plan in the fiscal year 2024 Congressional
Budget Justification to address the national primary care and
specialty provider shortages to improve access to care. The
plan shall include strategies to improve health outcomes by
diversifying the field of primary care through the
establishment of a pathway program for community college
students to pursue premedical training and enter medical
school.
In addition, the Committee looks forward to receiving the
report from the Advisory Committee on Minority Health advising
HHS on the best efforts to create pipeline programs that start
with pre-med students in underserved areas and end in more
graduate medical education training programs in those
underserved areas requested in House Report 117-96. The
Committee recognizes the need to build and strengthen the
pipeline for physicians who practice in medically underserved
areas. The COVID-19 pandemic has exposed how fragile the
frontline provider workforce is because of the physician
shortage crisis, and it is most pronounced in medically
underserved areas.
Office on Women's Health
The Committee includes $48,140,000 for the Office on
Women's Health (OWH), which is $10,000,000 above the fiscal
year 2022 enacted level.
Breastfeeding Analysis.--The Committee includes $1,250,000
for the Office on Women's Health to enter into an agreement
with the National Academy of Sciences (NAS) to provide an
evidence-based, non-partisan analysis of the macroeconomic,
health, and social costs of U.S. breastfeeding rates and
national breastfeeding goals. This analysis should include a
differential analysis of the current policies, programs, and
investments aimed at increasing breastfeeding initiation,
improving 3- and 6-month exclusive breastfeeding rates,
reducing racial, geographic, and income-related breastfeeding
disparities, and reducing U.S. reliance on formula. NAS should
propose recommendations for achieving the Healthy People 2020
and 2030 breastfeeding goals by 2030. The Committee requests a
briefing on this analysis within 90 days of the date of
enactment of this Act.
Combatting Violence Against Women.--The Committee includes
$10,000,000 to combat violence against women through the State
partnership initiative and directs the OWH to work in
conjunction with the Family Violence Prevention and Services
Program office. This program provides funding to State-level
public and private health programs to partner with domestic and
sexual violence organizations to improve health care providers
ability to help victims of violence and improve prevention
programs.
Interagency Coordinating Committee on the Promotion of
Optimal Birth Outcomes.--The Committee includes $2,000,000 for
the OWH to convene an Interagency Coordinating Committee on the
Promotion of Optimal Birth Outcomes (Coordinating Committee) to
oversee and coordinate the HHS Action Plan to Improve Maternal
Health in America. The Coordinating Committee shall meet
biannually and shall include, but not be limited to, the
Administrators of HRSA, CDC, CMS, ACF, ACL, SAMHSA, the Indian
Health Service, and the Secretaries of the VA and DOD. The
Coordinating Committee shall produce an annual progress report
that reports on activities and outcomes of the HHS programs
directed toward improving maternity outcomes.
Pregnant Women and Lactating Women Advisory Committee.--The
Committee includes $200,000 for the creation of an Advisory
Committee to monitor and report on the implementation of the
recommendations from the Task Force on Research Specific to
Pregnant Women and Lactating Women (PRGLAC). PRGLAC's 2020
Implementation Plan called for the creation of an Advisory
Committee to monitor and report on implementing
recommendations, updating regulations, and guidance, as
applicable, regarding the inclusion of pregnant women and
lactating women in clinical trials. Additionally, the Committee
directs the Secretary to submit a report to Congress within 180
days of the date of enactment of this Act outlining the
Department's progress on implementing each of PRGLAC's 15
recommendations from the Implementation Plan it submitted to
the Secretary in August 2020.
MEDICARE HEARINGS AND APPEALS
Appropriation, fiscal year 2022....................... $196,000,000
Budget request, fiscal year 2023...................... 196,000,000
Committee Recommendation.............................. 196,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
This appropriation supports activities carried out by two
Office of the Secretary Staff Divisions. The Office of Medicare
Hearings and Appeals supports Medicare appeals at the
administrative law judge level, the third level of Medicare
claims appeals. The Departmental Appeals Board represents the
fourth level of the Medicare appeals process and provides
impartial, independent hearings and appellate reviews.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY
Appropriation, fiscal year 2022....................... $64,238,000
Budget request, fiscal year 2023...................... 103,614,000
Committee Recommendation.............................. 86,614,000
Change from enacted level......................... +22,376,000
Change from budget request........................ -17,000,000
The Office of the National Coordinator (ONC) is the
principal Federal entity charged with coordinating efforts to
implement and use health information technology and exchange
electronically health information.
Electronic Health Information Security.--The Committee
notes that as patients electronically access and share their
electronic health information (EHI) in new ways, it is
important that both patients and their healthcare providers
have confidence in the privacy and security of that information
regardless of which entities hold that data, including those
that may not be subject to the HIPAA Rules. To better
understand and protect against potential security
vulnerabilities and cyberattacks to those entities not subject
to the HIPAA Rules, the Committee urges the Secretary to
examine and brief the Federal Trade Commission on the
vulnerabilities to patients' EHI associated with increased use
of application programming interfaces (APIs) by consumer-
oriented app companies and consumer data aggregation services,
the extent to which potential vulnerabilities may result
because of a lack of consistent security safeguards for
entities operating outside the bounds of Federal health
information privacy and security rules, and potential Federal
policy options to better protect the security of patients'
health information.
Information Blocking Guidance.--The Committee recognizes
that the ONC's rule to implement the interoperability and
information blocking provisions of the 21st Century Cures Act
took significant steps forward to give patients greater access
to and improve the electronic flow of electronic health
information across care settings. Given the significant
penalties and other consequences for information blocking, the
Committee urges ONC to provide regulated entities and other
affected stakeholders with clear, practical guidance regarding
foundational concepts in the rule. Guidance should clearly
outline how regulated entities can evaluate their particular
circumstances and scenarios against the rule's provisions,
including how to identify and apply relevant exceptions to the
information blocking definition.
Interoperability of Maternity Care Records.--The Committee
recognizes that Personal Health Records for pregnant people are
needed to improve patient health and safety as they move from
one level of care to another during pregnancy, and that efforts
must continue to improve the interoperability of electronic
health records in order to optimize the care of pregnant
persons. The Committee requests that within one year of
enactment of this Act, HHS create and publish guidelines that
address Perinatal Care and that leverage the skills of all
providers, including physicians and midwives, and all sites of
care, including hospitals and freestanding birth centers. The
guidelines should also outline best practices for creating and
maintaining accessible, longitudinal peri- and post-natal
health records for patients.
Patient Matching.--The Committee is concerned there is no
consistent and accurate way to link patients to their health
information as they seek care across the continuum, and
believes health information must be accurate, timely, and
robust to inform clinical care decisions for every patient. The
recommendation includes $5,000,00 for ONC to work with industry
to develop matching standards that prioritize interoperability,
patient safety, and patient privacy.
Standards for Interoperability.--The recommendation
includes not less than $5,000,000 to support Fast Healthcare
Interoperability Resource standards-related activities needed
to successfully achieve interoperability and information
sharing for better health and health care.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2022....................... $82,400,000
Budget request, fiscal year 2023...................... 106,329,000
Committee Recommendation.............................. 94,400,000
Change from enacted level......................... +12,000,000
Change from budget request........................ -11,929,000
The Committee recommends $94,400,000 for the Office of
Inspector General (OIG), which is $12,000,000 above the fiscal
year 2022 enacted level.
In addition, within the Health Care Fraud and Abuse Control
(HCFAC) program discretionary appropriations for fiscal year
2023, the Committee provides the OIG with $109,612,000.
Mandatory appropriations for this office also are contained in
the HCFAC program and the Health Insurance Portability and
Accountability Act of 1996.
OFFICE FOR CIVIL RIGHTS
Appropriation, fiscal year 2022....................... $39,798,000
Budget request, fiscal year 2023...................... 60,250,000
Committee Recommendation.............................. 49,798,000
Change from enacted level......................... +10,000,000
Change from budget request........................ -10,452,000
The Office for Civil Rights (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.
National Council on Disability.--The Committee strongly
encourages the HHS Office of Civil Rights (OCR) to clarify that
all HHS suicide prevention grants and services must comply with
existing disability rights laws, including the ADA, and
Sections 504 and 508 of the Rehabilitation Act, including the
provisions requiring accessible communications, so that all
videos, documents, and other products ensure access to persons
with disabilities. In addition, the Committee encourages OCR to
recommend that hospitals create a disability ombudsperson
position who is authorized to facilitate communication between
healthcare providers and patients with disabilities or their
proxies and advocate on the patient's behalf, when required, to
ensure that all clinical and LTSS options and choices are made
available.
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
Appropriation, fiscal year 2022....................... $673,278,000
Budget request, fiscal year 2023...................... 710,327,000
Committee Recommendation.............................. 710,327,000
Change from enacted level......................... +37,049,000
Change from budget request........................ - - -
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.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
Appropriation, fiscal year 2022....................... $3,199,678,000
Budget request, fiscal year 2023...................... 3,814,610,000
Committee Recommendation.............................. 3,699,356,000
Change from enacted level......................... +499,678,000
Change from budget request........................ -115,254,000
This account supports the activities of the Assistant
Secretary for Preparedness and Response (ASPR) and other
components within the Office of the Secretary to prevent,
prepare for, and respond to the health consequences of
bioterrorism and other public health emergencies, including
pandemic influenza. It also includes funding for the
Department's cybersecurity efforts.
Office of the Assistant Secretary for Preparedness and Response (ASPR)
The Committee provides $3,144,558,000 for activities
administered by ASPR. 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.
Chemical, Biological, Radiological, and Nuclear (CBRN)
Threats.--The Committee urges ASPR to prioritize the
development and stockpiling of critical CBRN vaccines,
treatments, and personal protective equipment. The Committee
encourages ASPR to engage more frequently with private sector
partners in the Broad Agency Announcement process to speed the
development of new medical countermeasures (MCMs) and the
stockpiling of existing MCMs against CBRN threats.
Cold Chain Technologies.--The Committee recognizes the
limitations that are presented by cold chain requirements for
vaccine distribution and storage, and supports efforts to
address these challenges in the coming years. The Committee
directs ASPR to explore opportunities for new technologies such
as dry power approaches or thin-film freeze drying that allow
for vaccines to be physiochemically stable for an extended
period without causing degradation or reduction in
immunogenicity. The Committee requests an update in the fiscal
year 2024 Congressional Budget Justification on such efforts.
Commercialization of COVID Vaccines and Therapeutics.--The
Committee directs ASPR to provide a briefing within 60 days of
enactment of this Act on the Department's planning for the
transition of COVID-19 medical countermeasures procurements to
the commercial market, including estimated timelines for
vaccines, therapeutics, and other products with FDA approval or
an emergency use authorization.
Far-Forward Patient Care.--The Committee recognizes that
conducting traditional medical care closer to the point of
injury can have many positive effects. ASPR is encouraged to
consider establishing a Federally Funded Research and
Development Center in partnership with an academic medical
center to improve far-forward care, transportation and
coordination, and advanced technology that can provide
additional solutions to future patient care.
Freeze-Dried Hemostatic Products.--The Committee urges the
further development of freeze-dried hemostatic products,
especially platelet-derived products, to include a wide range
of indications. Further, the Committee encourages the
consideration of additional efforts to expand the manufacturing
base for these products.
Medical Distribution Supply Chain.--The Committee
encourages ASPR to engage government partners and
pharmaceutical and medical distribution experts to proactively
prepare for the next public health emergency through tabletop
exercises and planning.
Performance Improvement.--The Committee encourages ASPR to
explore the Department of Veterans Affairs, Health
Administration Office of Emergency Preparedness Performance
Improvement Management System to determine if such a system
could benefit the ASPR ecosystem of programs.
Public Health Emergency Medical Countermeasures
Enterprise.--The Committee is aware that the National Academies
of Sciences, Engineering, and Medicine released a report in
November 2021, Ensuring an Effective Public Health Emergency
Medical Countermeasures Enterprise, that provides
recommendations for a re-envisioned Public Health Emergency
Medical Countermeasures Enterprise (PHEMCE). Four priority
areas of improvement emerged including collaborating more
effectively with external public and private partners. The
Committee encourages efforts by the PHEMCE to create an
advisory committee incorporating private sector and non-federal
partners and stakeholders to enhance transparency and
communication, identify and close gaps, and build collaborative
solutions.
Reporting.--The Committee directs ASPR to provide monthly
briefings regarding activities funded by this Act and other
available appropriations. The agency shall provide notification
24 hours in advance of any obligation greater than $25,000,000
from any appropriation. Such notification shall include the
source of funding, including section number where applicable or
program name, and a description of the obligation. In addition,
ASPR shall submit a monthly obligation report in electronic
format. Such report shall include information for each
obligation greater than $25,000,000, and each obligation shall
include the source of the appropriation and the program under
which the obligation occurred. Such report is due not later
than 30 days after the end of the month and shall be cumulative
for the fiscal year with the most recent obligations listed at
the top. Furthermore, the Secretary shall report to the
Committees on the current inventory of COVID-19 vaccines and
therapeutics, as well as the deployment of these vaccines and
therapeutics during the previous month, reported by State and
other jurisdiction not later than 30 days after the enactment
of this Act, and monthly thereafter until the inventory is
expended.
Operations
The Committee includes $34,376,000, an increase of
$3,438,000, for activities within the Assistant Secretary's
Immediate Office; the Office of the Chief Operating Officer;
the Office of Acquisitions Management, Contracts, and Grants;
and the Office of Financial Planning and Analysis.
Working Capital Fund.--The Committee provides funding for
the establishment of a working capital fund to increase fiscal
transparency and accountability of the use of funds. The
Committee supports ASPR's efforts to document cost allocation
methodologies and processes, and to clearly define the approval
process, including requirements for administrative adjustments,
and to update cost allocation practices to include current and
dynamic methodologies. While there was no finding of the misuse
of BARDA funds from the external audit requested by HHS, the
Committee urges ASPR to promptly implement such formal
processes to reduce occurrences of ``Administrative
Discretion.'' The Committee requests a briefing within 90 days
of the date of enactment of this Act on the status of the
working capital fund, including plans for the estimated
reduction in future year operations budget requests due to its
implementation.
HHS Coordination Operations and Response Element (H-CORE)
The Committee includes $132,801,000 to establish annual
funding to ensure the synchronization of the medical
countermeasure efforts for the COVID-19 response and other
threats, as they arise.
Preparedness and Emergency Operations
The Committee includes $28,300,000, an increase of
$3,646,000, for Preparedness and Emergency Operations. The
Preparedness and Emergency Operations account funds the Office
of Emergency Management, which supports a full spectrum of
emergency management responsibilities, including planning,
coordination, logistics, training, and responding to planned
events and unplanned incidents.
National Disaster Medical System
The Committee includes $93,904,000, an increase of
$18,500,000, for the National Disaster Medical System (NDMS).
NDMS deploys trained medical teams to communities impacted by
public health and medical emergencies due to natural and man-
made incidents.
Mission Zero.--The Committee includes $10,000,000, an
increase of $8,000,000, for civilian trauma centers to train
and incorporate military trauma care providers and teams into
care centers.
Pediatric Disaster Care.--The Committee includes
$8,000,000, an increase of $2,000,000, for the pediatric
disaster care program.
Hospital Preparedness Program
The Committee includes $327,055,000, an increase of
$31,500,000, for the Hospital Preparedness Program (HPP). HPP
supports a variety of programs to strengthen the preparedness
and response of the health care sector.
Hospital Preparedness Program Cooperative Agreements.--The
Committee includes $261,500,000, an increase of $30,000,000,
for critical support to State, local and regional partners to
advance health care system preparedness and response.
National Special Pathogen System.--The Committee includes
$8,000,000, an increase of $1,500,000, for the National
Emerging Special Pathogens Training and Education Center
(NETEC), and $21,000,000 for Regional Ebola and Other Special
Pathogen Treatment Centers (RESPTCs).
Regional Disaster Health Response System.--The Committee
includes $7,000,000 for these cooperative agreements.
Biomedical Advanced Research and Development Authority (BARDA)
The Committee includes $845,005,000, an increase of
$100,000,000, for BARDA. BARDA supports the advanced
development of vaccines, drugs, and therapeutics for potential
serious public health threats, including chemical, biological,
radiological, and nuclear threats, pandemic influenza, and
emerging and re-emerging infectious diseases. BARDA continues
to have an essential role in the response to COVID-19.
Active Pharmaceutical Ingredients and Manufacturing of
Essential Drugs.--The Committee continues to be concerned with
the risk of increased reliance on foreign-based sources of
active pharmaceutical ingredients (APIs), their chemical
components, and off-shore drug production. The Committee
recognizes the importance of domestic drug manufacturing and
onshore production of medicine and medical countermeasures, and
the successful work of BARDA in addressing these public health
vulnerabilities, including APIs, such as those included in
Heparin, and to collaborate within ASPR to support domestic
manufacturing surge capacity. The Committee requests an updated
report within 180 days of the date of enactment of this Act,
including efforts to ensure robust domestic drug manufacturing
and stockpiling and mitigation of supply chain vulnerabilities
to enable continuous manufacturing capabilities of APIs from
procurement to finished drug formulations.
Advanced Pharmaceutical Manufacturing Technologies.--The
Committee encourages BARDA to support the research, development
and facilitation of novel pharmaceutical manufacturing
technologies that provide flexible systems for the production
of medical countermeasures at a lower cost than traditional
manufacturing processes, including technologies that utilize
agricultural cell line development. The Committee urges BARDA
to partner with domestic manufacturers to bolster U.S. supply
chains to enhance our domestic capacity to respond to a variety
of new threats more effectively in the future.
Antifungal Research.--The Committee provides an increase to
support the research and development of novel antifungal
therapies, particularly for multi-drug resistant fungal
pathogens, to bolster national health security and minimize
their impact on public health. Antifungal development faces
similar challenges to antibacterial development and BARDA's
Advanced Research and Development program support will be
critical to generate additional antifungal products, including
for endemic fungal diseases, like Valley Fever. In addition,
the Committee urges the Secretary to update the scope of
support for the CARB-X program to include pathogens listed in
the 2019 CDC Antibiotic Resistant Threats report, which
includes products that target fungal pathogens. The Committee
requests a report within the 180 days of the date of enactment
of this Act on actions taken.
Antimicrobial Resistance.--The Committee provides an
increase for efforts to combat antimicrobial resistance,
recognizing the importance and challenges of this threat.
BARDA's Advanced Research and Development program support will
be critical to support new products. The Committee requests
within 180 days of the date of enactment of this Act a
professional judgement budget estimate to support a
comprehensive, long-term program for the development and
procurement of novel antibiotics.
At-Home Diagnostics.--The Committee encourages BARDA to
advance at-home infectious disease diagnostic technologies,
including those that are designed to diagnose more than one
viral agent, and to work collaboratively across HHS to advance
such tests and technological solutions that can facilitate at-
home test result reporting to relevant public health
authorities and providers. The Committee directs BARDA to
provide a briefing within 180 days of the date of enactment of
this Act on this topic.
Development of Immunomodulators as Therapeutics.--The
Committee encourages BARDA to consider the immunomodulators
category of therapeutics to treat Acute Respiratory Distress
Syndrome.
Long-COVID.--The Committee is concerned about the
prevalence of ``long-COVID'' in patients who have previously
been diagnosed with COVID-19. While there are no therapeutics
currently on the market for this condition, there are current
FDA-approved services being used to treat long-term vascular
disease which may also show promise in reducing long-COVID
symptoms. The Committee encourages BARDA to consider
investments to address this issue, with a specific focus on
therapies with demonstrated evidence of improvement of
symptoms.
Nanovaccines.--The Committee encourages BARDA to support
nanovaccine research to improve upon existing COVID-19
vaccines, as room temperature stable nanovaccines can be
rapidly designed, tested, and deployed.
Next Generation Blood Products.--The Committee urges BARDA
to continue investments in blood technologies, including the
completion of the ongoing clinical trials for nucleic acid
targeted pathogen reduction technology to improve red blood
cell transfusion safety.
Next Generation Vaccines.--The Committee encourages BARDA
to support a variety of vaccine platforms and the development
of novel technologies to improve vaccine immunogenicity,
durability, and tolerability, as well as thermostability,
storage, and transport.
Portfolio Updates.--The Committee encourages BARDA to
provide and regularly update portfolio webpages to mimic the
information posted on COVID-19 investments.
Strengthening Domestic Medical Manufacturing and
Production.--The Committee is concerned about the nation's
limited infrastructure to produce essential products such as
medical devices, medical equipment, pharmaceuticals, and
personal protective equipment. Weaknesses in the supply chain
and the dependence of the U.S. healthcare system on other
countries continues to impact the availability of products and
in some cases, limits care. The Committee recognizes the
importance of domestic manufacturing and raw materials and
urges HHS to undertake efforts to ensure a long-term
sustainable domestic supply chain for medical products.
Zika Vaccine.--The Committee is concerned about the risk of
Zika mutations and new variants. The Committee encourages BARDA
to continue to include Zika vaccine efforts in its portfolio.
Policy and Planning
The Committee includes $17,877,000, an increase of
$3,000,000, for Policy and Planning. The Office of Policy and
Planning leads the Department's emergency preparedness and
response strategic direction and policy coordination.
Project BioShield Special Reserve Fund
The Committee includes $800,000,000, an increase of
$20,000,000, for Project BioShield. These funds support the
acquisition of promising medical countermeasures developed
through BARDA contracts for the most serious public health
threats.
Strategic National Stockpile
The Committee includes $855,000,000, an increase of
$10,000,000, for the Strategic National Stockpile (SNS).
CDC Engagement.--The Committee directs ASPR to support the
significant role of the Centers for Disease Control and
Prevention in the SNS by providing scientific expertise in
decision-making related to procurement of countermeasures, and
maintaining strong relationships with State and local public
health departments to facilitate efficient deployment of
countermeasures in public health emergencies.
Domestic Diagnostic Manufacturing.--The Committee remains
concerned the COVID-19 pandemic demonstrated the need for warm-
base manufacturing for U.S. diagnostic companies. Therefore,
the Committee encourages ASPR to pursue public-private
partnerships with U.S. diagnostic manufacturers to invest in
warm-base manufacturing of over-the-counter tests for the SNS
and public health surveillance.
Influenza Antivirals.--The Committee remains concerned
about the stockpile of influenza antivirals. The Committee
supports the initiative to diversify and replenish its
stockpile of emergency influenza antivirals to ensure that the
U.S. has multiple treatment options.
Re-Envisioning the Strategic National Stockpile.--The
Committee recognizes that efforts are underway to review and
propose a path forward for the SNS, as directed by P.L. 117-
103, and awaits the release of these plans.
Strategic National Stockpile Supplies.--Not later than 30
days after the date of enactment of this Act, and monthly
thereafter until the public health emergency related to COVID-
19 is no longer in effect, the Secretary shall report to the
Committee on the current inventory of ventilators and personal
protective equipment in the SNS, including the numbers of face
shields, gloves, goggles and glasses, gowns, head covers,
masks, and respirators, as well as deployment of ventilators
and personal protective equipment during the previous month,
reported by State and other jurisdiction. Further, the
Committee directs the Assistant Secretary to ensure that the
working group under section 319F(a) of the Public Health
Service Act and the Public Health Emergency Medical
Countermeasures Enterprise (PHEMCE) established under section
2811-1 of such Act includes expenditures necessary to maintain
the minimum level of relevant supplies in the SNS, including in
case of a significant pandemic, in the yearly submission of the
PHEMCE multi-year budget.
Medical Reserve Corps
The Committee includes $6,240,000 for the Medical Reserve
Corps program, which is a network of local volunteers made up
of doctors, dentists, nurses, pharmacists, and other community
members who work to strengthen the public health infrastructure
and preparedness capabilities of their communities.
Preparedness and Response Innovation
The Committee provides $4,000,000, an increase of
$1,920,000, for a bilateral cooperative program with the
Government of Israel for the development of health
technologies.
Cybersecurity
The Committee provides $131,915,000, an increase of
$60,500,000, for information technology cybersecurity in the
Office of the Chief Information Officer and HHS-wide to
strengthen the Department's cybersecurity posture.
In addition, the Committee provides $21,900,000 for HHS
Protect and directs this effort to be transferred to CDC, as
proposed. The Committee directs CDC to lead HHS Protect and to
immediately reassess its scope and capabilities, considering
data quantity and quality as the COVID-19 pandemic evolves, and
to make appropriate modifications. The Committee directs HHS
Protect to be integrated into other programs and initiatives,
as appropriate but not be prioritized above other efforts. The
Committee requests a briefing not later than 60 days after the
date of enactment of this Act on the path forward for HHS
Protect, including current and future year budget estimates.
Office of National Security
The Committee provides $8,983,000, an increase of $473,000,
for the Office of National Security to maintain the security of
the Department's personnel, systems, and critical
infrastructure.
Office of the Assistant Secretary for Health
The Committee provides $10,000,000 for preparedness and
readiness activities.
Pandemic Influenza Preparedness
The Committee includes $382,000,000, an increase of
$82,000,000, for the pandemic influenza preparedness program.
This funding supports efforts to modernize influenza research
and development of vaccines and the next-generation influenza
medical countermeasures, preparedness testing and evaluation,
and stockpiling, as well as critical domestic vaccine
manufacturing infrastructure.
ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH
Appropriation, fiscal year 2022....................... $1,000,000,000
Budget request, fiscal year 2023...................... 5,000,000,000
Committee Recommendation.............................. 2,750,000,000
Change from enacted level......................... +1,750,000,000
Change from budget request........................ -2,250,000,000
The Committee includes $2,750,000,000 for the Advanced
Research Projects Agency for Health (ARPA-H), $1,750,000,000
above the fiscal year 2022 enacted level and $2,250,000,000
below the fiscal year 2023 budget request.
The Committee strongly supports the mission of ARPA-H to
drive transformational innovation in health research. The
Committee believes that given its focus on supporting high-
risk, high-reward projects and distinct approach to selecting
and managing research projects, establishing ARPA-H as a
separate entity within HHS will maximize the likelihood of the
agency's success. The Committee strongly encourages HHS to
collaborate with DARPA to develop the foundational policies,
procedures, and staff training for ARPA-H employees.
ALS Research and Treatments.--The Committee urges ARPA-H to
consider funding ALS research that prioritizes time to
beneficial impacts on people living with ALS and their
families.
Mental Health Research.--The Committee urges ARPA-H to
consider mental health research, including diagnosis and
treatment of SMI to address widespread behavioral health issues
to spur industry developments and new academic partnerships.
Nanovaccine Research.--The Committee recognizes the need to
invest in nanovaccine research at U.S. universities to improve
upon existing COVID-19 vaccines such as room temperature stable
nanovaccines that can be rapidly designed, tested, and
deployed. The Committee directs NIH to consider funding a
consortium of academic researchers working on nanovaccines.
General Provisions
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 receive a report detailing the
planned use of such funds.
Sec. 204. The Committee continues a provision regarding the
PHS evaluation set-aside.
(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
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 $5,000,000 per project with a total limit for NIH of
$100,000,000.
(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 specific report
requirements for CMS's Health Insurance Exchange activities in
the fiscal year 2024 budget request.
Sec. 220. The Committee continues a provision prohibiting
the CMS Program Management account from being used to support
risk corridor payments.
(TRANSFER OF FUNDS)
Sec. 221. The Committee continues language directing the
spending of the Prevention and Public Health fund.
PREVENTION AND PUBLIC HEALTH FUND
The Committee continues a provision that directs the
transfer of the Prevention and Public Health Fund. In fiscal
year 2023, the level appropriated for the fund is $943,000,000
after accounting for sequestration. The Committee includes bill
language in section 221 of this Act that requires that funds be
transferred within 45 days of enactment of this Act to the
following accounts, for the following activities, and in the
following amounts:
------------------------------------------------------------------------
Agency Budget Activity FY 2023 Committee
------------------------------------------------------------------------
ACL............................. Alzheimer's Disease $14,700,000
Program.
ACL............................. Chronic Disease 8,000,000
Self-Management.
ACL............................. Falls Prevention... 5,000,000
CDC............................. Breastfeeding 9,750,000
Grants (Hospitals
Promoting
Breastfeeding).
CDC............................. Diabetes........... 52,275,000
CDC............................. Epidemiology and 40,000,000
Laboratory
Capacity Grants.
CDC............................. Healthcare 12,000,000
Associated
Infections.
CDC............................. Heart Disease and 57,075,000
Stroke Prevention
Program.
CDC............................. Million Hearts 10,000,000
Program.
CDC............................. Preventive Health 160,000,000
and Health
Services Block
Grant.
CDC............................. Tobacco............ 120,850,000
CDC............................. Section 317 419,350,000
Immunization
Grants.
CDC............................. Lead Poisoning 17,000,000
Prevention.
CDC............................. Early Care 5,000,000
Collaboratives.
SAMHSA.......................... Garrett Lee Smith-- 12,000,000
Youth Suicide
Prevention.
------------------------------------------------------------------------
Sec. 222. The Committee modifies a provision related to
breast cancer screening.
Sec. 223. The Committee continues a provision related to
indirect cost negotiated rates.
(TRANSFER OF FUNDS)
Sec. 224. The Committee continues a provision permitting
transfer of funds within NIH, if such funds are related to
opioid, stimulant, and pain management research.
Sec. 225. The Committee continues certain Congressional
notification requirements.
Sec. 226. The Committee continues a provision related to a
report on staffing.
Sec. 227. The Committee continues a provision allowing HHS
to cover travel expenses when necessary for employees to obtain
medical care when they are assigned to duty in a location with
a public health emergency.
Sec. 228. The Committee modifies a provision related to
donations for unaccompanied children.
Sec. 229. The Committee modifies a provision related to the
use of funds to house unaccompanied children in facilities that
are not State-licensed for the care of unaccompanied children.
Sec. 230. The Committee continues a provision related to
the notification requirements regarding the use of facilities
that are not State-licensed for the care of unaccompanied
children.
Sec. 231. The Committee modifies a provision related to
Members of Congress and oversight of facilities responsible for
the care of unaccompanied children.
Sec. 232. The Committee continues a provision requiring
monthly reporting on unaccompanied children who were separated
from their parents or legal guardians and transferred to the
care of the Office of Refugee Resettlement.
Sec. 233. The Committee includes a new provision
prohibiting the use of funds for sharing any information
pertaining to unaccompanied children for use or reference in
removal proceedings or immigration enforcement.
Sec. 234. The Committee includes a new provision ensuring
that efforts are taken to place unaccompanied children who are
siblings together.
Sec. 235. The Committee includes a new provision requiring
the Secretary to submit a detailed spend plan outlining
anticipated uses of funds in the Refugee and Entrant Assistance
account.
Sec. 236. The Committee includes a new provision
authorizing the use of funds in the Refugee and Entrant
Assistance account for services to children, parents, and legal
guardians who were separated at the United States-Mexico border
in connection with the Zero-Tolerance Policy.
Sec. 237. The Committee continues a provision related to
primary and secondary school costs for eligible dependents of
HHS personnel stationed in the Commonwealth of Puerto Rico, the
Commonwealth of the Northern Mariana Islands, and the
possessions of the United States.
(RESCISSION)
Sec. 238. The Committee modifies a provision related to the
Nonrecurring Expenses Fund.
Sec. 239. The Committee continues a provision related to
flexibility for grantees of the Ryan White HIV/AIDS program.
Sec. 240. The Committee includes a new provision
prohibiting funds for foster care programs from being awarded
to an organization that excludes an individual based on non-
merit factors such as age, disability, sex, race, color,
national origin, religion, gender identity, or sexual
orientation.
Sec. 241. The Committee includes a new provision related to
premium pay authority.
Sec. 242. The Committee includes a new provision to amend
the PHS Act and related statutes to revise references to the
National Institute on Drug Abuse.
Sec. 243. The Committee includes a new provision to amend
the PHS Act and related statutes to revise references to the
National Institute on Alcohol Abuse and Alcoholism.
Sec. 244. The Committee includes a new provision to amend
the PHS Act and related statutes to revise references to the
Substance Abuse and Mental Health Services Administration.
Sec. 245. The Committee includes a new provision related to
notification requirements in the Social Security Act.
Sec. 246. The Committee continues a provision related to
multi-year grant funding for research projects that were
delayed due to COVID-19.
Sec. 247. The Committee includes a new provision related to
CDC fellowship and training participants.
TITLE III--DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
Appropriation, fiscal year 2022....................... $18,229,790,000
Budget request, fiscal year 2023...................... 21,280,551,000
Committee Recommendation.............................. 21,260,551,000
Change from enacted level......................... +3,030,761,000
Change from budget request........................ -20,000,000
This account provides foundational funding to help ensure
all children receive a fair, equitable and high-quality
education.
Of the total amount available, $10,306,490,000 is
appropriated for fiscal year 2023 for obligation on or after
July 1, 2024 and $10,841,177,000 is appropriated for fiscal
year 2023 for obligation on or after October 1, 2024.
Grants to Local Educational Agencies
For fiscal year 2023, the Committee recommends
$20,536,802,000 for Title I grants to Local Educational
Agencies (LEAs or school districts), an increase of
$3,000,000,000 over the fiscal year 2022 enacted level. Title I
is the cornerstone of Federal K-12 education programs and
critical to the nation's collective efforts to ensure that
every child has the opportunity to obtain a high-quality
education. The program serves an estimated 25 million students
in nearly 90 percent of school districts and nearly 60 percent
of all public schools. Providing additional resources so that
children can succeed in school and in life is one of the
Committee's highest priorities in the bill.
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 2022 enacted level. 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
(Secretary) on October 1, 2022, 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 2022
enacted level. 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 $6,357,550,000 for Title I
Targeted Grants, which is $1,500,000,000 above the fiscal year
2022 enacted level. Targeted Grants provide higher payments to
school districts with high numbers or percentages of low-income
students.
The Committee recommends $6,357,550,000 for Title I
Education Finance Incentive Grants (EFIGs) which is
$1,500,000,000 above the fiscal year 2022 enacted level. EFIGs
provide payments to States and school districts that
incorporate equity and effort factors to improve the equity of
State funding systems.
Fiscal Equity.--The Committee is concerned that school
districts serving majority students of color and students from
low-income backgrounds are more likely to be funded
inadequately. Data shows school districts with the highest
percentage enrollments of students of color receive nearly
$1,800 per student less in State and local funding than school
districts serving the fewest students of color, while districts
serving the most students in poverty receive $1,000 less than
districts serving the fewest students in poverty.
Against the backdrop of these unacceptable inequities,
Title I provides vital additional resources to support low-
income students in school. Since fiscal year 2002, the
Committee has directed increases to Title I through the
Targeted and EFIG formulas. Under the Targeted and within-State
EFIG formulas, a school district receives higher grants per
child counted in the Title I formula the higher its poverty
rate or number. A 2019 study of the Title I formulas by the
National Center for Education Statistics illustrates their
progressive structure--under Targeted, districts in the highest
poverty quarter received $118 more per formula-eligible child
than the lowest poverty quarter. Under EFIG, districts in the
highest poverty quarter received $143 more per formula-eligible
child than the lowest poverty quarter.
The Committee regards the Targeted and EFIG formulas as
essential tools for promoting funding equity nationwide;
however, the Committee recognizes that State and local funding
represents more than 90 percent of public K-12 funding
nationwide. Accordingly, the Committee believes States can do
far more to improve school district funding equity through
improvements to school finance formulas. While some will argue
that Federal legislative attention should exclusively focus on
improvements to Title I formulas, the Committee believes such
efforts represent work avoidance. Instead, the Committee
believes States have an opportunity to combat urgent funding
inequities through more progressive funding allocations to
districts. For instance, if State-level funding to school
districts were distributed via methods similar to the Federal
Targeted and within-State EFIG formulas, the impact would be
transformative for students attending the nation's highest-need
schools.
To begin this work, the Committee recommendation includes a
new provision, which allows the Secretary to use up to
$50,000,000 to award competitive grants to States for voluntary
activities designed to identify and close funding gaps between
high-poverty and low-poverty school districts. The Committee is
supportive of efforts to provide financial assistance to States
that request aid to identify disparities in State or local
funding for high-need LEAs; engage with local communities in
developing plans, goals and timelines for reducing identified
disparities; and report on interim goals, progress and
corrective actions.
The Committee also acknowledges that the Elementary and
Secondary Education Act (ESEA) contains several provisions
intended to reduce resource inequities between high-poverty and
low-poverty school districts, particularly regarding school
improvement activities. The Committee encourages the Department
to continue its efforts to assist States in evaluating resource
allocation in districts that serve a significant number of
schools identified for improvement and districts in identifying
resource inequities for schools identified for improvement as
part of a comprehensive school support and improvement plan.
Transportation and School Improvement.--The Committee
recognized a longstanding barrier to the implementation of
strategies to increase student diversity as a means of school
improvement in the Department of Education Appropriations Act,
2019 when it removed two decades-old prohibitions on the use of
Federal funds for transportation costs to carry out school
desegregation efforts. Subsequently, in the Department of
Education Appropriations Act, 2021, the Committee removed the
last of these long-standing prohibitions in the Federal code in
the General Education Provisions Act. With the recent removal
of these prohibitions, the Committee remains concerned many
States and districts may be unaware of their ability to use
ESEA funding to support voluntary school integration efforts.
In response, the Committee included a directive in House Report
117-96 requiring the Department to provide technical assistance
to school districts regarding the use of school improvement
funds under Title I, Part A for transportation to support
voluntary school integration efforts. The Committee looks
forward to receiving an update on the Department's progress in
carrying out this work by September 30, 2022.
Reservation for Homeless Students.--The Committee continues
to urge that the Department support LEAs' development of plans
under section 1112(b)(6) of the ESEA that describe the amount
of funds for homeless students reserved under section
1113(c)(3)(A) of the ESEA, how such amount was determined, and
the amount of the prior year's reservation that was spent on
homeless students. The Committee further urges that the
Department support State educational agencies' (SEAs)
development of plans under section 1111(g)(1)(F) of the ESEA
that describe how the SEA will monitor the amount and use of
funds reserved for homeless students under section
1113(c)(3)(A) and provide technical assistance to assist LEAs
in effectively using such funds to support homeless students.
Diverse Texts in School Libraries.--The Committee believes
that all students should be able to access texts that reflect
their interests and diverse cultures. Unfortunately, too many
Black, Latino, Asian-American, and Native students are unable
to access such books and printed materials in their classrooms
and school libraries. To address this challenge, the Committee
supports classroom and school libraries that seek to include
content that reflects the history and diversity of their
student populations.
School Names.--The Committee supports efforts by school
districts that are home to populations of Latino, Black, Asian-
American, and Native students to ensure public schools reflect
the diversity of their districts, which may extend to the
naming of schools to highlight the achievements of members from
Latino, Black, Asian-American, and Native communities.
History and Cultural Contributions of Racial and Ethnic
Minorities.--The Committee recognizes the increasing diversity
of student populations attending K-12 public schools in the
United States, and the value in developing curricula that fully
capture the history and cultural contributions of racial and
ethnic minorities in the U.S. The Committee supports efforts by
the Department to provide technical assistance to K-12 public
schools and educators interested in developing such courses and
curricula for their students. The Committee also supports
efforts by the Department to provide technical assistance
around professional development for K-12 educators to develop,
implement, and teach these emerging curricula using research-
based, culturally responsive teaching methods and best
practices. The Committee recognizes that well-taught and well-
designed courses highlighting the history and cultural
contributions of diverse populations provide academic benefits
to all students and contribute to students' sense of self and
belonging in school.
Increasing Equity in Advanced Coursework.--Research shows
that Black, Latino, and Native American students, students with
disabilities, and students from low-income families are
underrepresented in advanced programs and courses (gifted and
talented, advanced placement, international baccalaureate,
honors courses, dual enrollment). A major barrier for these
students is the over-reliance on subjective criteria not proven
to predict course success. The Committee is encouraged by
recent State and district actions to lessen these disparities,
including the implementation of open enrollment, automatic
enrollment for students who have demonstrated readiness, and/or
universal screening for gifted and talented programs. The
Committee notes that funds under ESEA may be used to implement
open enrollment, automatic enrollment, and/or universal
screening practices; as well as use these funds to increase
course access and success, provide coaching and training for
educators, purchase materials, and/or cover exam fees for
underrepresented students. To ensure these resources advance
student outcomes for historically underserved students, the
Committee continues to encourage the Department to resume
collecting data on passing rates for all Advanced Placement
subject areas.
Military Student Identifier.--The Committee notes that the
ESEA recognizes military-connected students as a distinct
subgroup of students. More than 80 percent of military-
connected children attend public schools. Students with
parents/guardians who serve full-time in the military move and
change schools frequently. In addition, they may experience
trauma resulting from separations from a parent/guardian due to
their parents' service to the U.S. Military. The Military
Student Identifier provides educators, school leaders, and
policymakers with critical information to personalize attention
and direct resources to better support military dependent
children. Current law directs the Military Student Identifier
toward the children of active duty families, leaving out the
nearly one-half million children of the reserve component, both
National Guard and Reserves. The Committee supports efforts to
address the unique needs of children whose parents/guardians
serve in the National Guard and reserve components.
Comprehensive Literacy Development Grants
The Committee recommends $192,000,000 for Comprehensive
Literacy Development Grants, which is the same as the fiscal
year 2022 enacted level. Funds are awarded to States to
subgrant to school districts and/or early education programs to
improve literacy instruction for disadvantaged students.
Innovative Approaches to Literacy
The Committee recommends $31,000,000 for Innovative
Approaches to Literacy (IAL), which is $2,000,000 above the
fiscal year 2022 enacted level. IAL funds support competitive
grants to school libraries and national not-for-profit
organizations to provide books and literacy activities to
children and families in high-need communities.
Underserved Urban School Districts.--The Committee directs
the Department in any new fiscal year 2023 competition to
continue prioritizing underserved communities in urban school
districts in which students from low-income families make up at
least 50 percent of enrollment.
State Agency Programs: Migrant
The Committee recommends $375,626,000 for the State Agency
Program for Migrant Education, which is the same as the fiscal
year 2022 enacted level. 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 $48,239,000, the same as the
fiscal year 2022 enacted level. 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 from the criminal justice system into postsecondary and
vocational programs.
Support for At-risk Youth.--The Committee is concerned with
findings from the Department's report to Congress on Neglected
and Delinquent Programs, which found that State-level data on
re-entry activities required under ESEA is insufficient to
provide an accurate sense of the success of such efforts
nationally. Given the disproportionate impact of the COVID-19
pandemic on the youth justice system, the Committee believes it
is essential that the Department monitor and ensure compliance
with re-entry activities required under ESEA. In the fiscal
year 2024 Congressional Budget Justification, the Committee
requests information regarding how the Department will support
each State in meeting the data reporting and re-entry
requirements for youth included in ESEA.
Children and Youth in Foster Care
The Committee includes $18,761,000 for a new program,
Improving Outcomes for Children and Youth in Foster Care.
The Committee notes the importance of mentoring in helping
children and youth in foster care thrive and strongly
encourages the Department to prioritize partnership grants that
match students in foster care with mentors and tutors.
Special Programs for Migrant Students
The Committee recommends $58,123,000 for the Special
Programs for Migrant Students, which is $10,000,000 above the
fiscal year 2022 enacted level. 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.
IMPACT AID
Appropriation, fiscal year 2022....................... $1,557,112,000
Budget request, fiscal year 2023...................... 1,541,112,000
Committee Recommendation.............................. 1,614,112,000
Change from enacted level......................... +57,000,000
Change from budget request........................ +73,000,000
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 $1,464,242,000 for Basic Support
Payments to LEAs, which is $55,000,000 above the fiscal year
2022 enacted level. 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 2022 enacted level. 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 2022 enacted
level. 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 2022 enacted
level. Funding is allocated by formula to eligible LEAs for
school construction activities under section 7007(b) of ESEA.
Payments for Federal Property
The Committee recommends $79,313,000 for Payments for
Federal Property, which is $2,000,000 above the fiscal year
2022 enacted level. Funds are awarded to school districts to
compensate for lost tax revenue as the result of Federal
acquisition of real property since 1938.
Data for Eligible Communities.--The reporting method used
to calculate the amount of Impact Aid a school receives is
critical to ensuring accurate data for eligible communities.
Correct student counts ensure adequate resources are provided
for students. The Committee repeats its request that the
Department assess the merits of such flexibilities in future
years, along with other potential process modifications, in the
fiscal year 2024 Congressional Budget Justification. In
addition, the Committee requests recommendations for helping
LEAs plan for discrepancies between estimated and actual award
levels.
SCHOOL IMPROVEMENT PROGRAMS
Appropriation, fiscal year 2022....................... $5,595,835,000
Budget request, fiscal year 2023...................... 5,525,982,000
Committee Recommendation.............................. 5,905,642,000
Change from enacted level......................... +309,807,000
Change from budget request........................ +379,660,000
The Committee recommendation includes $5,905,642,000 for
the School Improvement Programs account.
Supporting Effective Instruction State Grants
The Committee recommends $2,270,080,000 for Supporting
Effective Instruction State Grants (Title II-A), which is
$100,000,000 above the fiscal year 2022 enacted level. Title
II-A grants provide States and school districts with a flexible
source of funding to strengthen the skills and knowledge of
teachers, principals, and administrators to enable them to
improve student achievement.
Educator Diversity.--Research shows that all students, and
in particular students of color, benefit from a racially
diverse workforce. Research shows that students benefit both
academically and through the positive relationships they build
with educators. However, barriers such as unfavorable working
conditions or antagonistic work cultures mean that teachers of
color leave the profession at higher rates than their peers.
The Committee recognizes that the need for a more diverse
educator workforce is always pressing, but is especially urgent
right now, as nearly half of U.S. schools are facing COVID-
related staff shortages. The Committee is encouraged by efforts
to address factors undergirding teacher shortages and lack of
teacher diversity in States and districts, including using
evidence-based models such as Grow Your Own programs. The
Committee's increase to Title II-A for fiscal year 2023 is
intended to address concerns about staffing shortages, increase
educator diversity, and implement evidence-based programs. The
Committee encourages the Department to ensure funds support
States and districts with the greatest need and programs that
specifically aim to increase the diversity of the teaching
workforce.
Materials from Teacher Professional Development.--Given the
importance of funds under Title II-A in helping teachers
advance their own professional development and meet the needs
of their students, the Committee encourages the Department to
issue guidance clarifying allowable uses of funds. Teachers
often take professional development training that, in turn,
requires access to additional funding for instructional
materials to be able to utilize their training in the
classroom. The Committee continues to support efforts by the
Secretary to offer guidance on how an LEA may use Title II-A
funds on instructional materials that are directly connected to
teacher professional development training. In addition, the
Committee continues to note the benefits of posting guidance
online and communicating about guidance with outside
stakeholders, particularly district superintendents.
Supplemental Education Grants
The Committee recommends $24,464,000 for Supplemental
Education Grants to the Federated States of Micronesia and the
Republic of the Marshall Islands, which is $4,807,000 more than
the fiscal year 2022 enacted level. The Compact of Free
Association Amendments Act of 2003 (P.L. 108-188) authorizes
these entities to receive funding for general education
assistance.
Nita M. Lowey 21st Century Community Learning Centers
The Committee recommends $1,409,673,000 for Nita M. Lowey
21st Century Community Learning Centers, $120,000,000 more than
the fiscal year 2022 enacted level and $100,000,000 above the
fiscal year 2022 budget request. Funds are awarded by formula
to States, which in turn distribute funds on a competitive
basis to local school districts, nonprofit organizations, and
other public entities.
The Committee notes that only one in three 21st Century
Community Learning Centers grant applications is awarded,
reflecting substantial unmet demand for these opportunities.
The $120,000,000 increase over fiscal year 2022 will help
communities providing afterschool programs serve 144,000 more
students than in fiscal year 2022.
State Assessments
The Committee recommends $390,000,000 for State
Assessments, which is the same as the fiscal year 2022 enacted
level. 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 $122,000,000 for the Education for
Homeless Children and Youth program, which is $8,000,000 more
than the fiscal year 2022 enacted level. 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 2022 enacted level.
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 $40,897,000 for the Education for
Native Hawaiian program, which is $2,000,000 more than the
fiscal year 2022 enacted level. Funds are used to provide
competitive awards for supplemental education services to the
Native Hawaiian population.
Construction.--The Committee's $2,000,000 increase to this
program will specifically focus on construction needs for
schools that serve Native Hawaiian students. The Committee is
supportive of resources to public elementary and secondary
schools that serve Native Hawaiian students, including
activities for construction, renovation, and modernization of
any public elementary school, secondary school, or structure
related to a public elementary school or secondary school, as
authorized under part B of Title VI. The Committee encourages
the Department to prioritize funding to organizations with
construction needs that have experience providing supplemental
education services to Native Hawaiian children and youth.
Applicant Support.--For the fiscal year 2023 Education for
Native Hawaiians competition, the Committee encourages the
Department to offer technical assistance to quality applicants
who have not received awards in previous competitions in order
to promote grantee diversity among schools and programs that
have experience providing education services to Native Hawaiian
children and youth.
Alaska Native Education Equity
The Committee recommends $37,953,000 for the Alaska Native
Education Equity program, which is the same as the fiscal year
2022 level. Funds are used to provide competitive awards for
supplemental education services to the Alaska Native
population.
Rural Education
The Committee recommends $195,000,000 for Rural Education
programs, which is the same as the fiscal year 2022 enacted
level. There are two dedicated 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, which
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 $54,000,000 for Comprehensive
Centers, which is the same as the fiscal year 2022 enacted
level. The Comprehensive Centers program includes support for
regional centers that provide training, technical assistance,
and professional development to build State capacity to provide
high-quality education to all students.
Student Support and Academic Enrichment State Grants
The Committee recommends $1,355,000,000 for Student Support
and Academic Enrichment (SSAE) State Grants, which is
$75,000,000 above the fiscal year 2022 enacted level. SSAE
grants provide SEAs and LEAs with flexible resources that
provide students with access to a well-rounded education,
including rigorous coursework, and improve school conditions
and the use of technology.
Arts and Entertainment Pipeline Programs.--The Committee
continues to encourage the Department to work with States and
school districts that serve diverse youth to explore using SSAE
funding to support and create youth pipeline programs in the
arts and entertainment industries. The Committee is aware of
programs that focus on closing student opportunity gaps by
bringing filmmakers into Title I schools to partner with
teachers to expand access to the arts, implement social and
emotional learning strategies, and support rigorous academic
curricula. A 2019 evaluation by the Stanford Center for
Assessment, Learning, and Equity found that such programs
create a positive environment and learning community, promote
active and social learning, provide in-depth instruction of
vocabulary practices, and cultivate social and emotional
learning competencies.
Accelerated Learning Programs.--The Committee continues to
support efforts by States and LEAs to increase diversity in
accelerated student learning programs, such as advanced
placement courses, gifted and talented classes and honors
programs. The Committee supports the use of ESEA funding to
create State or local equity offices. Equity offices could
evaluate current data on the students enrolled in accelerated
student learning programs and use such data to inform
recommendations to LEAs on how to improve the diversity of
those programs. The Committee recognizes that Black, Latino,
and Native students, students living in poverty, and English
learners are historically underrepresented in accelerated
learning programs. Research shows that developing targeted
recruitment and outreach plans, as well as universal screening
for talented and gifted programs help address inequitable
access that lock students out of opportunities that engage them
more meaningfully in school and expand their postsecondary
success.
Menstrual Health.--The Committee is concerned about the
disruptions to educational opportunities that children living
in period poverty experience. Industry reports found that one
in five school age children have missed school due to lack of
access to safe and affordable menstrual products. In the fiscal
year 2024 Congressional Budget Justification, Committee directs
the Department to provide an update on the Department's
implementation of the directive provided under this heading in
House Report 117-96. In addition, the Committee requests
information around the feasibility of supporting free menstrual
product programs through the Nita M. Lowey 21st Century
Community Learning Centers program.
School Diversity.--The Committee strongly encourages the
Department to use the two percent set-aside for technical
assistance and capacity building under SSAE to award capacity-
building grants to LEAs and SEAs to reduce racial and
socioeconomic segregation across and within school districts.
Eye-care Services--The Committee is supportive of efforts
by SEAs and LEAs to provide on-campus eye-care services free of
charge to students in public elementary or secondary schools.
Youth Mental Health and Social and Emotional Learning.--In
the face of a youth mental health crisis, the Committee
believes it is critical to invest in key social and emotional
learning programs that build essential life skills as an
effective component of promoting student mental wellness and
preventing the development of substance use, child sexual
abuse, bullying, and youth suicide. Investments in evidence-
based social and emotional learning programs return $11 for
every dollar invested and the Committee encourages the
Department to work with the Department of Health and Human
Services on youth mental health to prioritize access to primary
prevention programs and ensure such programs across the
government are coordinated and leveraged for the maximum
impact.
Mentoring to Address Chronic Absence.--The Committee is
concerned about the high rates of student chronic absenteeism
across the country since the onset of the COVID-19 pandemic and
encourages the Department to inform SEAs on how Title IV-A and
other Federal funding sources can be used to support early
warning data systems that identify populations of students who
are chronically absent and successful interventions to address
chronic absence and school engagement, such as mentoring.
Technical Assistance on Inclusive Practices.--The Committee
notes that SSAE provides flexible funding to support activities
that promote a safe and healthy learning environment. With
respect to these authorized activities, the Committee believes
there is no more urgent charge than to support students through
inclusive practices that are evidence-based and address the
needs of the whole child. Further, the Committee is concerned
by efforts that would promote SSAE for unintended purposes,
including purposes that generate disproportionate negative
impacts on specific student subgroups. Accordingly, the
Committee directs the Department to describe the technical
assistance it provides on inclusive, evidence-based practices
that address the needs of the whole child in the fiscal year
2024 Congressional Budget Justification.
Trafficking Prevention Activities.--The Committee supports
the Department's current technical assistance support to SEAs
and LEAs in implementing human trafficking prevention
activities and encourages the Department to offer additional
support for these efforts.
Indian Education
Appropriation, fiscal year 2022....................... $189,246,000
Budget request, fiscal year 2023...................... 186,239,000
Committee Recommendation.............................. 195,246,000
Change from enacted level......................... +6,000,000
Change from budget request........................ +9,007,000
This account supports programs authorized by part A of
title VI of the ESEA.
Grants to Local Educational Agencies
The Committee recommends $110,381,000 for Grants to Local
Educational Agencies, which is $500,000 above the fiscal year
2022 enacted level. 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 American 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 American 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 $72,000,000 for Special Programs
for Indian Children, which is $2,000,000 more than the fiscal
year 2022 enacted level. 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.
The Committee's investment for Special Programs for Indian
Children is intended to help address the shortage of Native
American educators nationwide.
National Activities
The Committee recommends $12,865,000 for National
Activities, which is $3,500,000 above the fiscal year 2022
enacted level. Within this account, funding is provided for
grants to Tribes for education administrative planning,
development, and coordination, grants to support Native
language immersion schools and programs. Funds under this
authority also support research, evaluation and data collection
to provide information about the educational status of Indian
students and the effectiveness of Indian education programs.
Native American Language Immersion and the State-Tribal
Education Partnership Program.--The Committee provides a
$3,000,000 increase to the Native American Language Immersion
and the State-Tribal Education Partnership (STEP) programs
above the fiscal year 2022 enacted levels for these programs.
The Committee looks forward to a new fiscal year 2023 STEP
competition and directs a portion of this increase to support
new STEP awards.
Native American Language Resource Centers.--Within this
account, the Committee provides no less than $1,500,000 to
support American Indian, Alaska Native and Native Hawaiian
language activities for the Native American Language Resource
Center program established in the explanatory statement
accompanying the Department of Education Appropriations Act,
2022.
INNOVATION AND IMPROVEMENT
Appropriation, fiscal year 2022....................... $1,300,730,000
Budget request, fiscal year 2023...................... 1,572,000,000
Committee Recommendation.............................. 1,484,608,000
Change from enacted level......................... +183,878,000
Change from budget request........................ -87,392,000
The Committee recommends $1,484,608,000 for programs within
the Innovation and Improvement account.
Education Innovation and Research
The Committee recommends $384,000,000 for the Education
Innovation and Research (EIR) program, which is $150,000,000
above the fiscal year 2022 enacted level. This program makes
competitive grants to support the replication and scaling-up of
evidence-based education innovations.
Social and Emotional Learning Grants.--On April 6, 2022,
the Subcommittee on Labor-HHS Education-Related Agencies held a
hearing entitled ``Social and Emotional Learning (SEL) and
Whole Child Approaches in K-12 Education,'' during which the
Subcommittee heard from a panel of national experts on the
robust evidence of effectiveness for whole child interventions,
including SEL. The Subcommittee discussed how high-quality SEL
programs that support students' social, emotional, and
cognitive development result in lasting positive academic and
life outcomes. In addition, the Subcommittee explored how
dedicated Federal resources for these approaches are vital to
expanding their reach nationwide.
To address these critical needs, within the total for EIR,
the agreement includes $132,000,000, $50,000,000 above the
fiscal year 2022 enacted level, to provide high-quality,
evidence-based SEL grants. To fulfill the SEL set-aside, the
Committee urges prioritization of SEL for both the early- and
mid-phase evidence tiers.
The Committee requests a briefing within 90 days of
enactment of this Act on plans for carrying out the SEL
competition. In addition, the Department shall provide notice
and a briefing to the Committees at least seven days before
grantees are announced.
SEL Interventions for Educational Staff.--The Committee
notes that the EIR SEL competition can also support evidence-
based interventions for educational staff, including but not
limited to teachers, school counselors, school psychologists,
and school social workers. In light of the significant
challenges educators have faced during the COVID-19 pandemic,
the Committee recognizes that educational staff may experience
fatigue or stress related to their work in supporting students
and their families, as well as burnout due to a combination of
factors related to their work. While teacher retention and
teacher shortage challenges remain multifaceted, the Committee
recognizes the value of mental health resources and SEL
interventions in order to support the emotional and mental
health and wellbeing of educational staff.
STEAM and Computer Science Grants.--In addition, within the
total for EIR, the Committee recommendation includes
$87,000,000 for STEAM education, including computer science,
$5,000,000 above the fiscal year 2022 enacted level. Within the
STEAM and computer science set-aside, awards should expand
opportunities for underrepresented students such as minorities,
girls, and youth from families living at or below the poverty
line to help reduce the enrollment and achievement gap.
Teacher Education Programs in Computer Science.--The
Committee notes that the EIR STEAM and computer science
competition can also support grants to institutions of higher
education for teacher education programs in computer science.
Such grants can prepare aspiring teachers with the training,
experience, and resources needed to become successful computer
science educators; hire and retain faculty to carry out robust
computer science education research; train doctoral students in
the computer science field; educate graduate and undergraduate
students preparing to become teachers in computer science;
develop resources for computer science teachers or teachers in-
training, informed by credible computer science education
research or best practices from the computer science education
field; and provide scholarships to students, particularly for
students from traditionally underrepresented groups in computer
science and based on financial need.
Technology Access and Engagement.--The Committee notes that
the EIR STEAM and computer science competition can also support
grants that facilitate the implementation or expansion of
technology-focused experiences that strengthen STEAM education.
The Committee recognizes providing learning experiences to
students that incorporate innovative technologies, such as
digital learning platforms, improves STEM learning outcomes and
equips students with vital skills high-demand fields like
computer science and engineering. The Committee encourages the
Department to provide priority to Historically Black Colleges
and Universities (HBCUs) and Minority-Serving Institutions
(MSIs) and applicants seeking to implement or scale technology-
enabled learning experiences in K-12 schools, including via the
creation or acquisition of technological resources.
Publicizing Research Findings.--The Committee continues to
be supportive of efforts by the Department to publicize
research findings from the EIR program as described in House
Report 117-96.
Diverse Geographic Areas.--The Committee encourages the
Department to take steps necessary to ensure the statutory set-
aside for rural areas is met and that EIR funds are awarded to
diverse geographic areas.
Teacher and School Leader Incentive Grants
The Committee recommends $88,500,000 for the Teacher and
School Leader Incentive Grants program, which is $84,500,000
less than the fiscal year 2022 enacted level. 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 $3,000,000 for American History
and Civics Academies, which is the same as the fiscal year 2022
enacted.
American History and Civics National Activities
The Committee recommends $12,500,000 for American History
and Civics National Activities, which is $7,750,000 more than
the fiscal year 2022 enacted level.
Civics Secures Democracy.--The Committee acknowledges the
need for broad investment in civics education. In addition, the
Committee recognizes that students who receive quality civics
education are more likely to vote and to discuss politics at
home, complete college and develop skills that lead to
employment, and give back to their communities through
volunteering and working on community issues. The Committee
believes that Civics education in the United States is crucial
to preserving democracy and the future safety of our nation.
Therefore, the Committee directs the Department to run a
new competition in fiscal year 2023 for grants supporting
evidence-based practices proven to contribute to the
effectiveness of educational programs in civics, including
innovative and engaging classroom instruction in civics,
government, and history; community service linked to classroom
learning; learning through participation in models and
simulations of democratic processes; meaningful participation
in school governance; and instruction in media literacy through
the study of common informal fallacies in logic. The Department
is directed to prioritize grants that support traditionally
underserved communities, including students from low-income
urban and rural school districts, English learners, and
students with disabilities. Eligible entities shall include
LEAs, SEAs, and consortia of LEAs.
Improving Civics Education Engagement.--The Committee
recognizes that additional efforts are needed to ensure that
our elementary, secondary, and postsecondary schools and
institutions are coherently supporting civic education and
experiences, rather than reinforcing siloed approaches.
Accordingly, the Committee encourages partnerships that connect
elementary and secondary civic education efforts with similar
efforts at institutions of higher education. The Committee
encourages such efforts to prioritize LEA partnerships with
HBCUs and MSIs.
Supporting Effective Educator Development
The Committee recommends $90,000,000 for the Supporting
Effective Educator Development (SEED) grant program, which is
$5,000,000 more than the fiscal year 2022 level. SEED provides
competitive grants to support alternative certification and
other professional development and enrichment activities for
teachers, principals, and other school leaders. Funds are
included to fully support continuation costs for grants made in
prior years.
SEL and Whole Child Education.--The Committee continues to
support the SEL competitive preference priority within the SEED
competition. The priority supports professional development
that helps educators incorporate SEL practices into teaching
and supports pathways into teaching that provide a strong
foundation in child development and learning, including skills
for implementing SEL strategies in the classroom. The Committee
directs the Department to include the competitive preference
priority in any new SEED competition in fiscal year 2023.
If the Department issues a new notice inviting application
for fiscal year 2023, the Committee requests a briefing within
90 days of enactment of this Act on plans for carrying out the
SEL competitive preference priority in SEED. In addition, the
Department shall provide notice and a briefing to the
Committees at least seven days before grantees for a new
competition are announced.
Computer Science and Native Students.--The Committee
continues to encourage the Department, through the SEED
program, to support projects that increase the number of
teachers with computer science certifications with a priority
to increase the number of such teachers in rural public schools
and public schools serving high percentages of Native students.
Charter Schools Grants
The Committee recommends $400,000,000 for Charter School
Program (CSP) Grants, which is $40,000,000 below the fiscal
year 2022 enacted level and the fiscal year 2022 budget
request.
CSP awards grants to 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.
For-profit Entities.--The Department has long recognized
the particular risks posed by for-profit education management
organizations (EMOs). In response to a 2016 audit, the
Department conceded to the Inspector General, ``ED is well
aware of the challenges and risks posed by CMOs and, in
particular, EMOs, that enter into contracts to manage the day-
to-day operations of charter schools that receive Federal
funds. We recognize that the proliferation of charter schools
with these relationships has introduced potential risks with
respect to conflicts of interest, related-party transactions,
and fiscal accountability, particularly in regard to the use of
federal funds.'' Since that initial acknowledgement by the
Department regarding for-profit EMOs, the Committee has been
made aware of concerning instances of criminal fraud, conflicts
of interest, and inadequate transparency.
In addition, the Committee is deeply concerned that for-
profit charter schools, including those run by for-profit EMOs,
deliver concerning outcomes for students. A 2017 report from
Stanford University's Center for Research on Education Outcomes
compared student performance at non-profit charters, for-profit
charters, and traditional public schools and found that for-
profit charters perform worse in reading, and significantly
worse in math, than non-profit charters. In addition, the
report found that for-profit charters perform worse in math
than traditional public schools.
That is why the Committee is strongly supportive of the
Department's proposal to prohibit Federal CSP funding from
supporting for-profit EMOs through its notice published in the
Federal Register on March 14, 2022 (87 Fed. Reg. 14197). The
Committee includes bill language codifying the prohibition to
establish this precedent for fiscal year 2023 and for future
years. Moving forward, the Committee urges the Secretary to
work with Congress on efforts to fully phase out the concerning
for-profit EMO sector. Such efforts could include reasonable
transition periods that allow schools run by for-profit EMOs to
shift to independent or nonprofit management. In the interim,
the Committee is committed to continuing its oversight of the
for-profit EMO sector and ensuring fewer taxpayer dollars
enrich for-profit EMO shareholders.
Defunct CSP Grantees.--The Committee is deeply concerned by
the Department's analysis that fifteen percent of the charter
schools receiving CSP funding since 2001 have never opened or
closed before their three-year grant period is complete,
representing an unacceptable waste of at least $174,000,000 in
taxpayer funds. Accordingly, the Committee is strongly
supportive of the Department's fiscal year 2022 CSP notice (87
Fed. Reg. 14197) that requires applicants to demonstrate local
demand for new schools. The Committee rejects the premise that
grant failure and school closure is the cost of doing business
in CSP and welcomes reforms that will improve its performance.
GAO Mandate from House Report 116-450.--The Committee
continues to be supportive of GAO's work on the mandate
included in House Report 116-450 regarding the Department's
oversight over CSP and whether the program is being implemented
effectively among grantees and subgrantees. The Committee is
particularly interested in the issue of CSP-funded schools that
eventually closed or received funds but never opened; the
relationships between charter schools supported by CSP grants
and charter management organizations; and enrollment patterns
at these schools, especially for students with disabilities. In
addition, the Committee is interested in recommendations on
potential legislative changes to the program that would reduce
the potential for mismanagement and ineffective operations.
Oversight from the Office of Inspector General.--The
Committee continues to support efforts by the Department's
Office of Inspector General (OIG) to examine grantee
administration of Replication and Expansion Grants, including
charter management organization grantees. The Committee also
supports the OIG's efforts to evaluate whether the Department
adequately monitored grantees' performance and uses of funds
for CSP competitions.
Students with Disabilities and English Learners.--The
Committee encourages the Department to continue including in
their evaluation of State CSP grants the extent to which State
entities are utilizing the seven percent of funding received
under the program to ensure that charter schools receiving CSP
grants are equipped to appropriately serve students with
disabilities and, by extension, prepared to become high-quality
charter schools. In addition, the Committee urges the
Department to ensure subgrantees are equipped to meet the needs
of English learners. The Committee directs the Department to
provide an update on these efforts in the fiscal year 2024
Congressional Budget Justification.
Charter School Effects on School Segregation.--The
Committee is concerned by findings from a 2019 Urban Institute
report which concluded that growth in charter school enrollment
increases the segregation of Black, Latino, and white students.
To address this concern, the Committee urges the Department to
give priority to applicants that plan to use CSP funds to
operate or manage charter schools intentionally designed to be
racially and socioeconomically diverse.
The Committee is strongly supportive of proposed
requirements in the Department's fiscal year 2022 CSP notice
(87 Fed. Reg. 14197) that grantees show that they will not
exacerbate school segregation. Accordingly, the Committee urges
the Department to examine the merits of diversity reporting
that compares demographic data of grantees to that of local
districts. The Committee directs the Department to share its
assessment of CSP diversity reporting, along with any
prospective plans for implementation, in the fiscal year 2024
Congressional Budget Justification.
Magnet Schools Assistance
The Committee recommends $149,000,000 for the Magnet
Schools Assistance program (MSAP), which is $25,000,000 more
than the fiscal year 2022 enacted level. 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.
Inter-district Magnet Schools.--A 2019 report by Urban
Institute finds that two-thirds of total school segregation in
metropolitan areas is due to segregation between, rather than
within, school districts. Consortia of LEAs and regional
education services agencies are eligible to receive MSAP grants
to establish magnet schools that address inter-district school
segregation; however, the Committee is concerned that these
critical projects are infrequently funded. To address the
urgent issue of inter-district segregation, the Committee
continues to direct the Department to include a priority for
applicants seeking to establish new inter-district magnet
schools for any new competition in fiscal year 2023.
Whole School Magnet Programs.--A recent Learning Policy
Institute report finds that whole school magnet programs are
more effective at fostering diversity than in-school magnet
programs, which can create separate tracks and programs for
different student populations. The Committee urges the
Department to prioritize applicants seeking to establish and
operate whole school magnet programs.
Ready to Learn Programming
The Committee recommends $32,500,000 for Ready to Learn
Programming, which is $2,000,000 more than the fiscal year 2022
enacted level. 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 $38,500,000 for Arts in Education,
which is $2,000,000 more than the fiscal year 2022 level. This
program provides competitive grants to support professional
development and the development of instructional materials and
programming that integrate the arts into the curricula.
Javits Gifted and Talented Education
The Committee recommends $16,500,000 for the Javits Gifted
and Talented Education Program, which is $2,000,000 more than
the fiscal year 2022 enacted level. Funds are awarded through
grants and contracts to States, schools districts, and other
organizations to support a coordinated program of research,
demonstration projects, innovative strategies, and other
activities to help schools identify gifted and talented
students and address their unique educational needs.
Underrepresented Populations.--The Committee encourages the
Department to use funds to increase the number of grants that
assist schools in the identification of, and provision of
services to, gifted and talented students who may not be
identified and served through traditional assessment methods,
such as children with disabilities, English learners, children
of color, and economically disadvantaged students.
Statewide Family Engagement Centers
The Committee recommends $16,000,000 for the Statewide
Family Engagement Centers program, which is $1,000,000 more
than the fiscal year 2022 enacted level. Funds are awarded
through grants to organizations to provide technical assistance
and training to State and local educational agencies in the
implementation and enhancement of systemic and effective family
engagement policies, programs, and activities that lead to
improvements in student development and academic achievement.
Fostering Diverse Schools
The Committee includes $100,000,000 for a new competitive
grant program, Fostering Diverse Schools. The program
establishes competitive grants to local educational agencies
and State educational agencies to reduce racial and
socioeconomic segregation across and within school districts. A
2019 report by Urban Institute finds that two-thirds of total
school segregation in metropolitan areas is due to segregation
between, rather than within, school districts. In response to
this concerning dynamic, the Committee directs the Department
to prioritize resources to address segregation across
districts. The Committee notes the promise of strategies and
models such as inter-district magnet schools, voluntary two-way
transfer programs between segregated districts, district
regionalization, and regional education service agency
governance structures.
The State of School District Secessions.--The Committee is
concerned by research indicating that more than 128 school
districts have attempted to break off, or ``secede'', from
their school districts since the year 2000, and the likelihood
of this trend increasing school segregation throughout the
United States. The Committee continues to encourages the
Department, in consultation with the Department of Justice, to
issue a report describing the scope of the issue of school
district ``secession'' and its impact on school segregation.
Such a report could note which districts are party to Federal
desegregation orders and explain whether these secessions are
in violation of those orders. The report could also note what
oversight exists on the part of State agencies regarding school
district secession in the States where they have occurred.
Community Project Funding
Within the funds included in this account, $154,108,000
shall be used for the projects, and in the amounts, specified
in the table titled ``Labor, HHS, Education Incorporation of
Community Project Funding Items'' at the end of this report.
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Appropriation, fiscal year 2022....................... $361,000,000
Budget request, fiscal year 2023...................... 1,693,000,000
Committee Recommendation.............................. 1,708,000,000
Change from enacted level......................... +1,347,000,000
Change from budget request........................ +15,000,000
The Committee recommends a total of $1,708,000,000 for
activities to promote safe schools, healthy students, and
citizenship education, which is $1,347,000,000 more than the
fiscal year 2022 enacted level.
Promise Neighborhoods
The Committee recommends $96,000,000 for Promise
Neighborhoods, which is $11,000,000 above the fiscal year 2022
enacted level. 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.
Planning Grants.--The Committee is supportive of planning
grants within Promise intended to strengthen communities'
abilities to scale city and regional reinvestment strategies
and allow for direct services. These planning grants can
support the alignment of resources and efforts across multiple
sectors and focus on measurable shared goals.
School Safety National Activities
The Committee recommends $1,134,000,000 for School Safety
National Activities, which is $933,000,000 more than the fiscal
year 2022 enacted level. The Committee's recommendation
provides up to $5,000,000 for the Project School Emergency
Response to Violence (Project SERV) program.
School-based Mental Health Professionals.--The Committee
applies the $1,000,000,000 fiscal year 2023 budget request for
school-based mental health professionals to provide
$500,000,000 for the Mental Health Services Professional
Demonstration Grants program established in the Department of
Education Appropriations Act, 2019 and $500,000,000 for the
School-Based Mental Health Services Grants program established
in the Department of Education Appropriations Act, 2020.
The Committee does not expand the scope of these grants to
include school nurses; however, the Committee helps address
these urgent needs through increased support for School-based
Health Centers administered by the Health Resources & Services
Administration.
The Committee notes that the School-Based Mental Health
Services Grants program was created to award grants to SEAs,
LEAs, or consortia of LEAs to increase the number of qualified,
well-trained mental health professionals in schools. To achieve
this critical goal, the Committee urges the Department to focus
any new fiscal year 2023 competition on directly increasing the
number of these vital mental health professionals, including
school counselors, social workers, psychologists, or other
mental health professionals qualified to provide school-based
mental health services. In recognition of the role LEAs play in
mental-health personnel decision making, the Committee directs
the Department to guarantee no less than 75 percent of grants
support LEA recipients. The Committee notes that the
explanatory statement accompanying the Department of Education
Appropriations Act, 2020 seeks to promote the sustainability of
these services, by requiring that awards include a 25 percent
match from grantees and by requiring that the awards do not
supplant existing mental health funding.
The Committee notes that other mandatory appropriations
provided in fiscal year 2022 for School-Based Mental Health
Services Grants are intended to supplement resources provided
by the Committee through the Department of Education
Appropriations Act, 2022 under a single competition that makes
awards to school districts prior to December 31, 2022. The
Committee looks forward to a briefing in the coming months on
these transformative investments, which will assist school
districts in their efforts to increase the number of qualified
mental health professionals supporting students.
The Committee requests a briefing within 90 days of
enactment of this Act on plans for carrying out any new fiscal
year 2023 Mental Health Services Professional Demonstration
Grants and the School-Based Mental Health Services Grants
competitions. In addition, the Department shall provide notice
and a briefing to the Committees at least seven days before
grantees for any new competitions are announced.
Active Shooter Drills.--The Committee is concerned about
the possible mental, emotional, and behavioral health effects
on students and staff resulting from lockdown drills and active
shooter drills conducted in elementary and secondary schools.
In response, the Committee provides $1,000,000 for the
Department to enter into an agreement with the National
Academies of Sciences, Engineering, and Medicine (National
Academies) under which the National Academies will conduct a
study to assess the science on the potential mental, emotional,
and behavioral health effects of firearm violence prevention
activities on students and staff in elementary and secondary
school settings. The study and subsequent report should include
an analysis of the effects of active shooter simulations, full-
scale lockdowns, secured-perimeter lockouts, and other school
security measures (e.g. metal detectors, visibility of police/
policing on campus) and their mental, emotional and behavioral
consequences. The assessment should review the potential
effects on children and youth of different ages and on students
with disabilities. The National Academies report should
identify practices and procedures that can minimize any adverse
mental, emotional, and behavioral health effects on children,
youth, and staff in elementary and secondary schools resulting
from the drills and make recommendations where appropriate.
School Climate and Safety Pilot.--Within School Safety
National Activities, the Committee recommends $5,000,000 to
establish a pilot program that would provide competitive grants
to States to develop comprehensive school climate and safety
plans that include effective, culturally competent, and
evidence-based initiatives to strengthen, promote, and enhance
school climates, affirm identities, and ensure school safety.
Grant applications should be designed and submitted in
consultation with a State multidisciplinary team of education
and mental health professionals and should maintain the rights
and dignity of all students. In addition, the plans must
include diversity in placement, hiring, and retention of
specialized instructional support personnel, including
restorative practice practitioners, counselors, school social
workers, school psychologists, and other supportive school
staff. Once awarded, States should provide competitive grants
to LEAs to implement the plan developed by the State and
preference LEAs that utilize alternatives to exclusionary
discipline, culturally sustaining education programs,
community-based programs, and alternatives to law enforcement
involvement.
Digital Citizenship Education.--Technology has become an
integral part of classroom learning, and students of all ages
have access to digital media and devices at school. This
dynamic highlights a significant need for students to partake
in educational opportunities within the school setting focused
on digital citizenship education, such as screen time balance,
privacy and security, digital footprint, online relationships
and communication, cyberbullying, civic engagement and news and
media literacy, among other topics. The Committee continues to
recognize the increased need to provide students with the tools
and skills necessary to participate safely and responsibly in
the digital world. To ensure the digital safety and well-being
of K-12 students, the Committee continues to strongly urge the
Department to raise awareness of digital citizenship education
and identify opportunities to improve and expand digital
citizenship education in K-12 schools.
Mental Health Services.--The Committee recognizes that even
prior to COVID-19, significant need existed among students for
mental health services, while schools faced critical shortages
of open positions and qualified practitioners, which includes
school counselors, school psychologists, and school social
workers. As schools reopen and efforts are underway to meet the
academic needs of students, capacity to address their mental
and emotional well-being is imperative. Adequate access to
school-employed mental health professionals improves delivery
and integration of school-wide programming to foster positive
school climate, prevent violence, and balance physical and
psychological safety. Without a highly qualified workforce of
school-employed mental health professionals, schools lack the
capacity to provide comprehensive social and emotional learning
and mental, behavioral, and academic interventions and
supports. The Committee's robust investments in initiatives to
increase the amount of school-based mental health professionals
and related programs that recruit, train, and retain well-
trained, high-qualified school-based mental health
professionals are a high priority in this bill. The Committee
believes this bill's investments will lay the foundation for a
future where all students nationwide can benefit from a mental
health professional working in their school.
School Infrastructure.--The Committee strongly supports the
Department's plans to fund a National Clearinghouse on School
Infrastructure and Sustainability and to establish an Office of
School Infrastructure and Sustainability, as described in the
fiscal year 2023 Congressional Budget Justification, and
provides sufficient funding under this account, and under
Program Administration, for those purposes.
Trauma-informed Practices.--The Committee encourages the
Department to prioritize trauma-informed practices in grant
activities.
Secure Firearm Storage.--The Committee is concerned by
studies showing that between 73 and 80 percent of school
shooters under the age of 18 obtained their firearm(s) from
their home or the home of a close relative or friend. In
addition, the Committee is aware that researchers estimate
roughly 4,600,000 children in the United States live in a home
with an unsecured and loaded firearm. Accordingly, the
Committee encourages the Department to offer support to Federal
agencies that are leading efforts to promote secure household
firearm storage.
Full-Service Community Schools
The Committee recommends $468,000,000 for Full-Service
Community Schools, which is $393,000,000 more than the fiscal
year 2022 level. This program makes competitive grants to
support school-based comprehensive services for students,
families, and communities.
Integrated Student Supports
The Committee recommends $10,000,000 for a new competitive
grant program that would help school districts design and
implement integrated student supports focused on addressing a
range of student and family needs.
Mentorship.--The Committee recognizes the importance of the
coordination of mentorship programs with student participants'
schools in order to support the goals of whole child learning
and social and emotional learning. The Committee encourages the
funding of activities that advance student success in the
classroom in a manner that is informed by the coordination,
insight, and partnership of mentorship programs.
ENGLISH LANGUAGE ACQUISITION
Appropriation, fiscal year 2022....................... $831,400,000
Budget request, fiscal year 2023...................... 1,075,000,000
Committee Recommendation.............................. 1,000,000,000
Change from enacted level......................... +168,600,000
Change from budget request........................ -75,000,000
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 students and recent
immigrant student population. Funds under this account also
support professional development to increase the pool of
teachers prepared to serve LEP students as well as evaluation
activities. The bill continues language to calculate all State
awards based on a three-year average of data from the American
Community Survey.
The Committee recommends $1,000,000,000 for English
Language Acquisition (ELA) in fiscal year 2022, which is
$168,600,000 above the fiscal year 2022 enacted level. Federal
data shows that significant achievement gaps exist between
English learners (ELs) and their peers. Since fiscal year 2020,
the Committee has increased support for EL students by
$94,000,000; however, at a time when many States and school
districts have experienced rapid growth in their EL
populations, the Committee remains concerned that services and
supports for EL students are not adequately funded. Providing
increased resources to improve educational quality for EL
students is a top priority for the Committee in fiscal year
2023.
Translation and Interpretation Services.--The Committee
continues to recognize that parents of ELs often need
translation and interpretation services to stay abreast of
school activities, help with homework, and support their
children's college and career readiness goals. Many schools
lack dedicated funding for translation and interpretation
services, despite a growing EL population. In response to these
concerns, the Committee encourages the Office of English
Language Acquisition (OELA) to support LEAs and SEAs in
providing robust translation and interpretation services for
parents and guardians of ELs.
Asian American, Native Hawaiian, and Pacific Islander
(AANHPI) Data Disaggregation.--The Committee is concerned that
aggregated AANHPI racial and ethnic subgroup data continues to
obscure the experiences of AANHPI students. The Committee
encourages OELA to prioritize funding for AANHPI data
disaggregation within ELA national activities to support
additional racial and ethnic subgroup data collection and
reporting.
Resources for EL Students.--The Committee recognizes that
EL students have been the fastest growing student population in
U.S. schools and that many schools and do not receive
sufficient funding to meet the needs of these students. To
promote EL student success, the Committee encourages the
Department to prioritize technical assistance to SEAs and LEAs
on how Title I and Title III funding in ESEA can improve
academic achievement. In the fiscal year 2024 Congressional
Budget Justification, the Committee requests information on how
the Department assists SEAs and LEAs to ensure Title I and
Title III funds support complementary activities for maximizing
impact on EL student outcomes.
SPECIAL EDUCATION
Appropriation, fiscal year 2022....................... $14,519,119,000
Budget request, fiscal year 2023...................... 18,130,170,000
Committee Recommendation.............................. 17,760,679,000
Change from enacted level......................... +3,241,560,000
Change from budget request........................ -369,491,000
Of the total amount available, $8,036,736,000 is available
for obligation on July1, 2023, and $9,283,383,000 is available
for obligation on October 1, 2023. These grants help States and
localities pay for a free, appropriate education for students
with disabilities aged 3 through 21.
Grants to States
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 recommends $16,259,193,000 for Part B Grants
to States, which is $2,915,489,000 above the fiscal year 2022
enacted level.
Preschool Grants
The Committee recommends $439,620,000 for Preschool Grants,
which is $30,071,000 above the fiscal year 2022 enacted level.
These funds provide additional assistance to States to help
them make free, appropriate public education available to
children with disabilities ages 3 through 5.
Grants for Infants and Families
The Committee recommends $621,306,000 for Grants for
Infants and Families, which is $125,000,000 above the fiscal
year 2022 enacted level. These funds provide additional
assistance to States to help them make free, appropriate public
education available to children with disabilities from birth
through age 2.
The Committee continues bill language to promote the
continuity of services for eligible infants and their families.
In addition, the Committee recommendation includes new bill
language to increase access for infants and families who have
been traditionally underrepresented in the program, eliminate
out-of-pocket costs for participating families, and conduct
certain activities with individuals expecting to become parents
of infants or toddlers with disabilities.
IDEA National Activities
The Committee recommends $440,560,000 for IDEA National
Activities, which is $171,000,000 above the fiscal year 2022
enacted level. The IDEA National Activities programs support
State efforts to improve early intervention and education
results for children with disabilities.
Educational Technology, Media, and Materials.--The
Committee recommends $32,433,000 for Educational Technology,
Media, and Materials, which is $2,000,000 above the fiscal year
2022 enacted level. 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.
Within these amounts, the Committee provides no less than
$11,000,000 for Educational Materials in Accessible Formats for
Children and Students with Visual Impairments and Print
Disabilities grants. The Department is encouraged to continue
to expand this program's reach to K-12 students in underserved
areas, further support eligible students enrolled in
postsecondary schools, and expand or enhance models for
postsecondary schools to produce and disseminate accessible
educational materials and textbooks that align with the key
recommendations from the Advisory Commission on Accessible
Instructional Materials in Postsecondary Education for Students
with Disabilities.
Parent Information Centers.--The Committee recommends
$40,152,000 for Parent Information Centers, which is
$10,000,000 above the 2022 enacted level. 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.
Personnel Preparation.--The Committee recommends
$250,000,000 for Personnel Preparation, which is $155,000,000
above the fiscal year 2022 enacted level. 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. The
Committee notes the critical role the Personnel Preparation
program plays in helping to address the nation's shortage of
teachers for students with disabilities.
On May 25, 2022, the Subcommittee on Labor-HHS Education-
Related Agencies held a hearing entitled ``Tackling Teacher
Shortages,'' during which the Subcommittee heard from a panel
of national experts on the scope and severity of nationwide
teacher shortages. The Subcommittee discussed root causes of
teacher shortages and explored acute challenges with the
retention and recruitment of educators of color and special
educators. In addition, the Subcommittee identified strategies
to help rebuild educator pipelines and address shortages and
highlight needed investments in programs funded in this bill
that support educator pipelines and address challenges related
to recruitment and retention.
The Committee is strongly supportive of the proposed
increase in the fiscal year 2023 Congressional Budget
Justification within Personnel Preparation for doctoral-level
personnel preparation in special education. The Committee
agrees that this investment would expand the teacher
preparation pipeline and ensure that more well-prepared special
education teachers enter the classroom per year than ever
before.
State Personnel Development.--The Committee recommends
$38,630,000 for State Personnel Development, which is the same
as the fiscal year 2022 enacted level. 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 $44,345,000 for Technical Assistance and
Dissemination, which is the same as the fiscal year 2022
enacted level. Funding supports 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.
Special Olympics Education Programs.--The Committee
recommends $35,000,000 for Special Olympics Education Programs,
which is $4,000,000 above the fiscal year 2022 enacted level,
to support activities authorized by the Special Olympics Sport
and Empowerment Act, including Project UNIFY. This funding
supports efforts to expand Special Olympics programs and the
design and implementation of Special Olympics education
programs that can be integrated into classroom instruction and
are consistent with academic content standards.
Prohibition on Use of Federal Funds for Electric Shock
Devices.--The Committee is deeply concerned that Federal funds
support services for children at private schools that use
electric shock devices and equipment for student discipline and
conditioning. The Committee includes new bill language to
prohibit Federal funds from supporting institutions that carry
out this horrific practice.
Parent Supports.--The Committee encourages the Department
to support SEAs and LEAs to counsel parents of children with
504 plans, prior to them turning 18, on options for support
once the child leaves the K-12 education system, including but
not limited to the guardianship process.
Students with Speech-Language Disorders.--The Committee
encourages the Department to offer technical assistance to
support students with speech-language disorders within school
settings. The Committee notes the importance of providing
guidance and sharing best practices to ensure the delivery of
effective services for all children and youth with disabilities
and speech-language disorders.
REHABILITATION SERVICES
Appropriation, fiscal year 2022....................... $3,862,645,000
Budget request, fiscal year 2023...................... 4,125,906,000
Committee Recommendation.............................. 4,104,906,000
Change from enacted level......................... +242,261,000
Change from budget request........................ -21,000,000
The programs in this account are authorized by the
Rehabilitation Act of 1973, the Helen Keller National Center
Act, and the Randolph-Sheppard Act.
Vocational Rehabilitation State Grants
The Committee recommends $3,949,707,000 in mandatory
funding for Vocational Rehabilitation (VR) State Grants, which
is $230,586,000 above the fiscal year 2022 enacted level.
This program supports vocational rehabilitation services
through formula grants to 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 2022 enacted
level. 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 2022 enacted
level. 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 $15,796,000 for Demonstration and
Training Programs, which is $10,000,000 above the fiscal year
2022 enacted level. These programs support activities designed
to increase employment opportunities for individuals with
disabilities by expanding and improving the availability and
provision of rehabilitation and other services. The Committee
recommendation includes no less than the fiscal year 2022
enacted level for parent information and training programs.
National Consortium of Interpreter Education Centers
(NCIEC) and Regional Interpreter Education Centers (RIEC).--The
Committee commends the work by the Rehabilitation Services
Administration to create resources for deaf, hard of hearing,
and deaf-blind individuals and commends their support of
special needs and sensory disabled persons. In addition, the
Committee recognizes the positive impact the NCIEC and RIEC
have had on the deaf, hard of hearing, and deaf-blind community
through a variety of educational resources, interpreter
development programs, and specialized services.
Protection and Advocacy of Individual Rights
The Committee recommends $21,150,000 for Protection and
Advocacy of Individual Rights, which is $2,000,000 more than
the fiscal year 2022 enacted level. 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 $22,548,000 for Supported
Employment State Grants, which is the same as the fiscal year
2022 enacted level. These formula grants assist States in
developing collaborative programs with public agencies and
nonprofit agencies for training and post-employment services
leading to supported employment. In supported employment
programs, persons with the most significant disabilities are
given special supervision and assistance to enable them to work
in integrated settings.
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 2022 enacted level. 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 $20,000,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults, which is
$2,000,000 more than the fiscal year 2022 enacted level. 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
Appropriation, fiscal year 2022....................... $275,292,000
Budget request, fiscal year 2023...................... 265,292,000
Committee Recommendation.............................. 291,292,000
Change from enacted level......................... +16,000,000
Change from budget request........................ +26,000,000
The Committee recommends $291,292,000 for Special
Institutions for Persons with Disabilities, which is
$16,000,000 above the fiscal year 2022 enacted level.
AMERICAN PRINTING HOUSE FOR THE BLIND
Appropriation, fiscal year 2022....................... $40,431,000
Budget request, fiscal year 2023...................... 37,431,000
Committee Recommendation.............................. 43,431,000
Change from enacted level......................... +3,000,000
Change from budget request........................ +6,000,000
This funding subsidizes the production of educational
materials for legally blind persons enrolled in pre-college
programs. The American Printing House for the Blind (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.
Innovative Braille and Tactile Display Products.--Within
amounts for the Printing House, the Committee provides
$1,500,000 to support field testing of an innovative braille
and tactile display product developed by the Printing House and
its partners.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriation, fiscal year 2022....................... $88,500,000
Budget request, fiscal year 2023...................... 84,500,000
Committee Recommendation.............................. 91,500,000
Change from enacted level......................... +3,000,000
Change from budget request........................ +7,000,000
Congress established the National Technical Institute for
the Deaf (Institute) 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 related to 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
Appropriation, fiscal year 2022....................... $146,361,000
Budget request, fiscal year 2023...................... 143,361,000
Committee Recommendation.............................. 156,361,000
Change from enacted level......................... +10,000,000
Change from budget request........................ +13,000,000
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
Appropriation, fiscal year 2022....................... $2,091,436,000
Budget request, fiscal year 2023...................... 2,308,981,000
Committee Recommendation.............................. 2,214,981,000
Change from enacted level......................... +123,545,000
Change from budget request........................ -94,000,000
This account includes vocational education programs
authorized by the Carl D. Perkins Career and Technical
Education Act of 2006, as recently reauthorized by the
Strengthening Career and Technical Education for the 21st
Century Act, and the Adult Education and Family Literacy Act
(AEFLA).
Career and Technical Education: State Grants
The Committee recommends $1,424,848,000 for Career and
Technical Education (CTE) State Grants, which is $45,000,000
above the fiscal year 2022 enacted level. Of these funds,
$633,848,000 will become available on July 1, 2023, and
$791,000,000 will become available for obligation on October 1,
2023.
State Grants support a variety of career and technical
education programs developed in accordance with the State plan.
This program focuses Federal resources on institutions with
high concentrations of low-income students. The populations
assisted by State Grants range from secondary students in
prevocational 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 students in secondary schools and
community and technical colleges.
CTE Teacher Shortages.--The Committee is concerned about
the growing shortage of qualified public school teachers at all
levels of education and the lack of Federal data on CTE teacher
shortages. Specifically, the Department's Teacher Shortage Area
database does not account for schools which have ceased to
offer a CTE course due to a staffing shortage. Further, the
Department does not currently collect data on the
characteristics of the CTE teacher workforce including
demographic information, salary, years of industry experience,
and highest level of educational attainment. In the fiscal year
2024 Congressional Budget Justification, the Committee requests
for the Department to identify Federal data that can help
Congress and stakeholders better understand CTE teacher
shortages. If such data are unavailable, the Committee requests
the Department suggest methods for obtaining necessary data
prospectively.
National Programs
The Committee recommends $57,421,000 for National Programs,
which is $50,000,000 more than the fiscal year 2022 enacted
level.
Career-Connected High Schools.--Within amounts for CTE
National Programs, the Committee includes $50,000,000 and new
bill language supporting the Department's proposal for Career-
Connected High Schools. The Committee encourages the Department
to prioritize applications that establish plans with State
agencies to improve policy and program alignment between K-12,
higher education, and workforce systems, including through
statewide credit transfer agreements and alignment of high
school graduation requirements with college entrance
requirements. In addition, the Committee encourages the
Department to establish a competitive preference priority for
LEAs serving students historically underrepresented in higher
education and to require applicants to set goals for Career-
Connected High School enrollment to be representative of the
LEAs' overall population. Finally, the Committee encourages the
Department to require Career-Connected High School applicants
to offer articulated course pathways that terminate in at least
a two-year credential and to require Career-Connected High
School applicants to offer at least 12 credits of dual
enrollment, including both academic and CTE coursework.
Cybersecurity Skills.--The Committee recognizes the
cybersecurity threats facing our nation's critical
infrastructure sectors and the need for workers in these
industries, including those who operate cyber physical systems,
to be equipped with skills to keep systems secure. The
Committee acknowledges that many of these operators are
educated through CTE programs that do not incorporate
cybersecurity skills. Therefore, the Committee encourages the
Secretary to support CTE programs that integrate cybersecurity
into curricula used by students preparing for careers in
critical infrastructure sectors.
Youth Entrepreneurship and Financial Literacy.--The
Committee recognizes the importance of preparing our students
for the 21st century workforce through CTE programs, including
entrepreneurship and financial literacy. The Committee is
supportive of efforts to provide technical assistance and make
resources available to help LEAs and IHEs prepare students for
successful employment and attain high-skilled jobs through the
implementation of entrepreneurship and financial literacy
programs during and after school.
Adult Basic and Literacy Education State Grants
The Committee recommends $714,000,000 for Adult Basic and
Literacy Education State Grants, which is $23,545,000 more than
the fiscal year 2022 enacted level. State formula grants,
authorized under the AEFLA, support programs to enable 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 $18,712,000 for National
Leadership Activities, which is $5,000,000 more than the fiscal
year 2022 enacted level. This program supports applied
research, development, dissemination, evaluation, and program
improvement efforts to strengthen the quality of adult
education services.
Improved Coordination between Career and Technical
Education and Adult Education.--To ensure that individuals can
succeed in today's economy, the Committee encourages the
Department to identify and pursue opportunities to better align
the postsecondary CTE system with the adult education system.
Adult education can be an effective on-ramp to postsecondary
CTE and a valuable partner in designing and implementing
integrated education and training (IET) models that blend basic
skills instruction and occupational training to expand
equitable access to skills training, high-quality credentials
and family-supporting careers.
STUDENT FINANCIAL ASSISTANCE
Appropriation, fiscal year 2022....................... $24,580,352,000
Budget request, fiscal year 2023...................... 26,345,352,000
Committee Recommendation.............................. 24,639,234,000
Change from enacted level......................... +58,882,000
Change from budget request........................ -1,706,118,000
Pell Grants
The Committee recommends $22,475,352,000 in discretionary
funding for the Pell Grant program, which is the same as the
fiscal year 2022 enacted level. These funds will support Pell
grants to students for the 2023-2024 academic year.
Combined with mandatory funding streams, the Committee
recommendation supports a maximum Pell Grant in academic year
2023-2024 of $7,395, a $500 increase over fiscal year 2022.
Pell Grants help to ensure access to educational and
economic 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. The
Committee recognizes that Pell Grants help to ensure access to
education and economic opportunities for low-and-middle-income
students by providing need-based financial assistance. The
recommendation includes new language extending eligibility for
DACA-eligible students for all Title IV Student Assistance
programs in the Higher Education Act (HEA), including Pell
Grants.
Federal Supplemental Educational Opportunity Grants
The Committee recommends $920,000,000 for the Federal
Supplemental Educational Opportunity Grants (SEOG) program,
which is $25,000,000 more than the fiscal year 2022 enacted
level.
SEOG provides 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
67 percent of dependent recipients have annual family incomes
under $30,000 and 70 percent of independent SEOG recipients
have annual family incomes under $20,000. Institutions must
contribute a 25 percent match toward their SEOG allocation. The
recommendation includes new language extending eligibility for
DACA-eligible students for all Title IV Student Assistance
programs in the Higher Education Act (HEA), including SEOG.
Federal Work-Study
The Committee recommends $1,243,882,000 for the Federal
Work-Study program, which is $33,882,000 more than the fiscal
year 2022 enacted level.
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 3,200 colleges and
universities receive funding, according to a statutory formula,
and may allocate it for job location and development centers.
Work-study jobs must pay at least the Federal minimum wage and
institutions must provide 25percent of student earnings.
The Committee recommendation continues funding for the Work
Colleges program, which supports institutions that require all
resident students to participate in a work-learning program.
The recommendation includes new language extending eligibility
for DACA-eligible students for all Title IV Student Assistance
programs in the Higher Education Act (HEA), including Work
Study.
Social Work Students.--The Committee notes that social work
students at the undergraduate and graduate levels are required
to complete hundreds of hours of field experience; however, the
Committee is concerned that many times these experiences are
unpaid. In the fiscal year 2024 Congressional Budget
Justification, the Committee directs the Department to share
information around the feasibility of using its Experimental
Sites authority for a pilot to use Federal Work Study and other
financial aid funding to support social work students involved
in internships and field experiences.
For-profit College Accountability.--The 85/15 Rule was
first implemented in 1992 as a bipartisan amendment to the
Higher Education Act (HEA). It is based on the rationale that
if an institution provides a quality education, individuals
without access to Federal funding sources should be willing to
pay for it. The rule prevented for-profit postsecondary
institutions from deriving more than 85 percent of revenues
from Title IV of the HEA. It was based on a longstanding
principle first enacted in 1952 to protect veterans from for-
profit college abuses dating back to the original GI Bill (the
Servicemen's Readjustment Act) in 1944, and was in response to
widespread reports that many for-profit colleges were using
aggressive, sometimes fraudulent recruiting tactics in order to
profit off of students with access to Federal student aid
funding. In 1992, the rule was amended to allow for-profits to
derive an extra five percent of their revenue from Title IV and
became known as the 90/10 Rule. Since that time, thousands of
students have been defrauded by schools that have since gone
out of business. Students who graduate from these schools can
obtain degrees that often offer little value. A 2016 National
Bureau of Economic Research study using data from the
Department and the Internal Revenue Service found that the
earnings of students who attend for-profit colleges or
universities are lower than if they had never enrolled at all.
And while the for-profit college sector enrolls only nine
percent of all students, 33 percent of all borrower who
defaulted on student loans attend for-profit colleges.
Given these deeply disappointing outcomes, the Committee
believes that reverting back to the 85/15 ratio is a critical
step in holding for-profit colleges accountable and protecting
students from predatory practices and taxpayer dollars from
being wasted. Therefore, the Committee includes new bill
language requiring that for-profit institutions of higher
education receive not more than 85 percent of their revenue
from Federal sources.
Federal Direct Student Loan Program Account
Appropriation, fiscal year 2022....................... $25,000,000
Budget request, fiscal year 2022...................... - - -
Committee Recommendation.............................. - - -
Change from enacted level......................... -25,000,000
Change from budget request........................ - - -
Since fiscal year 2018, the Committee has provided
$825,000,0000 for the Federal Direct Student Loan Program
Account program (also known as Temporary Extended Public
Service Loan Forgiveness or TEPSLF). Congress created the
Public Service Loan Forgiveness (PSLF) program in 2007 to
provide loan relief to borrowers pursuing careers in public
service. After making 120 qualifying payments, the equivalent
of 10 years, borrowers first became eligible for forgiveness
under the program in 2017. TEPSLF was established to address
the administrative challenges associated with the PSLF program.
This account provides funding for loan forgiveness for
borrowers who were led to believe they qualified for PSLF by
their loan servicers but were denied forgiveness. However, many
of the constraints and program features of TEPSLF have made the
program similarly difficult to access. As of May 2022, the
Department estimates that unused, previously appropriated
TEPSLF resources provided in this account could forgive
approximately $821,000,000 in loan volume for affected
borrowers.
The Committee is strongly supportive of the Department's
Limited PSLF Waiver, established in October 2021, which has
offered a more streamlined pathway to loan forgiveness for
borrowers who dedicated a decade of their lives to public
service. To date, the waiver has provided over $7,300,000,000
in relief to over 127,000 student borrowers. To build on the
success of the Department's administrative action, the
Committee includes new bill language applying the streamlined
terms and features of the Department's PSLF waiver to unused
TEPSLF resources. The Committee hopes an enhanced TEPSLF, with
similar terms to the Department's PSLF waiver, will allow for a
seamless transition for affected borrowers after the PSLF
waiver expires.
The Committee requested an update in the fiscal year 2023
Congressional Budget Justification identifying areas where the
Department can further improve the administration of the PSLF
and TEPSLF programs and directs the Department to provide a
clear, comprehensive update on this topic in the fiscal year
2024 Congressional Budget Justification.
Student Aid Administration
Appropriation, fiscal year 2022....................... $2,033,943,000
Budget request, fiscal year 2023...................... 2,654,034,000
Committee Recommendation.............................. 2,579,034,000
Change from enacted level......................... +545,091,000
Change from budget request........................ -75,000,000
Programs administered under the Student Aid Administration
(SAA) include Pell Grants, campus-based programs, Teacher
Education Assistance for College and Higher Education (TEACH)
grants, and Federal student loan programs.
Salaries and Expenses.--Within the total provided for SAA,
the Committee recommends $1,187,788,000 for salaries and
expenses, which is $128,845,000 more than the fiscal year 2022
enacted level.
Loan Servicing Activities.--Within the total provided for
SAA, the Committee recommends $1,391,246,000 for Loan Servicing
Activities, which is $416,246,000 more than the fiscal year
2022 enacted level.
Quarterly Briefings.--The Department is directed to provide
quarterly briefings to the Committee on general progress
related to solicitations for Federal student loan servicing
contracts.
Spend Plans.--Not later than 60 days after enactment, the
Committee directs the Department to provide a detailed spend
plan of anticipated uses of funds made available in this
account for fiscal year 2023 and provide quarterly updates on
this plan (including contracts awarded, change orders, bonuses
paid to staff, reorganization costs, and any other activity
carried out using amounts provided under this heading for
fiscal year 2023).
State and Nonprofit Subcontracting.--The Committee
encourages the Department to evaluate opportunities for
qualified State and nonprofit organizations to contribute in
the new servicing environment.
Transparency in College Costs.--The Committee looks forward
to the briefing it requested in House Report 117-96 on the
Department's efforts to work with institutions of higher
education to improve college cost transparency.
Online Program Management (OPM) Companies.--The Committee
is deeply concerned by the proliferation of for-profit OPMs in
higher education. Specifically, the Committee is troubled by
how tuition-sharing agreements between universities and for-
profit OPM companies can create perverse incentives that drive
up costs, waste taxpayer dollars, and rip off students. In
addition, the Committee is concerned by the role OPMs play in
saddling graduate students with unsustainable student debt by
taking advantage of the Grad Plus program, which lets students
borrow as much as colleges charge. Though the practice has
proven to be a valuable revenue stream for OPMs and
universities, the Committee is not persuaded that these
relationships are in the best interests of students.
A November 2021 Wall Street Journal investigation revealed
how for-profit OPM 2U and the University of Southern California
(USC) recruited thousands of students to an expensive online
graduate program which left student borrowers with median debt
of $112,000 and median earnings of $52,000 two years later. 2U,
which received 60 percent of the program's total revenue,
helped USC use demographic profiles to target low-income and
minority students to maximize profits. The Committee believes
this behavior is straight from the playbook of the predatory
for-profit colleges. Further, the Committee believes a status
quo that allows for the continuation and proliferation of
wasteful, abusive relationships between OPMs and universities
is untenable. The Committee is disappointed by the
inappropriately loose regulatory environment and sparse
enforcement that has allowed OPMs to gain their foothold across
the higher education landscape.
The Committee is aware of GAO's recent report (GAO-22-
104463) and agrees with recommendations for the Department to
improve its audit and review process regarding OPM
arrangements, including via revisions to the Compliance
Supplement; however, given the severity of OPM-driven waste and
abuse, the Committee supports stronger, more urgent measures.
Specifically, the Committee supports the complete rescission of
March 2011 sub-regulatory guidance that established a loophole
to the statutory incentive compensation ban. Under the HEA,
individuals and entities cannot provide commissions, bonuses,
or incentive payments based on securing enrollments or the
awarding of Federal student aid. However, the misguided 2011
guidance establishes a loophole if recruiting is part of a
``bundle of services'' provided by an ``unaffiliated third
party'' contractor, such as an OPM. The Committee strongly
urges the Department to immediately rescind the 2011 bundled
services guidance and to establish a process to wind down
institutions' inappropriate reliance on wasteful, abusive OPM
tactics.
In the interim, the Committee strongly urges the Department
to immediately enforce commonsense aspects of the otherwise
flawed guidance. Specifically, the Committee urges the
Department to ensure any contractors are independent entities,
unaffiliated with the institution, and uninvolved in decision
making. The Committee believes several common practices by OPMs
clearly overstep the existing guidance, including, the
establishment of steering committees or other governing bodies
that give the OPM an official and regular role in decision
making; higher shares of revenue paid to the OPM as enrollment
increases; and OPM control over marketing and recruiting, in
the name of school. The Committee urges the Department to
employ meaningful consequences and penalties to deter predatory
behavior.
Finally, the Committee urges the Department to develop
adequate guidance to institutions that indicates when marketing
could be considered a covered activity under the ban on
incentive compensation payments. In addition, the Committee
urges the Department to revise audit and program review guides
to meet oversight goals of the incentive compensation ban.
Moving forward, the Committee is committed to vigorous
oversight of relationships between universities and for-profit
OPMs and urges the Department to crack down on OPM waste and
abuse to protect students and the overall integrity of
taxpayer-funded Federal student aid programs.
Graduate Student Debt.--According to the fiscal year 2023
budget request, excluding consolidations, graduate student
loans are expected to make up over 47 percent of new Federal
student loan originations in fiscal year 2023. This proportion
is significantly up from the 34 percent of new loan
originations graduate student debt represented in fiscal year
2014. While OPMs play a concerning role in this trend, the
Committee is also concerned about the broader landscape of
graduate student debt. In response, the Committee urges the
Department to analyze the disproportionate share of new student
loan originations represented by graduate student programs and
to determine whether graduate student programs leave students
with reasonable debt levels. In addition, the Committee
strongly urges the Department to take actions to ensure that
graduate program outcomes are commensurate with the debt levels
of their students.
Borrower Defense Recoupment and OPMs.--The Committee is
strongly supportive of the Department's most recent proposal
for an automatic, formalized process for recouping funds from
institutions that commit wrongdoings against student borrowers.
Under the proposal, schools that commit wrongdoings are fully
liable for any amounts discharged through the Borrower Defense
process except under certain reasonable circumstances. The
Committee notes that institutions in partnerships with
predatory for-profit OPMs will incur liabilities for discharges
resulting from predatory behavior. To build on these strong
protections, the Committee urges the Department to clarify that
OPMs function as third party servicers. Further, the Committee
urges the Department to develop methods for determining when
Borrower Defense liabilities should be shared jointly between
the institution and OPM. Under such circumstances, the
Committee urges the Department to recoup funds from both
entities.
The Committee notes that investors and shareholders have
contributed to the growth of the OPM industry under an
expectation of loose regulation or non-existent oversight.
Accordingly, the Committee's recommendations regarding OPMs are
intended to indicate that such assumptions are outdated, and
that unscrupulous behavior will yield straightforward,
substantial financial consequences.
Appropriate Conditions for High-risk Schools.--The
Committee recognizes that use of Federal student aid by
institutions of higher education is contingent on their
eligibility to be certified to do so under the Title IV of the
HEA. To ensure that institutions are responsible stewards of
Federal student aid, the Committee encourages the Department to
place appropriate conditions on high-risk schools and to
clarify procedures for when a high-risk institution may be
eligible for a provisional program participation agreement.
Spousal Consolidation Loans.--The Committee is aware that
hundreds of borrowers remain in the spousal consolidation loan
program which stopped originating new loans in 2006. The
Committee is concerned that these loans cannot be separated and
leave both borrowers liable for the entire debt, even after a
divorce. The Committee believes it is deeply unwise for a
Federal program to link the financial fates of two borrowers
when their personal relationships may have deteriorated or
perhaps become abusive. In response, the Committee urges the
Department to assist struggling spousal consolidation loan
borrowers and directs the Department to describe such efforts
in the fiscal year 2024 Congressional Budget Justification.
Postsecondary Research and Analysis.--The Committee is
supportive of the Office of the Chief Economist's mission to
conduct rigorous research in postsecondary education and notes
that the Department maintains robust data sets that provide
vital information on student outcomes, including those for
student borrowers. The Committee supports the Department's
continuous efforts to provide user-friendly, accessible
postsecondary data through enhanced fields on the College
Scorecard; however, the Committee believes the Department has
fallen short in its efforts to interpret these data for
policymakers and stakeholders. Accordingly, the Committee
encourages the Office of the Chief Economist to produce regular
working papers that present meaningful original research on the
Department's postsecondary data, including outcomes for student
borrowers. Specifically, the Committee is interested in
analysis around the rapid growth of graduate student borrowing
and whether this expansion in borrowing is beneficial to
student borrowers and the overall economy.
HIGHER EDUCATION
Appropriation, fiscal year 2022....................... $2,994,111,000
Budget request, fiscal year 2023...................... 3,792,802,000
Committee Recommendation.............................. 3,959,485,000
Change from enacted level......................... +965,374,000
Change from budget request........................ -166,683,000
Strengthening Institutions
The Committee recommends $175,070,000 for the Part A,
Strengthening Institutions program, which is $65,000,000 more
than the fiscal year 2022 enacted level. Funding supports
competitive grants for general operating subsidies to
institutions with below 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.
Developing Hispanic-Serving Institutions
The Committee recommends $246,732,000 for the Developing
Hispanic-Serving Institutions (HSI) program, which is
$63,878,000 more than the fiscal year 2022 enacted level.
The Developing HSIs 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.
Departmental Support for HSIs.--The Committee is interested
in learning more about actions the Department has taken to
support and improve HSIs, in addition to future actions the
Department plans to take. Accordingly, the Committee directs
the Department to include information on such efforts in the
fiscal year 2024 Congressional Budget Justification.
HSI Facilities.--The Committee is appreciative to GAO for
their initial engagement and work on a requested report
regarding HSI facilities and looks forward to reviewing its
findings upon completion.
Promoting Postbaccalaureate Opportunities for Hispanic Americans
The Committee recommends $28,845,000 for the Promoting
Postbaccalaureate Opportunities for Hispanic Americans program,
which is $9,184,000 more than the fiscal year 2022 enacted
level. This program provides expanded postbaccalaureate
educational opportunities for the academic attainment of
Hispanic and low-income students. In addition, it expands
academic offerings and enhances program quality at IHEs
educating the majority of Hispanic college students.
Strengthening Historically Black Colleges and Universities
The Committee recommends $402,619,000 for Strengthening
Historically Black Colleges and Universities (HBCUs), which is
$39,796,000 more than the fiscal year 2022 enacted level. This
program provides operating subsidies to accredited HBCUs 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 Black students are
underrepresented.
Maximum Higher Education Emergency Relief Funding (HEERF)
Flexibility.--The Committee urges the Department to use the
broadest possible interpretation of allowable uses of funds
when evaluating applications for grants awarded under the HEERF
program as allocated in the Coronavirus Aid, Relief, and
Economic Security Act (HEERF I), Coronavirus Response and
Relief Supplemental Appropriations Act (HEERF II) and American
Rescue Plan Act (HEERF III). These flexibilities are critical
as institutions of higher education, such as HBCUs and MSIs,
navigate ongoing and emerging challenges. HEERF fund
flexibilities for HBCUs and MSIs could be used by these
institutions to make critical investments in campus
infrastructure, deferred maintenance projects, technological
updates, and more robust building construction.
Strengthening Historically Black Graduate Institutions
The Committee recommends $102,313,000 for the Strengthening
Historically Black Graduate Institutions (HBGIs) program, which
is $9,184,000 more than the fiscal year 2022 enacted level. The
program provides five-year grants to postsecondary institutions
that are specified in section 326(e)(1) of the HEA.
Institutions may use funds to build endowments, provide
scholarships and fellowships, and to assist students with the
enrollment and completion of postbaccalaureate and professional
degrees.
Strengthening Predominantly Black Institutions
The Committee recommends $23,218,000 for the Strengthening
Predominantly Black Institutions (PBIs) program, which is
$5,100,000 more than the fiscal year 2022 enacted level and the
same as the fiscal year 2022 budget request. This program
provides grants to PBIs to increase their capacity to serve the
academic needs of students.
The bill continues bill language allowing certain PBIs to
be eligible for additional grants.
Strengthening Asian American and Native American Pacific-Islander-
Serving Institutions
The Committee recommends $20,120,000 for the Strengthening
Asian American and Native American Pacific-Islander-Serving
Institutions (AANAPISIs) program, which is $9,184,000 more than
the fiscal year 2022 enacted level. 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 $25,044,000 for the Strengthening
Alaska Native and Native Hawaiian-Serving Institutions program,
which is $3,673,000 more than the fiscal year 2022 enacted
level. Through the Strengthening Alaska Native and Native
Hawaiian-Serving Institutions program, the Department provides
grants to assist institutions of higher education in serving
Alaska Native and Native Hawaiian students.
Strengthening Native American Serving Non-Tribal Institutions
The Committee recommends $12,120,000 for the Native
American Serving Non-Tribal Institutions program, which is
$4,286,000 more than the fiscal year 2022 enacted level. 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 $53,080,000 for the Strengthening
Tribally Controlled Colleges and Universities (TCCUs) program,
which is $9,184,000 more than the fiscal year 2022 enacted
level. This program makes grants to TCCUs to increase their
capacity to serve the academic needs of students.
Strengthening HBCU Masters Program
The Committee recommends $20,956,000 for the Strengthening
HBCU Masters Programs, which is $6,122,000 more than the fiscal
year 2022 enacted level. This program provides grants to
specified colleges and universities making a substantial
contribution to graduate education opportunities at the
Master's level in mathematics, engineering, the physical or
natural sciences, computer science, information technology,
nursing, allied health, or other scientific disciplines.
International Education and Foreign Language Studies
Domestic Programs.--The Committee recommends $76,853,000
for the Domestic Programs of the International Education and
Foreign Languages Studies program, which is $5,000,000 more
than the fiscal year 2022 enacted level. Authorized by Title VI
of the HEA, 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 $11,811,000
for the Overseas Programs, which is $2,000,000 more than the
fiscal year 2022 enacted level. Funding for these programs
support group projects, faculty research, special bilateral
research, and doctoral dissertation research conducted abroad.
Model Comprehensive Transition and Postsecondary Programs for Students
With Intellectual Disabilities
The Committee recommends $15,180,000 for the Model
Comprehensive Transition and Postsecondary Programs for
Students with Intellectual Disabilities (TPSID) program, which
is $1,380,000 more than the fiscal year 2022 enacted level.
TPSID supports grants to create model transition programs into
postsecondary education for students with intellectual
disabilities.
Minority Science and Engineering Improvement
The Committee recommends $18,370,000 for the Minority
Science and Engineering Improvement Program, which is
$3,831,000 more than the fiscal year 2022 enacted level. 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 $10,953,000 for this program,
which is the same as the fiscal year 2022 enacted level. The
Tribally Controlled Postsecondary Career and Technical
Institutions program awards 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 $1,297,761,000 for TRIO programs,
which is $160,761,000 more than the fiscal year 2022 enacted
level. The TRIO programs provide a variety of outreach and
support services to encourage low-income, first-generation
college students and individuals with disabilities 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 recommendation includes new language extending eligibility
for DACA-eligible students for all Title IV Student Assistance
programs in the HEA, including TRIO.
The Committee directs the Department to allocate increases
to each TRIO program. In addition, the Committee directs the
Department to fund down the slate of unfunded high-quality
applications from the Student Support Services competition held
in fiscal year 2020; the Talent Search and Educational
Opportunity Centers competitions in fiscal year 2021; and the
Upward Bound, Upward Bound Math-Science, Veterans Upward Bound,
and McNair Postbaccalaureate Achievement competitions in fiscal
year 2022. Further, the Committee directs that such grantees
are eligible for prior experience points for demonstrated
performance outcomes in subsequent competitions.
Gaining Early Awareness and Readiness for Undergraduate Programs
The Committee recommends $408,000,000 for Gaining Early
Awareness and Readiness for Undergraduate Programs (GEAR UP),
which is $30,000,000 more than the fiscal year 2022 enacted
level. 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.
The Committee continues bill language allowing the
Department to maintain the GEAR UP evaluation set-aside at 1.5
percent to work with the GEAR UP community and grantees to
standardize data collection, including through the use of
third-party data systems. The recommendation includes new
language extending eligibility for DACA-eligible students for
all Title IV Student Assistance programs in the HEA, including
GEAR UP.
Furthermore, the Committee directs the Department to
announce Notices Inviting Applications for New Awards for State
Grants and Partnership Grants in the Federal Register. In
making new awards, the Committee directs the Department to
ensure that not less than 33 percent of the new award dollars
are allocated to State awards, and that not less than 33
percent of the new award dollars are allocated to Partnerships
awards, as described in section 404B of the HEA. In such notice
for State grants, the Committee directs the Department to
uphold the long-standing guidance that States may only
administer one active State GEAR UP grant at a time. The
Secretary is directed to provide written guidance in the
Federal Register notifying applicants that only States without
an active State GEAR UP grant, or States that have an active
State GEAR UP grant that is scheduled to end prior to October
1, 2023, will be eligible to receive a new State GEAR UP award
funded in whole or in part by this appropriation. The Secretary
is further directed to ensure that no request from a State
Grant applicant to receive an exception to the GEAR UP
scholarship (as described in section 404E(b)(2) of the HEA)
shall be denied on the basis of 34 CFR 694.14(c)(3).
Graduate Assistance in Areas of National Need
The Committee recommends $24,047,000 for the Graduate
Assistance in Areas of National Need (GAANN) program, which is
$500,000 more than the fiscal year 2022 enacted level. GAANN
provides fellowships through grants to degree granting
postsecondary institutions, for students of high financial need
studying in areas of national need. The Department consults
with appropriate agencies and organizations to designate the
fields of study ``in areas of national need.'' GAANN offers
innovative graduate education programs, with associated
fellowship opportunities, at the intersection of humanities,
arts, STEM, and health associated fields in order to prepare
our national graduate students for increasingly
interdisciplinary global challenges. Recent examples include
engineering, nursing, and physics.
Teacher Quality Partnership Grants
The Committee recommends $132,092,000 for the Teacher
Quality Partnerships (TQP) program, which is $73,000,000 more
than the fiscal year 2022 enacted level. The TQP program helps
improve the quality of teachers working in high-need schools
and early childhood education programs by creating model
teacher preparation and residency programs.
State Teaching Fellowship Programs.--The Committee
recognizes the importance of State teaching fellowship programs
and encourages the Department to continue to work with eligible
State teaching fellowship programs that wish to apply for the
TQP program.
Teacher Preparation to Support EL Students.--The Committee
recognizes the needs of the nation's growing EL student
population, including a robust teacher workforce equipped with
the skills to teach them. The Committee is concerned by the
shortage of EL teachers in the majority of States, as well the
academic achievement gap between ELs and their native English-
speaking peers. Therefore, the Committee encourages the
Secretary to support the development and strengthening of high-
quality teacher preparation programs that enable graduates to
meet licensure or certification requirements to teach ELs.
Teacher Residency Programs.--The Committee notes that high-
quality teacher residency programs prepare diverse cohorts of
teachers to serve high-need schools, improve teacher efficacy
in the classroom, and are a high-retention teacher preparation
pathway. In fact, 49 percent of residents are teachers of
color, while only 20 percent of all teachers nationally are
teachers of color. Further, a review of teacher residency
programs shows that residents tend to have higher retention
rates over time than nonresident teachers. As such, the
Committee encourages the Department to prioritize grants under
TQP for applicants that apply to fund high-quality teacher
residency programs as authorized under Section 202(e) of the
HEA. The Department is further encouraged to include a priority
for teacher residency program applicants that include explicit
admissions goals and priorities, as permitted under Section
202(e)(2)(A)(vi)(II), for the consideration of teacher
residency applicants from underrepresented populations in the
teaching profession.
Child Care Access Means Parents in School
The Committee recommends $95,000,000 for the Child Care
Access Means Parents in School program, which is $30,000,000
more than the fiscal year 2022 enacted level. 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.
The Committee continues bill language that lifts the
statutory cap on grant awards to institutions of higher
education, to more accurately reflect the costs of providing
high-quality, convenient child care options for students.
Consistent with this bill language, the Committee urges the
Department to establish a maximum grant cap based on a
reasonable estimation of the costs of providing child care
rather than a fixed percentage of Pell Grant funding received
by an institution. Additionally, the Committee urges the
Department to prioritize applications from programs that
connect parenting students with public benefits, case
management, or sources of additional financial support, and to
provide an application period of no less than 60 days.
Fund for the Improvement of Postsecondary Education
The Committee recommendation includes $520,000,000 for the
Fund for the Improvement of Postsecondary Education, which is
$452,000,000 more than the fiscal year 2022 enacted level.
------------------------------------------------------------------------
FY 2023
Budget Activity Committee
------------------------------------------------------------------------
Basic Needs Grants................................... $15,000,000
Centers of Excellence for Veteran Student Success 15,000,000
Program.............................................
Distributed Digital Learning Infrastructure Pilot.... 10,000,000
Emergency Aid Grants................................. 5,000,000
Increasing MSI PhDs Pilot............................ 5,000,000
Matched Savings Program Grants....................... 10,000,000
Menstrual Products Programs.......................... 5,000,000
Modeling and Simulation Programs..................... 10,000,000
Open Textbook Pilot.................................. 10,000,000
Postsecondary Student Success Grants................. 200,000,000
Research and Development Infrastructure Grants....... 225,000,000
Transitioning Gang-Involved Youth to Higher Education 10,000,000
------------------------------------------------------------------------
Basic Needs Grants.--The Committee recognizes that many
college and graduate students are unable to achieve academic
success because they cannot afford to meet their basic needs,
such as housing, food, transportation, and access to physical
and mental health services. The Committee includes $15,000,000
for competitive grants to institutions of higher education, as
defined by section 101 of the HEA, or consortia or systems of
such institutions, to advance systemic solutions to student
basic needs insecurity. Such grants shall include one or more
of the following activities: establishing processes to
automatically identify and conduct outreach students who may be
eligible for public benefit programs in accordance with recent
Federal guidance; conducting surveys and assessments of student
basic needs security, including surveys of student needs
conducted upon enrollment; or providing referrals and case
management to students to enroll in local, State, and Federal
public benefit programs. Activities may also include
coordinating and collaborating with government and community-
based organizations and providing direct services such as
temporary housing, secure sleeping arrangements, free or
subsidized food, access to on-campus childcare. At least 25
percent of grants must go to community colleges and at least 25
percent must go to four-year HBCUs, HSIs, and other MSIs. Grant
priority will go to institutions serving a significant number
of students with low incomes using multiple indicators of
student financial need.
Centers of Excellence for Veteran Student Success
Program.--The Committee includes $15,000,000 to support
existing and new grantees for the Centers of Excellence for
Veterans Student Success Program, as authorized by section 873
of the HEA.
Over one million veterans attend college every year and
often need assistance receiving their benefits or transitioning
to student life. Veteran Student Centers provide a one-stop-
shop for academic support, networking opportunities, peer
mentorship, financial assistance, counseling, and career
services.
The Department should ensure that this program continues to
support comprehensive services including veteran benefits
assistance, tutoring, counseling, and housing. The Committee
directs the Department to brief the Committees on
Appropriations no later than 90 days after enactment of this
Act on its plan to continue to carry out this program, as well
as a plan for evaluation and accountability, and to notify the
Committees no later than 15 days in advance of making any new
grant award or changes to the programs.
Distributed Digital Learning Infrastructure Pilot.--The
Committee includes $10,000,000 to establish pilot programs for
an institution of higher education with established remote
learning infrastructure to work with MSIs in the grantee's
region to provide support and technical assistance to expand
MSI digital learning infrastructure.
Emergency Aid Grants.--The Committee is aware of the large
number of postsecondary students dropping out of school or
failing to graduate due to not having the financial resources
to cover emergency situations such as paying for a car repair,
paying a late utility bill, or covering unforeseen or increased
living costs. The COVID-19 pandemic raised the awareness of the
public of these often small, but insurmountable financial
challenges delaying or halting a student's education. The
Committee includes $5,000,000 in competitive grants to
institutions of higher education to provide direct financial
support to their students to cover these emergency costs. To
apply, institutions are required to submit a plan to the
Secretary that defines how the institution would establish
criteria to determine a student's eligibility for a direct
emergency financial aid grant that would enable a student to
enroll, stay enrolled or complete their program of study.
Institutions that receive such grants must provide direct
payments to such students and conduct outreach and awareness
activities as to the existence of this program at the
institution.
Increasing MSI PhDs Pilot.--The Committee includes
$5,000,000 to create the Increasing MSI PhDs Pilot program.
This funding should support awards to a consortium of MSIs,
including HSIs, that award PhDs to underrepresented student
populations. Funding should be used to develop and test new
models of cross-institutional intellectual, research, and
resource-sharing communities, create mentorship programs for
PhD students, support graduate research experiences, and other
uses associated with the pursuit of PhDs by underrepresented
postsecondary students.
Matched Savings Grants.--The Committee includes $10,000,000
for to establish matched savings programs for Pell-eligible
postsecondary students. Grants will be awarded as partnerships
between States and non-profits to establish and expand matched
savings programs for eligible students that provide
postsecondary cost assistance and financial literacy training.
The grantees will establish savings accounts for each
participating student, support financial literacy education,
and support matching funds for amounts deposited by students
and their families.
A December 2020 report on matched savings programs by the
Urban Institute found that safe, affordable matched savings
account programs that offer strong match rates and provide
financial education can help low-income families save and
increase their financial well-being. The Committee is
encouraged by the evidence base behind this innovative approach
to improving the affordability of postsecondary education.
Menstrual Products Programs.--Congress recognizes that the
lack of access to menstrual products impedes the academic
success of many college and graduate students as well as
impacts their physical and mental well-being. Congress includes
$5,000,000 for competitive grants to at least ten institutions
of higher education, as defined by section 101 of the HEA, to
support institutional programs that provide free menstrual
products to students, as well as report on best practices. In
order to qualify, grantees must agree to use funds to carry out
or expand activities that fund programs that support direct
provision of menstrual products in appropriate campus locations
including, but not limited to, campus restroom facilities,
wellness centers, on campus residential buildings; conduct
outreach to students to encourage participation in menstrual
equity programs and services; help eligible students apply for
and enroll in local, State, and Federal public assistance
programs; or coordinate and collaborate with government and/or
community-based organizations. At least 50 percent of grants
must go to community colleges. Grant priority will go to
institutions with 25 percent or higher Pell enrollment, HBCUs,
HSIs, AANAPISIs, and other MSIs.
Modeling and Simulation Programs.--The Committee includes
$10,000,000 for Modeling and Simulation Programs as authorized
under section 891 of the HEA. Modeling and simulation
technology has numerous applications for Federal and State
governments and their partners in the defense, education,
gaming, shipbuilding, and workforce training sectors, allowing
them to generate data to help make decisions or predictions
about their systems.
Open Textbook Pilot.--The Committee includes $10,000,000 to
continue the Open Textbook Pilot and fund a new grant
competition in fiscal year 2023. The Department shall issue a
notice inviting applications consistent with notice and comment
procedures and allow for a 60-day application period. This
funding should support a significant number of grant awards to
IHEs as defined by 20 U.S.C. 1001, a group of IHEs, or State
higher education agencies that lead the activities of (and
serve as fiscal agent for) a consortium. Funding should be used
to create new open textbooks and expand the use of open
textbooks in courses that are part of a degree granting
program, and particularly those with high enrollments.
Allowable uses of funds should include professional development
for faculty and staff, including relating to the search for and
review of open textbooks; the creation or adaptation of open
textbooks; development or improvement of tools and
informational resources that support the use of open textbooks,
including accessible instructional materials for students with
disabilities; and research evaluating the efficacy of the use
of open textbooks for achieving savings for students and the
impact on instruction and student learning outcomes. The
Secretary shall require that any open textbooks created with
these funds shall be released to the public under a non-
exclusive, royalty-free, perpetual, and irrevocable license to
exercise any of the rights under copyright conditioned only on
the requirement that attribution be given as directed by the
copyright owner. Further, any tools, technologies, or other
resources that are created, developed, or improved wholly or in
part with these funds for use with any open textbook must be
similarly licensed. Any eligible entity receiving a grant
through the Open Textbooks Pilot, upon completion of the
supported project, shall report to the Secretary regarding the
effectiveness of the project in expanding the use of open
textbooks and in achieving savings for students; the impact of
the project on expanding the use of open textbooks at IHEs
outside of the institution receiving the grant; open textbooks
created or adapted under the grant, including instructions on
where the public can access each open textbook; the impact of
the project on instruction and student learning outcomes; and
all project costs, including the value of any volunteer labor
and institutional capital used for the project. The Secretary
shall make such reports publicly available.
Postsecondary Student Success Grants (PSSG).--The Committee
provides $200,000,000 for grants to support evidence-based
activities to improve postsecondary retention and completion
rates, including critical persistence benchmarks. Eligible
applicants may include institutions of higher education, a
consortium of institutions of higher education, statewide
systems of higher education, a non-profit organization, or any
of the preceding entities in partnership with a non-profit or
business.
The Committee directs the Secretary to execute this program
as a tiered-evidence competition through the same structure as
the EIR program authorized under ESEA. Under PSSG, the
Secretary may award early-phase, mid-phase, or expansion grants
that differ in terms of the level of prior evidence of
effectiveness required for consideration for funding, the
expectations regarding the kind of evidence and information
funded projects should produce, the level of scale funded
projects should reach, and, consequently, the amount of funding
available to support each type of project. Early-phase grants
will be supported by promising evidence, mid-phase grants will
be supported by moderate evidence, and expansion grants will be
supported by strong evidence as defined in the Department's
fiscal year 2022 EIR notices. Under PSGG, all grantees must
carry out rigorous, independent evaluations of the
effectiveness of their projects. In carrying out PSGG, the
Committee strongly encourages the Department to leverage the
expertise of staff within the Office of Elementary and
Secondary Education and the Institute of Education Sciences who
have made EIR a highly successful program.
The Committee is strongly encouraged by the evidence base
behind comprehensive approaches to student success programs
such as the What Works Clearinghouse-recognized CUNY ASAP
program, which has been found to nearly double participant
graduation rates. In addition, the Committee recognizes that
other rigorously evaluated, effective comprehensive support
programs such as One Million Degrees and Bottom Line have not
yet been included in the Clearinghouse. In advance of the
fiscal year 2023 competition, the Committee encourages the
Department to review additional studies and strive to increase
the number of postsecondary interventions included in the
Clearinghouse.
The Committee believes that the evidence of effectiveness
for high-quality comprehensive support programs is
transformative and that it is vital to expand their reach to
more postsecondary students. Accordingly, for the fiscal year
2023 PSSG competition, the Committee directs the Department to
provide no less than $100,000,000 for grants at the mid-phase
or expansion levels. By ensuring at least half of resources
fund proven strategies, PSGG will strike a balance between
testing innovative interventions and funding what works to help
students succeed.
The Committee directs the Department to brief the
Committees on Appropriations no later than 90 days after
enactment of this Act on its plan to continue to carry out this
program, as well as a plan for evaluation and accountability,
and to notify the Committees no later than 15 days in advance
of making any new grant award or changes to the programs.
Research and Development Infrastructure Grants.--The
Committee provides $225,000,000 for planning and implementation
grants designed to promote transformational investments in
research infrastructure, including physical infrastructure and
human capital development. Eligible entities include four-year
HBCUs, TCUs, or other MSIs, either alone or as the lead entity
in consortia including other academic partners such as
community colleges, industry, and philanthropic partners.
Transitioning Gang-Involved Youth to Higher Education.--The
Committee directs the Department to work in conjunction with
the Department of Labor to allocate no less than $10,000,000 to
provide a funding opportunity for organizations that work
directly with gang-involved youth to help such youth pursue
higher education opportunities.
National Center for College Students with Disabilities.--
The Committee encourages the National Center for College
Students with Disabilities to continue providing technical
assistance and best practice information about disability as
students transition to institutions of higher education,
collect information and research on disability services on
college campuses, and report to the Department about the status
of college students with disabilities in the United States.
Reasonable Modifications at Institutions of Higher
Education.--The Committee is interested in information
pertaining to reasonable modifications and the provision of
auxiliary aids and services, including those to access
educational media, required by the Americans with Disabilities
Act of 1990 and Section 504 of the Rehabilitation Act of 1973
for college students with disabilities at institutions of
higher education. The Committee directs the Department to
include information on how it monitors institutional support
for college students with disabilities, and information on
technical assistance it provides to colleges regarding students
with disabilities, in the fiscal year 2024 Congressional Budget
Justification.
Workforce Development Funding for University Consortia
Focused on High-skill Fields.--The Committee is supportive of
funding to consortia of institutions of higher education for
innovative approaches to improve rates of baccalaureate
exposure to artificial intelligence, data science, cyber
security, additive manufacturing, clean energy and other high-
skill, high-wage, and in-demand industry sectors and
occupations within a State region. Specifically, the Committee
is supportive of funding that supports the development of
career pathways in these sectors that support and subsidize
wages for students in work-based learning settings.
Reserve Officers' Training Corps (ROTC) Programs.--The
Committee applauds all universities and colleges that host ROTC
programs as they assist in the creation of each of the
Services' officer corps. However, the Committee is concerned
that some hosting ROTC activities may face challenges in
maintaining the infrastructure needs to meet the ROTC mission
goals. To ensure that ROTC candidates have the structures they
need to become successful officers in their respective
Services, the Committee encourages the Department to facilitate
Service Secretaries' efforts to analyze the functionality and
utilization of all ROTC facilities on university and college
campuses.
Foreign Gift Disclosures.--The Committee notes that, under
section 117 of the HEA, colleges and universities receiving
Federal funds must disclose certain gifts from or contracts
with foreign entities and that the Department makes such
information publicly available on its website. The Committee
supports efforts by the Department to work with institutions to
improve the reporting process in order to increase
transparency, protect our national security, and preserve
academic integrity.
Community Project Funding
Within the funds included in this account, $209,301,000
shall be used for the projects, and in the amounts, specified
in the table titled ``Labor, HHS, Education Incorporation of
Community Project Funding Items'' at the end of this report.
Augustus F. Hawkins Centers of Excellence
The Committee recommends $30,000,000 for the Hawkins
Centers of Excellence program, which is $22,000,000 more than
the fiscal year 2022 enacted level. This program provides five-
year competitive grants to eligible institutions (HBCUs, HSIs,
TCUs, and other MSIs) to establish centers of excellence. These
centers will help strengthen and improve teacher preparation
programs, increase the availability of educators from diverse
backgrounds, and aid in the retention of teachers and
principals of color.
Comprehensive Educator Preparation.--The Committee notes
that greater diversity in the teaching profession can have
positive impacts on students' educational experiences and
outcomes, especially for students of color. For example, one
reanalysis of test score data from the Tennessee STAR class
size study found that Black elementary students with Black
teachers had reading and math test scores 3 to 6 percentile
points higher than students without Black teachers and that
gains in test scores accumulated with each year that Black
students were in a class with a Black teacher. The Committee
also notes that our current educator workforce does not reflect
the increasing diversity of our nation or its students. The
Committee also recognizes that HBCUs, TCUs, and other MSIs play
a disproportionate and important role in preparing teachers of
color, for example, preparing nearly 40 percent of Black
teachers with bachelor's degrees in the United States. The
Committee recognizes the importance of comprehensive educator
preparation on student learning and educator retention, and
therefore encourages the Department to create an absolute grant
priority for eligible institutions that propose to establish or
scale up comprehensive educator preparation programs as
outlined in sections 202 (d),(e), and (f), of the HEA. The
Committee also encourages the Secretary to prioritize grants to
eligible institutions that will provide scholarships or grants
to students based on financial need, for use in students
accessing comprehensive educator preparation pathways that
offer extensive preservice clinical training and mentoring by
exemplary teachers.
Preservice Clinical Training and Mentoring.--The Committee
recognizes the importance of high-quality teacher preparation
on student learning and teacher retention, and therefore
encourages the Secretary to prioritize grants to eligible
institutions that propose to establish or scale up high-quality
teacher preparation pathways that offer extensive preservice
clinical training and mentoring by exemplary teachers in grade
and subject areas deemed high need by their State. The
Committee also recognizes the value of a racially diverse
teacher workforce and directs the Secretary to prioritize
grants to eligible institutions that commit to increasing the
number and proportion of students of color they serve by
providing scholarships or grants, based on financial need, as
well as academic supports to help teacher candidates
successfully complete the preparation program and State
licensure requirements, and to publicly report on these efforts
and outcomes. The Committee also encourages the Department to
include the establishment of formal partnerships between
eligible institutions of higher education and local school
districts as an allowable use of grant funding as well as
programming that includes tutoring and support to prepare for
licensure exams and funding to compensate mentors during the
preservice clinical experience.
Shortages of Black Male Teachers.--The Committee is
concerned that Black men make up just two percent of teachers
nationwide. The Committee's support for Hawkins is intended to
address such shortages. In addition, the Committee encourages
the Department to leverage the expertise and institutional
capacity of HBCUs in mitigating this problem.
HOWARD UNIVERSITY
Appropriation, fiscal year 2022....................... $344,018,000
Budget request, fiscal year 2023...................... 311,018,000
Committee Recommendation.............................. 394,018,000
Change from enacted level......................... +50,000,000
Change from budget request........................ +83,000,000
Howard University is a leading research university located
in the District of Columbia and provides undergraduate liberal
arts, graduate and professional instruction to students.
The Committee recommends $394,018,000 for Howard University
Hospital, an increase of $50,000,000 above the fiscal year 2022
enacted level. Within the total, the agreement includes
$150,000,000 to support construction of a new hospital. These
amounts are in addition to the $107,000,000 provided for
hospital construction in fiscal year 2021 and fiscal year 2022.
The hospital serves as a major acute and ambulatory care center
for the District of Columbia, and functions as a teaching
facility. To continue this vital function, the Committee notes
the need to modernize the hospital's facilities.
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM
Appropriation, fiscal year 2022....................... $435,000
Budget request, fiscal year 2023...................... 298,000
Committee Recommendation.............................. 298,000
Change from enacted level......................... -137,000
Change from 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
Appropriation, fiscal year 2022....................... $20,484,000
Budget request, fiscal year 2023...................... 20,678,000
Committee Recommendation.............................. 20,678,000
Change from enacted level......................... +194,000
Change from budget request........................ - - -
The Committee recommends $20,678,000 for the HBCU Capital
Financing program, which is $194,000 more than the fiscal year
2022 enacted level. This program is authorized under part D of
Title III of the HEA and makes capital available for repair and
renovation of facilities at HBCUs. 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 $528,000 for the administrative
expenses to carry out the program and $20,150,000 for loan
subsidy costs. In addition, the Committee raises the limit to
the amount of bonds that may be insured under the HBCU Capital
Financing program to $752,000,000, an increase of $477,916,725
over the fiscal year 2022 enacted level.
INSTITUTE OF EDUCATION SCIENCES
Appropriation, fiscal year 2022....................... $737,021,000
Budget request, fiscal year 2023...................... 662,516,000
Committee Recommendation.............................. 844,075,000
Change from enacted level......................... +107,054,000
Change from budget request........................ +181,559,000
The Committee recommends $844,075,000 for the Institute of
Education Sciences (IES), $107,054,000 more than the fiscal
year 2022 enacted level.
Research, Development, and Dissemination
The Committee recommends $289,877,000 for Research,
Development, and Dissemination, which is $85,000,000 more that
the fiscal year 2022 enacted level. This 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.
National Center for Advanced Development in Education.--
Within amounts for Research, Development, and Dissemination,
the Committee provides $75,000,000 for a new National Center
for Advanced Development in Education (NCADE). Modeled on the
Defense Advanced Research Projects Agency, the Department of
Defense's renowned research and development center, NCADE will
invest in high-reward, scalable solutions to address
longstanding deficits and inequities in the education system.
NCADE will be housed at IES and have a management structure
that prioritizes solutions aligned with the science of learning
and development that have the potential to dramatically improve
student achievement and address gaps between advantaged and
disadvantaged students. Specifically, NCADE programs will
invest in breakthrough technologies; new pedagogical
approaches; innovative learning models; and more efficient,
reliable, and valid forms of measurement of student learning,
experiences, and opportunities. Amounts for NCADE provided
under Research, Development, and Dissemination will
specifically support the Center's high-reward project funding.
Personnel costs to support the Center's nimble program
management structure will be supported through funding provided
under IES Program Administration.
Building State and Local Research and Development
Capacity.--The Committee encourages IES to build State and
local research and development capacity by creating a matching
competitive grant program for American Rescue Plan Elementary
and Secondary School Emergency Relief funds. These funds would
allow States or districts to develop or implement diverse
approaches specifically tailored to their contexts, including
building research-practice partnerships, recruiting research
and data talent into their agencies, and investing in their own
research and development priorities to develop or implement
more evidence-based solutions.
Statistics
The Committee recommends $111,500,000 for the activities of
the National Center for Education Statistics (NCES), which is
the same as the the fiscal year 2022 enacted level. Statistics
activities are authorized under Title I of the Education
Sciences Reform Act of 2002. NCES collects, analyzes, and
reports statistics on all levels of education in the U.S.
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.
Governing Boards of Institutions of Higher Education.--The
Committee is interested in the disclosure of the gender,
racial, and ethnic composition of governing boards of
institutions of higher education in an ongoing effort to
increase transparency and promote inclusive and equitable
educational institutions. The Committee encourages the
Department to ensure governing body composition, including the
gender, racial, and ethnic composition of members, is included
as a data component in surveys administered by the Integrated
Postsecondary Education Data System (IPEDS) or other Federal
postsecondary institution data collection effort. The Committee
directs the Department to assess the feasibility of including
such data in the fiscal year 2024 Congressional Budget
Justification.
Non-Academic Considerations in Postsecondary Data.--The
Committee is aware of a 2019 report from NCES detailing
recommendations to include non-academic considerations to
improve and expand the IPEDS Admissions survey component (ADM)
for prospective students, their families, and researchers
interested in the college admissions process. The Committee is
also aware of the lack of data available demonstrating how
legacy status, or relationship to alumni of the institutions,
factors in first-time, first-year degree-seeking admissions
decisions. The Committee encourages the NCES to include non-
academic items, including alumni relationship, as factors for
admissions in the next IPEDS ADM.
Regional Educational Laboratories
The Committee recommends $63,733,000 for Regional
Educational Laboratories (RELs), which is $5,000,000 more than
the fiscal year 2022 enacted level. This program supports a
network of 10 laboratories that promote the use and development
of knowledge and evidence to increase student learning and
further school improvement efforts.
The Committee notes the critical role RELs play in helping
to translate education research to policymakers and
practitioners, which assists SEAs and LEAs in implementing the
ESEA and providing a high-quality education for more children.
Research in Special Education
The Committee recommends $64,255,000 for Research in
Special Education, which is $4,000,000 more than the fiscal
year 2022 enacted level. 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 $13,318,000 for Special Education
Studies and Evaluations, which is the same as the fiscal year
2022 enacted level. 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 $35,500,000 for Statewide Data
Systems, which is $2,000,000 more than the fiscal year 2022
enacted level. Competitive grants under this authority are made
to SEAs to help them manage, analyze, disaggregate and use
student data consistent with the ESEA.
Growing Statewide Longitudinal Data Systems (SLDS).--The
Committee supports the growth of the SLDS program to so that
every State and locale has a robust data infrastructure capable
of supporting effective education and talent development
practices. The Committee believes these investments provide for
the data backbone of education transparency, monitoring, and
evidence building.
Assessment
The Committee recommends $192,799,000 for Assessment, which
is $5,054,000 more than the fiscal year 2022 enacted level.
This amount includes $7,779,000 for the National Assessment
Governing Board (NAGB), which is $54,000 more than the fiscal
year 2022 enacted level.
The National Assessment of Educational Progress (NAEP) is
the only nationally representative and continuing survey of
educational ability and achievement of students in the U.S. 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, history,
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.
Civics and U.S. History Assessment.--Assessment.--The
Committee's recommendation will support the current assessment
schedule for the National Assessment of Educational Progress,
including administration in 2022 of the Civics and U.S. History
assessment in 8th grade at the national level; necessary
research and development needed to maintain assessment quality,
integrity and continuity, and achieve efficiencies; and
maintain plans for the administration of a State-level Civics
assessment in future years. The Committee directs NAGB and IES
to consult with the Committee as it considers strategies in
achieving cost efficiencies in and upgrades of its assessment
program. Further, the Committee directs the Department to
describe implemented and planned strategies for cost
efficiencies and necessary research and development projects in
the fiscal year 2024 Congressional Budget Justification.
Program Administration
The Committee recommends $73,093,000 for Program
Administration, which is $6,000,000 more than the fiscal year
2022 enacted level.
Operating Plan.--The agreement directs the Director to
submit an operating plan within 90 days of enactment of this
Act to the Committees detailing how IES plans to allocate
funding available to the Institute for research, evaluation,
statistics, administration and other activities.
School Pulse Panel.--The Committee is supportive of IES'
School Pulse Panel, which tracks the effects of COVID on
schools through a national sample of elementary, middle, and
high schools. This program has provided invaluable information
as one of the nation's few sources of reliable data focused on
school reopening efforts, as reported by school district staff
and principals in U.S. public schools.
Unique Needs of Military-Connected Youth in Mentorship
Programs.--The Committee recognizes the unique circumstances of
highly mobile students, including youth growing up in military-
connected families. The Committee supports IES' uplifting of
mentorship programming tailored to military families' needs.
DEPARTMENTAL MANAGEMENT
Appropriation, fiscal year 2022....................... $ 594,407,000
Budget request, fiscal year 2023...................... 785,752,000
Committee Recommendation.............................. 690,252,000
Change from enacted level......................... + 95,845,000
Change from budget request........................ -95,500,000
Program Administration
The Committee recommends $462,500,000 for Program
Administration, which is $67,593,000 more than the fiscal year
2022 enacted. 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.
Advertising Contracts.--The Committee understands that, as
the largest advertiser in the U.S., the Federal Government
should work to ensure fair access to its advertising contracts
for small disadvantaged businesses and businesses owned by
minorities and women. The Committee directs the Department to
include the following information in its fiscal year 2024
Congressional Budget Justification: Expenditures for fiscal
years 2022, 2023, and expected expenditures for fiscal year
2024 respectively, for (1) all contracts for advertising
services; and (2) contracts for the advertising services of (I)
socially and economically disadvantaged small business concerns
(as defined in section 8(a)(4) of the Small Business Act (15
U.S.C. 637(a)(4)); and (II) women- and minority-owned
businesses.
Investments in Impoverished Areas.--The Committee is deeply
appreciative to the Department for its thorough work on a
report on educational investments in impoverished areas,
particularly in persistent poverty counties and in other high
poverty census tracts as described in House Report 117-81. The
Committee directs the Department to update the report to
include persistent poverty percentages for competitions in
fiscal year 2022 once those data are available.
Lead Testing and Remediation.--The Committee strongly
agrees with recommendations from a 2018 GAO report, Lead
Testing of School Drinking Water Would Benefit from Improved
Federal Guidance, that the Assistant Secretary for Elementary
and Secondary Education should collaborate with the
Environmental Protection Agency (EPA) to disseminate guidance
related to lead testing and remediation in schools. The
Committee is aware that EPA has made available updated guidance
and web-based toolkits for lead testing and remediation in
schools. The Committee is also aware that EPA is soliciting
applications from education officials to provide grant funds to
assist States and local education agencies with testing and
remediation efforts. The Committee appreciates the technical
assistance provided by the Department to school districts in
response to language included in House Report 116-62. The
Committee directs the Department to continue coordinating with
EPA in disseminating this new guidance and resources, assisting
school systems seeking to remediate lead contamination in
working with EPA, and sharing best practices among States and
local school systems. The Committee directs the Department to
report on ongoing efforts on these issues in the fiscal year
2024 Congressional Budget Justification.
FTE and Attrition Report.--The Committee directs the
Department to provide the Committees on Appropriations a
report, not later than 30 days after the conclusion of each
quarter, detailing the number of full-time equivalent employees
and attrition by principal office and appropriations account.
Protecting Scientific Research on Marihuana.--Through
scientific research, institutions of higher education advance
our understanding and knowledge of various aspects of our
world. Moreover, when in the public interest, such institutions
should be able to conduct such research without fear of
reprisal or loss of Federal funding. This includes research on
cannabis, a Schedule I controlled substance under the
Controlled Substances Act. As more States and localities move
to legalize cannabis, many institutions of higher education are
expanding the knowledge-base on this controlled substance. As a
result, the Committee notes that such research is in the public
interest, and the recommendation includes new bill language
prohibiting the Department from penalizing institutions of
higher education that conduct scientific research on marihuana.
Evidence-based Grants and Policy.--The Committee requests
an update in the fiscal year 2024 Congressional Budget
Justification on implementation of the Foundations for
Evidence-based Policymaking Act (P.L. 115-435) and
implementation plans for the coming year. The Committee
encourages the Secretary to develop guidance to ensure relevant
participants and grantees are involved in the Department-wide
process of prioritizing evidence needs, including participating
in Department led evaluations. Consistent with program
statutes, the Committee encourages the Secretary to ensure that
evidence of effectiveness is a consideration in grant
opportunities.
Film Programs at Institutions of Higher Education.--The
Committee recognizes the importance of ensuring diversity in
student populations enrolled in film programs at institutions
of higher education that receive any Federal funds and grants
administrated by the Department of Education. The Committee
encourages institutions of higher education to continue
building on best practices in recruitment and retention to
ensure student enrollment is reflective of the American
population's diverse demographics.
Customer Service.--The Committee continues to support
efforts to improve customer service in accordance with
Executive Order 13571--Streamlining Service Delivery and
Improving Customer Service. The Committee directs the Secretary
to develop standards to improve customer service and
incorporate the standards into the performance plans required
under 31 U.S.C. 1115. The Committee further directs the
Department to include an update on the progress of these
efforts in the fiscal year 2024 Congressional Budget
Justification.
Performance Measures.--The Committee directs the Department
to comply with title 31 of the United States Code, including
the development of organizational priority goals and outcomes
such as performance outcome measures, output measures,
efficiency measures, and customer service measures. The
Committee further directs the Department to include an update
on the progress of these efforts in the fiscal year 2024
Congressional Budget Justification.
Regional Councils and Councils of Governments.--The
Committee encourages the Department to list regional councils
and councils of governments as eligible entities in
competitions for Federal funding whenever local governments or
non-profit agencies are eligible entities. Furthermore, the
Committee encourages the Department to seek opportunities for
regional councils and councils of governments to serve as lead
applicants and grantees to encourage and expand greater
regional collaboration.
Predispute Nondisclosure and Nondisparagement Clauses.--The
Committee recognizes that harassment, including sexual
harassment and assault, continue to be pervasive in the
workplace, and that the use of predispute nondisclosure and
nondisparagement clauses as conditions of employment can
perpetuate illegal conduct by silencing survivors and shielding
perpetrators. The Committee directs the Department to include
proposals in its fiscal year 2024 Congressional Budget
Justification to eliminate the use of grants and contracts to
employers that use this practice.
Geographical Distribution of Grants and Poverty.--The
Committee acknowledges the value of ensuring K-12 grant
competitions support entities across geographically diverse
areas, including urban, suburban, and rural areas; however, the
Committee is concerned that, without careful consideration and
planning, efforts to prioritize specific geographical areas may
have unintended negative consequences. The Department's 2021
Condition on Education finds that 41 percent of students
attending public schools in cities attend high-poverty schools,
compared with 20 percent of students who attend schools in
towns, 17 percent of students who attend suburban schools, and
15 percent of students who attend rural schools. Given the
significant differences in the share of students attending
high-poverty schools across areas, the Committee urges the
Department to consider the socioeconomic and racial equity
implications of prioritizing specific geographic areas over
cities in competitive grants.
Out of School Time Organizations Supporting Mental Health
for Youth.--The Committee notes that thousands of out of school
time organizations are working with State governments,
districts, schools, and youth to supplement the critical work
of school-based mental health organizations without significant
support from Federal funding streams. In order to better
understand the Federal resources available, the Committee
encourages the Department, in partnership with other relevant
Federal agencies, to provide information on the ways community-
based organizations, specifically out of school time
organizations, can utilize existing Federal funding streams to
provide mental health and student support services that
supplement school-based mental health services.
OFFICE FOR CIVIL RIGHTS
Appropriation, fiscal year 2022....................... $135,500,000
Budget request, fiscal year 2023...................... 161,300,000
Committee Recommendation.............................. 151,300,000
Change from enacted level......................... +15,800,000
Change from budget request........................ -10,000,000
The Office for Civil Rights (OCR) 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 SEAs, LEAs, and IHEs,
including proprietary schools. They also extend to State
rehabilitation agencies, libraries, museums, and other
institutions receiving Federal funds.
The Committee recommendation includes $151,300,000, which
is $15,800,000 more than the fiscal year 2022 enacted level.
The School to Prison Pipeline.--The Committee directs GAO
to study the role and oversight of policing in schools,
including the impact of school policing on Black and Latino
students. The study should also explore the extent to which
school resource officers and evidence-based interventions, such
as restorative justice practices, can enhance school safety,
student well-being, and--to the extent practical--student
outcomes. GAO should begin this work no later than September
2022 and issue a final report on a date thereafter as agreed
between GAO and the Committee.
The State of Desegregation Orders.--The Committee is
concerned by research from the UCLA Civil Rights Project
indicating that schools and school districts are becoming
increasingly racially and socioeconomically segregated across
the country. At the same time, there is no clear or accurate
reporting or transparency on the number of Federal
desegregation orders, the status of these orders, or the impact
they have had on segregation in districts. The Committee,
therefore, continues to urge OCR to make a report publicly
available on the Department's website, detailing a
comprehensive list of all existing Federal desegregation orders
in the United States, their principle requirements, and the
status of the affected districts' compliance with these orders.
Racial and Economic Segregation in Schools.--The Committee
looks forward to receiving the report the Department was
directed to complete in House Report 117-96.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2022....................... $64,000,000
Budget request, fiscal year 2023...................... 76,452,000
Committee Recommendation.............................. 76,452,000
Change from enacted level......................... +12,452,000
Change from budget request........................ - - -
OIG 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.
The Committee recommendation continues bill language
allowing the OIG to better respond to unexpected oversight
needs by modifying the availability of funds.
General Provisions
Sec. 301. The Committee continues a provision related to
the implementation of programs of voluntary prayer and
meditation in public schools.
(TRANSFER OF FUNDS)
Sec. 302. The Committee continues a provision regarding
transfer authority.
Sec. 303. The Committee continues a provision allowing ESEA
funds consolidated for evaluation purposes to be available from
July 1, 2023 through September 30, 2024.
Sec. 304. The Committee continues a provision allowing
certain institutions to continue to use endowment income for
student scholarships.
Sec. 305. The Committee continues a provision extending the
authorization of the National Advisory Committee on
Institutional Quality and Integrity.
Sec. 306. The Committee continues a provision extending the
authority to provide account maintenance fees to guaranty
agencies for Federal student loans.
Sec. 307. The Committee continues a provision allowing
administrative funds to cover outstanding Perkins loans
servicing costs.
(RESCISSION)
Sec. 308. The Committee modifies a provision rescinding
fiscal year 2023 mandatory funding to offset the mandatory
costs of increasing the discretionary Pell award and expanding
Title IV eligibility.
Sec. 309. The Committee continues a provision regarding
outreach to borrowers and the Public Service Loan Forgiveness
program.
Sec. 310. The Committee modifies a provision regarding
Public Service Loan Forgiveness.
Sec. 311. The Committee continues a provision allowing up
to 0.5 percent of funds appropriated in this Act for programs
authorized under the HEA, except for the Pell Grant program, to
be used for evaluation of any HEA program.
Sec. 312. The Committee continues a provision providing an
additional amount for the projects, and in the amounts, as
specified in the table titled ``Labor, HHS, Education
Incorporation of Community Project Funding Items'' in the
report accompanying this title.
Sec. 313. The Committee includes a new provision regarding
charter schools that contract with a for-profit entity to
operate, oversee or manage the activities of the school.
Sec. 314. The Committee includes a new provision regarding
research on marihuana.
Sec. 315. The Committee includes a new provision related to
the use of electric shock devices and equipment.
Sec. 316. The Committee includes a new provision related to
the 85-15 rule.
Sec. 317. The Committee includes a new provision regarding
Title IV eligibility under HEA.
Sec. 318. The Committee includes a new provision regarding
section 344 of the HEA.
TITLE IV--RELATED AGENCIES
Committee for Purchase From People Who Are Blind or Severely Disabled
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $11,000,000
Budget request, fiscal year 2023...................... 13,124,000
Committee Recommendation.............................. 13,124,000
Change from enacted level......................... +2,124,000
Change from 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 of direct labor required for the
production or provision of the products or services to Federal
government agencies. To ensure the Committee for Purchase from
People Who Are Blind or Severely Disabled (AbilityOne
Commission) maintains its oversight capacity, the Committee
continues bill language requiring the AbilityOne Commission to
establish written agreements with central nonprofit agencies.
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 requests
the reports as described in the explanatory statement
accompanying P.L. 117-103.
Office of Inspector General.--The Committee recommends not
less than $3,124,000 for the Office of Inspector General.
Corporation for National and Community Service
OPERATING EXPENSES
Appropriation, fiscal year 2022....................... $865,409,000
Budget request, fiscal year 2023...................... 982,126,000
Committee Recommendation.............................. 947,829,000
Change from enacted level......................... +82,420,000
Change from budget request........................ -34,297,000
The Committee recommends $947,829,000 for operating
expenses for the Corporation for National and Community Service
(CNCS), an increase of $82,420,000 over the fiscal year 2022
enacted level and $34,297,000 below the fiscal year 2023 budget
request.
Service Learning.--Within the total for Operating Expenses,
the Committee directs $20,000,000 for CNCS to support service-
learning activities, such as the Summer of Service and Semester
of Service, within existing programs. The Committee further
recommends that CNCS prioritize grants directed to public
schools and institutions of higher education in economically
disadvantaged communities.
Civic Bridgebuilding.--The Committee supports CNCS' goal of
uniting Americans through national service and recognizes that
national service is a proven model of civic bridgebuilding. To
advance these shared goals, the Committee directs $15,000,000
to CNCS for bridgebuilding activities, such as those modeled in
the bipartisan Building Civic Bridges Act (H.R. 6843), within
existing programs. These initiatives may include administering
a grant program to support civic bridgebuilding programs and
establish standardized criteria to track the effectiveness of
funded projects and activities; providing training in civic
bridgebuilding skills and techniques to AmeriCorps members and
host sites; the establishment of a committee to advise on civic
bridgebuilding initiatives at CNCS; the creation of a public
research base focused on civic engagement, civic
bridgebuilding, and civic renewal; and providing resources that
can be publicly disseminated to support local civic
bridgebuilding efforts, among other activities.
Volunteers in Service to America
The Committee recommends $106,264,000 for Volunteers in
Service to America (VISTA), an increase of $5,979,000 over the
fiscal year 2022 enacted level and the same as the fiscal year
2023 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.
National Senior Volunteer Corps
The Committee recommends $245,145,000 for the National
Senior Volunteer Corps programs, an increase of $14,377,000
over the fiscal year 2022 enacted level and the same as the
fiscal year 2023 budget request. Senior Corps is a collection
of programs that connect individuals older than the age of 55
with opportunities to contribute their job skills and expertise
to community projects and organizations.
The Committee intends for all funding to be used to support
programs and volunteers.
The funding breakout by program is as follows:
------------------------------------------------------------------------
National Senior Volunteer Corps: FY 2023 Committee
------------------------------------------------------------------------
Foster Grandparents Program.......................... $131,335,000
Senior Companion Program............................. 58,705,000
Retired Senior Volunteer Program..................... 55,105,000
------------------------------------------------------------------------
AmeriCorps State and National Grants
The Committee recommends $522,797,000 for AmeriCorps State
and National Grants, an increase of $56,048,000 over the fiscal
year 2022 enacted level. This program provides funds to local
and national organizations and agencies to address community
needs in education, public safety, health, and the environment.
The increase supports enhanced opportunities for more
individuals to serve as AmeriCorps State and National members
by increasing disability accommodation and eligibility for
Segal Education awards for individuals with DACA status.
AmeriCorps State and National members support children to
achieve academic success, respond to natural disasters, build
and renovate homes for families in under-resourced communities,
give back to veterans and their families, preserve and restore
the environment, and address other needs identified by
communities.
Digital Equity.--The Committee recognizes that digital
equity needs persist in underserved or marginalized communities
at a time when more Americans than ever before depend on, or
could significantly benefit from, access to digital services.
The Committee recognizes the role that national service
organization volunteers through CNCS could play in helping to
meet the IT needs of these communities across the country while
also supporting IT skills and career development among
participating volunteers. The Committee encourages CNCS to
support existing programs that would focus on digital equity
and digital literacy projects for underserved communities.
Randomized Control Trials.--The Committee encourages
AmeriCorps to continue its use of randomized control trials to
build causal evidence for effective interventions.
Innovation, Assistance, and Other Activities
The Committee recommends $10,100,000 for Innovation,
Assistance, and Other Activities, an increase of $212,000 over
the fiscal year 2022 enacted level and the same as the fiscal
year 2023 budget request.
National Days of Service.--The Committee continues to
support the September 11 National Day of Service and
Remembrance and the Martin Luther King, Jr. National Day of
Service--two important national events. The Committee
encourages CNCS to prioritize eligible organizations with
expertise in representing families of victims of the September
11, 2001 terrorist attacks and other impacted constituencies
when planning for the September 11 National Day of Service and
Remembrance.
Evaluation
The Committee recommends $6,250,000 for evaluation, an
increase of $2,130,000 over the fiscal year 2022 enacted level
and the same as the fiscal year 2023 budget request. These
funds support research on program effectiveness.
National Civilian Community Corps
The Committee recommends $37,735,000 for National Civilian
Community Corps, an increase of $3,230,000 over the fiscal year
2022 enacted level and the same as the fiscal year 2023 budget
request. This program supports residential, team-based service
opportunities for individuals aged 18-24.
State Commission Administrative Grants
The Committee recommends $19,538,000 for State Commission
Support Grants, an increase of $444,000 over the fiscal year
2022 enacted level and the same as the fiscal year 2023 budget
request. Funds are used for formula grants to support State
oversight of service programs.
Payment to the National Service Trust
Appropriation, fiscal year 2022....................... $190,550,000
Budget request, fiscal year 2023...................... 235,000,000
Committee Recommendation.............................. 235,000,000
Change from enacted level......................... +44,450,000
Change from 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 for National and Community Service.
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $88,082,000
Budget request, fiscal year 2023...................... 114,686,000
Committee Recommendation.............................. 109,686,000
Change from enacted level......................... +21,604,000
Change from budget request........................ -5,000,000
Evidence-based Grant Making.--The Committee is supportive
of efforts by the Corporation to consider evidence of
effectiveness in grant competitions. The Committee encourages
CNCS to develop guidance to ensure relevant participants and
grantees are involved in the Corporation-wide process of
prioritizing evidence needs, including participating in CNCS
led evaluations. Consistent with program statutes, the
Committee encourages CNCS to ensure that evidence of
effectiveness is a consideration in grant opportunities.
Civilian Climate Corps (CCC).--Within the total, the
Committee includes $15,000,000 to hire new staff, develop new
capacity, and enhance core business functions to successfully
stand up the Civilian Climate Corps program in partnership with
other Federal agencies. These investments in staff and
administrative capacity will support grantees' work related to
climate resilience, environmental stewardship, and climate
mitigation, as well as AmeriCorps' collaboration with other
agencies implementing the CCC.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2022....................... $6,595,000
Budget request, fiscal year 2023...................... 8,121,000
Committee Recommendation.............................. 8,121,000
Change from enacted level......................... +1,526,000
Change from budget request........................ - - -
The Committee recommends $8,121,000 for the Office of the
Inspector General (OIG), an increase of $1,526,000 over the
fiscal year 2022 enacted level and the same as the fiscal year
2023 budget request.
ADMINISTRATIVE PROVISIONS
Sec. 401. The Committee continues a provision requiring
CNCS to make any significant changes to program requirements or
policy through rulemaking.
Sec. 402. The Committee continues a provision related to
National Service Trust minimum share requirements.
Sec. 403. The Committee continues a provision related to
donations.
Sec. 404. The Committee continues a provision related to
veterans.
Sec. 405. The Committee continues a provision related to
criminal history background checks.
Sec. 406. The Committee continues a provision related to
1,200 hour service positions.
Sec. 407. The Committee continues a provision related to
VISTA members and Segal Education Awards.
Sec. 408. The Committee includes a new provision related to
allowing individuals with Deferred Action of Childhood Arrivals
(DACA) status who successfully serve a term in AmeriCorps State
and National, NCCC, or VISTA, to be eligible for a Segal
AmeriCorps Education Award.
Sec. 409. The Committee includes a new provision related to
allowing AmeriCorps NCCC to keep teams in place over the 12-
month statutory restriction for work on disaster response or
recovery, enabling overlap in NCCC service and coverage over
the summer months.
Sec. 410. The Committee includes a new provision related to
allowing AmeriCorps NCCC members ages 18-26 to participate for
a period of 3 to 6 months, as opposed to the usual term of 11
to 12 months.
Corporation for Public Broadcasting
Appropriation, fiscal year 2024....................... $525,000,000
Budget request, fiscal year 2025...................... 565,000,000
Committee Recommendation.............................. 565,000,000
Change from enacted level......................... +40,000,000
Change from budget request........................ - - -
The Committee recommends $565,000,000 as an advance
appropriation for fiscal year 2025, an increase of $40,000,000
over the fiscal year 2024 advance and the same as the fiscal
year 2023 budget request. In addition, the Committee
recommendation includes $60,000,000 in fiscal year 2023 for
continued support of CPB in replacing and upgrading the public
broadcasting interconnection system and further investing in
system-wide infrastructure and services.
National Multicultural Alliance.-- 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 Multicultural
Alliance to help accomplish this goal. The Corporation is
directed to provide a briefing to the Committee within 90 days
of enactment of this Act on this investment.
Continued Access to Public Broadcasting.--The Committee
recognizes the importance of continued access to public
broadcasting in local communities. The Committee directs
Federally funded public radio stations to engage in public-
private partnerships with State and local entities, including
nonprofits, in this effort. The Committee looks forward to
information in the fiscal year 2024 Congressional Budget
Justification on how public private partnerships may be used to
ensure continued access to public broadcasting in underserved
areas.
Diversity in CPB Funded Programming.--The Committee
recognizes the importance of diversity and inclusion in
federally funded public media in television and radio
programming. The Committee requests CPB include in its fiscal
years 2024/2026 Congressional Budget Justification information
on its diversity and inclusion efforts, including programming
supported by funding from the Corporation, as well as
professional development opportunities and services provided by
CPB for individuals from underrepresented communities.
Diverse Content and Content Creators.--In recognizing the
importance of public media and the inclusion of diverse and
independent voices, Congress encourages CPB to continue to
support the Independent Television Service (ITVS) and the
National Multicultural Alliance (NMCA) and encourages CPB to
expand its support through other established and emerging
intermediaries that fund and support diverse filmmakers and
production of diverse content. The Committee further encourages
CPB to continue fulfilling its Congressional mandate to enrich
the public media landscape with diverse content on broadcast
and digital platforms by funding more content creators and
producers from underrepresented backgrounds. As the federal
funding provided for CPB also supports the work of ITVS, the
Committee urges CPB to ensure that the increases in funding for
future fiscal years are also used to provide additional
financial support for ITVS, the National Multicultural
Alliance, and content creators and producers from
underrepresented backgrounds.
Federal Mediation and Conciliation Service
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $50,058,000
Budget request, fiscal year 2023...................... 53,705,000
Committee Recommendation.............................. 53,705,000
Change from enacted level......................... +3,647,000
Change from budget request........................ - - -
The Federal Mediation and Conciliation Service promotes
labor-management cooperation through mediation and conflict
resolution services to industry, government agencies, and
communities.
Federal Mine Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $17,539,000
Budget request, fiscal year 2023...................... 18,012,000
Committee Recommendation.............................. 18,012,000
Change from enacted level......................... +473,000
Change from budget request........................ - - -
The Federal Mine Safety and Health Review Commission is an
independent adjudicative agency that provides administrative
trial and appellate review of legal disputes arising under the
Federal Mine Safety and Health Act of 1977.
Institute of Museum and Library Services
OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND ADMINISTRATION
Appropriation, fiscal year 2022....................... $268,000,000
Budget request, fiscal year 2023...................... 276,800,000
Committee Recommendation.............................. 280,000,000
Change from enacted level......................... +12,000,000
Change from budget request........................ +3,200,000
Within the total for the Institute of Museum and Library
Services (IMLS), the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2023 Committee
------------------------------------------------------------------------
Library Services Technology Act:
Grants to States................................. $170,000,000
Native American Library Services................. 5,763,000
National Leadership: Libraries................... 15,787,000
Laura Bush 21st Century Librarian................ 10,000,000
Museum Services Act:
Museums for America.............................. 29,180,000
Native American/Hawaiian Museum Service.......... 3,272,000
National Leadership: Museums..................... 9,848,000
African American History and Culture Act:
Museum Grants for African American History and 6,000,000
Culture.........................................
National Museum of the American Latino Act
Museum Grants for American Latino History and 6,000,000
Culture.........................................
Museum and Library Services Act General Provisions:
Research, Analysis and Data Collection........... 5,650,000
Program Administration............................... 18,500,000
------------------------------------------------------------------------
Library Services and Technology
The Grants to State Library Agencies program provides funds
to State Library Administrative Agencies using a population-
based formula.
Online Education Programs.--Bringing quality, online career
high school education to adults is essential for entering the
skilled workforce and/or matriculating into the community
college system. Local libraries play a vital, central role in
providing adult online high school education to patrons in
their local communities. The Committee encourages IMLS to
prioritize state grants to local libraries to further develop
ways for libraries to adopt and utilize adult online career
high school education programs.
Program Administration
The Committee recommends $18,500,000 for Program
Administration, which is the same as the fiscal year 2022
enacted level. These funds provide administrative and
management support for all programs administered by IMLS. The
Committee also includes $5,650,000 for IMLS' activities in
policy, research, and data collection, including functions
formerly conducted by the National Commission on Libraries and
Information Science.
Holocaust Education and Survivor Stories.--The Committee is
aware that the number of Holocaust survivors in the U.S. is
diminishing due to the advanced age of the survivors. The
Committee continues to commend the work that museums,
libraries, and archives are doing to preserve their memories
and to educate the public of the Holocaust. The Committee
encourages IMLS to support the work organizations are doing
across the country to preserve and present the living memories
of Holocaust survivors in an interactive format, which can help
educate future generations about the atrocities of the
Holocaust.
Information Literacy Taskforce.--The Committee encourages
IMLS to support the Information Literacy Taskforce funded in
fiscal year 2023 and to continue to follow the guidelines and
priorities described in the explanatory statement accompanying
P.L. 117-103.
Public Library Assessment.--The Committee notes growing
concern regarding the physical condition of public libraries.
The Committee supports efforts to assess the availability and
condition of public library facilities, the availability and
condition of public library facilities located in economically
disadvantaged or underserved communities, the accessibility of
public library facilities for individuals with disabilities,
the condition of public library facilities affected by natural
disasters and extreme weather, and potential costs associated
with bringing public library facilities to a state of good
repair.
Medicare Payment Advisory Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $13,292,000
Budget request, fiscal year 2023...................... 13,440,000
Committee Recommendation.............................. 13,824,000
Change from enacted level......................... +532,000
Change from budget request........................ +384,000
The Medicare Payment Advisory Commission (MedPAC) is an
independent agency tasked with advising the Congress on issues
affecting the Medicare program. In addition to advising 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.
Report on Spending.--The Committee requests a report no
later than the March 15th following the enactment of this Act
comparing per enrollee spending on behalf of Medicare
beneficiaries enrolled in the Medicare Advantage (MA) program
and beneficiaries enrolled in traditional fee-for-service (FFS)
Medicare. In conducting such analysis, MedPAC shall evaluate at
least the previous five plan years for which data is available.
The analysis shall rely on data, as determined necessary, from
the Centers for Medicare and Medicaid Services (CMS) Office of
the Actuary, MA bids, the Medicare Trustees, and any other
sources to assess spending on the MA and FFS Medicare programs.
MedPAC shall conduct this analysis using the method used by CMS
in calculating spending on FFS for use in the calculation of MA
benchmarks, as well as spending on FFS beneficiaries only
enrolled in both Part A and Part B. MedPAC shall also provide a
detailed description of their methodology for any spending
comparison between FFS and MA, including, but not be limited
to, a description of data sources used, inclusions or
exclusions of populations or services, and any adjustments made
to prices, utilization, or payments.
Medicaid and Chip Payment and Access Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $9,043,000
Budget request, fiscal year 2023...................... 9,727,000
Committee Recommendation.............................. 9,405,000
Change from enacted level......................... +362,000
Change from budget request........................ -322,000
The Medicaid and CHIP Payment and Access Commission
(MACPAC) is an independent agency tasked with advising the
Congress on issues affecting Medicaid and the State Children's
Health Insurance Program (CHIP). MACPAC conducts policy and
data analysis on Medicaid and CHIP to support policymakers and
support program accountability.
National Council on Disability
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $3,500,000
Budget request, fiscal year 2022...................... 3,850,000
Committee Recommendation.............................. 3,850,000
Change from enacted level......................... +350,000
Change from budget request........................ - - -
The National Council Disability (NCD) is an independent
Federal agency charged with advising the President, Congress,
and other Federal agencies regarding policies, programs,
practices, and procedures that affect people with disabilities.
NCD is comprised of a team of Presidential and Congressional
appointees, an Executive Director appointed by the Chair, and a
full-time professional staff.
National Labor Relations Board
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $274,224,000
Budget request, fiscal year 2023...................... 319,424,000
Committee Recommendation.............................. 319,424,000
Change from enacted level......................... +45,200,000
Change from budget request........................ - - -
The National Labor Relations Board (NLRB) is an independent
agency responsible for enforcing U.S. labor law related to
collective bargaining and unfair labor practices, including the
National Labor Relations Act (NLRA) of 1935.
The Committee includes $319,424,000 for the NLRB, which is
$45,200,000 above the fiscal year 2022 enacted level and the
same as the fiscal year 2023 budget request. Within this
amount, at least $1,000,000 is provided, along with new bill
language, for the Board to develop and implement an electronic
voting system.
National Mediation Board
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $14,729,000
Budget request, fiscal year 2023...................... 15,113,000
Committee Recommendation.............................. 15,113,000
Change from enacted level......................... +384,000
Change from budget request........................ - - -
The National Mediation Board (NMB) is an independent agency
that coordinates labor-management relations within the U.S.
railroads and airlines industries.
The Committee includes $15,113,000 for the NMB, which is
$384,000 above the fiscal year 2022 enacted level and the same
as the fiscal year 2023 budget request. The Committee urges NMB
to use this increase to supplement, not supplant, existing
resources devoted to Section 3 arbitrator salaries and expenses
and to address the backlog of Section 3 arbitration cases at
the NMB. The Committee has prioritized these additional funds
to allow the Board to better accomplish its statutory mission
in a timelier manner.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2022....................... $13,622,000
Budget request, fiscal year 2023...................... 15,449,000
Committee Recommendation.............................. 15,449,000
Change from enacted level......................... +1,827,000
Change from budget request........................ - - -
The Occupational Safety and Health Review Commission is an
independent Federal agency, providing administrative trial and
appellate review, created to decide contests of citations or
penalties resulting from OSHA inspections of American
workplaces.
Railroad Retirement Board
DUAL BENEFITS PAYMENTS ACCOUNT
Appropriation, fiscal year 2022....................... $11,000,000
Budget request, fiscal year 2023...................... 9,000,000
Committee Recommendation.............................. 9,000,000
Change from enacted level......................... -2,000,000
Change from 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 (``RRB'') estimates that
approximately $1,000,000 may be derived in this manner.
FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS
Appropriation, fiscal year 2022....................... $150,000
Budget request, fiscal year 2023...................... 150,000
Committee Recommendation.............................. 150,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
LIMITATION ON ADMINISTRATION
Appropriation, fiscal year 2022....................... $124,000,000
Budget request, fiscal year 2023...................... 131,666,000
Committee Recommendation.............................. 131,666,000
Change from enacted level......................... +7,666,000
Change from budget request........................ - - -
The Committee recommends $131,666,000 for Limitation on
Administration, an increase of $7,666,000 above the fiscal year
2022 enacted level and the same as the fiscal year 2023 budget
request.
LIMITATION ON THE OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2022....................... $12,650,000
Budget request, fiscal year 2023...................... 13,269,000
Committee Recommendation.............................. 13,269,000
Change from enacted level......................... +619,000
Change from budget request........................ - - -
Social Security Administration
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
Appropriation, fiscal year 2022....................... $11,000,000
Budget request, fiscal year 2023...................... 11,000,000
Committee Recommendation.............................. 11,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
This appropriation provides reimbursement to the Social
Security trust funds for non-trust fund activities.
SUPPLEMENTAL SECURITY INCOME PROGRAM
Appropriation, fiscal year 2022....................... $45,913,823,000
Budget request, fiscal year 2023...................... 48,828,722,000
Committee Recommendation.............................. 48,713,576,000
Change from enacted level......................... +2,799,753,000
Change from budget request........................ -115,146,000
The Committee recommends $15,800,000,000 in advance funding
for the first quarter of fiscal year 2024, as requested.
Research and Demonstration
Section 1110 of the Social Security Act provides authority
to the Social Security Administration (SSA) for conducting
research and demonstration projects related to SSA's programs.
Within the appropriation for Supplemental Security Income
(SSI), the Committee recommends $86,000,000 for research and
demonstration activities, which is equal to the fiscal year
2022 enacted level and the fiscal year 2023 budget request.
Administration
Within the appropriation for SSI, the Committee recommends
$4,878,576,000, which is $346,895,000 above the fiscal year
2022 enacted level. This funding is for payment to the Social
Security trust funds for SSI's share of the administrative
expenses of SSA.
LIMITATION ON ADMINISTRATIVE EXPENSES
Appropriation, fiscal year 2022....................... $11,494,945,000
Budget request, fiscal year 2023...................... 12,833,300,000
Committee Recommendation.............................. 12,501,945,000
Change from enacted level......................... +1,007,000,000
Change from budget request........................ -331,355,000
The Limitation on Administrative Expenses (LAE) funds the
administrative and operational costs for administering the Old
Age and Survivors Insurance, Disability Insurance, and
Supplemental Security Income programs, and associated costs for
support to the Centers for Medicare and Medicaid Services in
administering their programs.
The Committee recognizes that Social Security is an
essential component of the nation's economic security, and that
SSA faces unprecedented challenges as it recovers from years of
underfunding and a pandemic that severely disrupted its
operations, closing offices to most in-person visitors and
generating delays in services and decisions on disability
claims. The Committee believes that the critical need to
rebuild the Social Security Administration's ability to serve
the American people starts with adequately funding fixed cost
increases. The recommendation includes funding to cover Federal
employee salaries and benefits, fixed cost increases for State
DDS partners, facilities, and other contracted expenses that
will be necessary to fund regardless of investments that can be
made to improve SSA operations in fiscal year 2023. In
addition, the Committee includes increased funding necessary to
help correct long-standing deficiencies, improve operations,
and better serve the public. Within the total recommended
increase, the Committee expects SSA to direct not less than
$630,000,000 for field offices, teleservice centers, and
program service centers, and $190,000,000 to replace losses and
build capacity at the State Disability Determination Services
(DDS) agencies that make disability determinations for SSA.
In addition, within the recommended funding level, the
Committee provides $89,500,000 for SSA to mail paper statements
to all contributors aged 25 and older not yet receiving
benefits, in accordance with Section 1143 of the Social
Security Act (42 U.S.C. 1320b-13).
Administrative Appeals Hearings.--The Committee continues
to consider the Final Rule ``Hearings Held by Administrative
Appeals Judges of the Appeals Council'' (85 Fed. Reg. 73138,
December 16, 2020) to be an unjustified erosion of due process
for individuals who are appealing a denial of Social Security
or SSI benefits. As part of a beneficiary's right to an
impartial appeal process, an on-the-record hearing, conducted
by an impartial judge with decisional independence, must be
conducted in accordance with the Administrative Procedure Act
to ensure due process, without agency interference, or
political bias. Replacing this appeals step and the role of
independent administrative law judges (ALJs) with SSA employees
jeopardizes the independence of the process. In light of the
harm that would be caused by this policy change, the Committee
strongly urges SSA not to exercise this authority.
Authorization of Disability Evidence Collection.--The
Committee appreciates that SSA is working to increase its
ability to directly obtain electronic medical records and other
evidence necessary for disability claims determination. The
Committee expects that the Commissioner will continue to ensure
that evidence is only accessed under a voluntary, time-limited,
and revokable authorization by the claimant to permit medical
providers and other sources to disclose information directly to
SSA, consistent with Federal, State, and local laws.
Disability Backlogs.--The Committee recognizes that the
pandemic disrupted SSA operations, generating significant new
delays in initial disability claims and reconsideration
appeals, and temporarily halting in-person hearings before
ALJs. The Committee requests SSA submit to the Committee within
90 days of enactment of this Act a plan for reducing the
initial and reconsideration claims backlogs, and continue to
submit to the Committee quarterly reports on disability
hearings backlogs until SSA has eliminated the hearings backlog
and achieved its monthly average processing time goal. The
Committee urges the Commissioner to prioritize the hiring of
additional staff at the DDS agencies to determine initial
claims and reconsideration appeals, as well as ALJs and
requisite staff to adjudicate backlogged hearings claims.
Disability Determinations.--The Committee remains concerned
about the time it takes SSA to effectuate favorable SSI and/or
SSDI disability determinations and requests a briefing on the
issue withing 30 days of receiving the report on Disability
Determinations as requested in House Report 117-96.
Employee Incentives.--The Committee directs SSA to submit a
report to the Committee within 180 days of enactment of this
Act exploring the feasibility of using employee incentives,
including an agency student loan repayment program, to improve
recruitment and retention for qualified candidates across the
agency.
Field Office Closures.--The Committee recognizes the
essential role that field offices play in the public's ability
to access SSA benefits and services and strongly encourages the
Commissioner to take every action possible to maintain
operations at existing field offices. The Committee urges SSA
to ensure its policies and procedures for closing field offices
include at least 120 days advance notice to the public, SSA
employees, Congress, and other stakeholders. Such notice should
include a rationale for the proposed closure, and an evaluation
of the effects on the public and SSA operations.
Improving Ticket to Work Administration and Reducing
Overpayments.--The Committee recognizes that overpayments due
to delays in SSA processing are an issue for beneficiaries who
are attempting to return to work, including through the Ticket
to Work program. The Committee recommends SSA work to identify
the root causes of overpayments and requests a briefing within
90 days of enactment of this Act on agency efforts to improve
administrative processes to reduce overpayments.
Information Technology.--The Committee is concerned that
SSA's antiquated Information Technology (IT) service management
system is adversely impacting agency staff's ability to deliver
the value, service, and efficiency that the public expects and
deserves. The Committee recognizes that SSA began modernizing
its IT Service Management tools in fiscal year 2021, and
expects SSA to continue working on IT solutions to improve
customer service, ensure high availability and service
continuity, optimize operational efficiency, and maximize
enterprise productivity.
The Committee continues to monitor the IT Modernization
Plan and encourages SSA to focus on improvements to customer
service and efficiency as it makes updates to the plan. In
addition, SSA should take steps to automate manual processes
performed by staff, to reduce human error and improve
processing time. The Committee continues to request an update
of the plan referenced under this heading in House Report 114-
699.
Legal Assistants.--The Committee understands that the
Office of Hearings Operations (OHO) relies on legal assistants
to conduct a broad range of work supporting hearings and
reviewing work of its administrative law judges, and urges SSA
to examine the position descriptions of legal assistants, pay
and actual work conducted, to ensure that job classifications
and compensation are commensurate with current duties.
Pilot Program Metrics.--The Committee expects SSA to
continue to follow the guidance and directives under this
heading in House Report 116-450 for fiscal year 2023, and to
include descriptions of pilots and associated pilot program
metrics in its fiscal year 2024 Congressional Budget
Justification.
Professional Representatives.--The Committee believes that
quality representation in matters with SSA assists claimants
and beneficiaries, and can also help SSA work more accurately
and efficiently. The Committee appreciates that the
Commissioner is raising the cap on fees payable via fee
agreement, and encourages the Commissioner to index the cap to
account for inflation in future years.
Program Integrity.--The Committee notes that the FY 2023
President's Budget again proposes language for this account to
expressly prohibit program integrity funding from being
reprogrammed or transferred for non-program integrity
activities.
With respect to the reprogramming restriction portion of
the proposal, the Committee does not accept this proposal again
because the Congress need not expressly prohibit actions that
it has not authorized. Under the statutory terms of the
appropriation, amounts provided for program integrity
activities may not be reprogrammed to base activities (or to
any other non-program integrity activity). That is because this
appropriation account statutorily establishes a required
appropriation amount for program integrity activities--in this
bill, at $1,799,000,000--which is provided by the sum of the
amounts specified in the first and second provisos of the
account's second paragraph. The bill also continues to
emphasize that ``no more than'' that required sum for program
integrity activities may be used for program integrity
purposes. The Committee reminds SSA that this emphasis has been
included since FY 2017 in response to SSA's view that other
funds in the account, in addition to the sum statutorily
required for program integrity activities, were otherwise
available for program integrity activities. The Committee
continues to agree with the explanatory statement accompanying
the Consolidated Appropriations Act, 2017 that this emphasis
``is for SSA to support program integrity activities solely
from funds available for that purpose.''
Finally, with respect to the transfer prohibition portion
of the proposal, the Committee has not been apprised of any
applicable transfer authority available to SSA that the
President's Budget proposal seeks to prevent and therefore does
not accept the proposal again.
Report on LAE Expenditures.--The Committee continues to
request that the data referenced under this heading in House
Report 114-699 be included in future budget justifications. In
addition, the Committee requests the fiscal year 2024
Congressional Budget Justification include a historical table
of costs and fiscal year 2024 requests for personnel and
benefits, by major SSA component to include Operations (field
offices, teleservice centers, processing centers, and regional
offices); Office of Hearings Operations; Systems; Office of
Analytics, Review, and Oversight; and Headquarters.
Service to the Public.--SSA uses Public Service Indicators
to measure the agency's progress in meeting the needs of the
public in local field offices and teleservice centers. The
Committee directs SSA to submit to the Committee within 90 days
of enactment of this Act an updated report on Public Service
Indicators for field offices and teleservice centers, providing
the indicators and performance for Fiscal Years 2016 to 2022.
Such report shall also detail any staffing needs and resources
necessary in its field offices and teleservice centers to
restore previous levels of public service.
Telework.--The Committee reiterates its support for well-
managed telework programs in the Federal workplace and
understands that SSA is in the process of evaluating how
telework affects service delivery during the reentry evaluation
period of March 30 through September 30, 2022. Within 90 days
of enactment of this Act, the Committee requests a briefing on
how the results of that evaluation will be used to measure and
monitor the impact of telework on customer satisfaction,
service availability including continuity of operations,
workloads management, employee experience, stewardship, and
environmental considerations. In addition, the Committee
directs SSA to submit an update of the report that was
requested under this heading in House Report 117-96, with
updated data on the number of employees eligible and ineligible
to telework, and any limitations or restrictions on the
frequency of telework as a result of the evaluation.
Video Hearings.--The Committee appreciates that SSA has
resumed in-person hearings, and reiterates its support for SSA
allowing a claimant to choose to use video and telephone
hearings on a voluntary basis or to have an in-person hearing
or proceeding if the party chooses to do so.
Work Incentives Planning and Assistance (WIPA) and
Protection and Advocacy for Beneficiaries of Social Security
(PABSS).--The recommendation includes $23,000,000 for WIPA
grants and $10,000,000 for PABSS.
Social Security Advisory Board
The Committee recommends $2,700,000 for the Social Security
Advisory Board (SSAB), $100,000 above the fiscal year 2022
enacted level and $50,000 below the fiscal year 2023 budget
request.
User Fees
In addition to the other amounts provided, the Committee
recommends $140,000,000 for administrative activities funded
from user fees. Of this amount, $139,000,000 is derived from
fees collected from States that request SSA to administer State
SSI supplementary payments. The remaining $1,000,000 is derived
from fees charged to non-attorneys who apply for certification
to represent claimants under titles II and XVI of the Social
Security Act.
Continuing Disability Reviews and Redeterminations
The Committee recommends $1,799,000,000 for program
integrity activities. This includes the maximum cap adjustment
authorized in the terms of section 1(i) of H. Res. 1151 of the
117th Congress as engrossed in the House of Representatives on
June 8, 2022. The bill includes language allowing for the
transfer of up to $15,100,000 to the Office of the Inspector
General for the cost of jointly operating co-operative
disability investigation units.
OFFICE OF THE INSPECTOR GENERAL
Appropriation, fiscal year 2022....................... $108,665,000
Budget request, fiscal year 2023...................... 117,500,000
Committee Recommendation.............................. 117,500,000
Change from enacted level......................... +8,835,000
Change from budget request........................ - - -
The Office of the Inspector General (OIG) is responsible
for meeting the statutory mission of promoting economy,
efficiency, and effectiveness in the administration of SSA
programs and operations and to prevent and detect fraud, waste,
abuse, and mismanagement in such programs and operations. To
accomplish this mission, the OIG directs, conducts, and
supervises audits, evaluations, and investigations relating to
SSA's programs and operations. In addition, the OIG searches
for and reports on systemic weaknesses in SSA programs and
operations, and makes recommendations for needed improvements
and corrective actions.
The bill includes $2,000,000, as requested, for information
technology modernization.
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
use of funds for certain research involving human embryos.
Sec. 507. 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. 508. The Committee continues a provision related to
annual reports to the Secretary of Labor.
Sec. 509. 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. 510. 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. 511. The Committee continues a provision regarding
procedures for reprogramming of funds.
Sec. 512. The Committee continues a provision pertaining to
appointments to scientific advisory committees.
Sec. 513. 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. 514. 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 containing certain information on noncompetitive
contracts, grants, and cooperative agreements exceeding
$500,000 in value.
Sec. 515. 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. 516. The Committee continues a provision prohibiting
the use of funds to implement a Social Security totalization
agreement with Mexico.
Sec. 517. The Committee continues a provision prohibiting
the use of funds for the downloading or exchanging of
pornography.
Sec. 518. The Committee continues a provision related to
reporting requirements for conference expenditures.
Sec. 519. The Committee continues a provision related to
disclosure of U.S. taxpayer funding for programs used in
advertising.
Sec. 520. The Committee continues a provision related to
performance partnership pilots.
Sec. 521. 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.
Sec. 522. The Committee continues a provision related to
grant notifications.
Sec. 523. The Committee continues a provision related to
questions for the record.
Sec. 524. The Committee modifies a provision to make funds
from the Children's Health Insurance Program Performance Bonus
Fund unavailable for obligation in fiscal year 2023.
Sec. 525. The Committee continues a provision related to
research and evaluation funding flexibility.
LABOR, HHS, EDUCATION INCORPORATION OF COMMUNITY PROJECT FUNDING ITEMS
----------------------------------------------------------------------------------------------------------------
Agency Account Project House Amount
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Agape Child & Family Services, $1,000,000
Administration. Memphis, TN for job training,
career placement, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Apprentice Training for the 1,994,875
Administration. Electrical Industry,
Collegeville, PA for green job
workforce development and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Apprenticeship and 675,000
Administration. Nontraditional Employment for
Women, Renton, WA to expand
construction pre-
apprenticeship programming and
CDL training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Artpreneurs, Inc. dba Arts on 100,000
Administration. the Block, Silver Spring, MD
for a creative workforce
apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Association House of Chicago, 500,000
Administration. Chicago, IL for workforce
development training programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Augusta University, Augusta, GA 2,000,000
Administration. for workforce training and job
placement in the healthcare
industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Baltimore Alliance for Careers 827,905
Administration. in Healthcare, Baltimore, MD
for healthcare workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Baycare Health Systems Inc, 963,620
Administration. Clearwater, FL for a workforce
development program focused on
nurses and nursing support
professionals.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Bidwell Training Center, 400,000
Administration. Pittsburgh, PA for the
development of a controlled
environment agriculture
workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Black Veterans for Social 1,000,000
Administration. Justice, Inc., Brooklyn, NY
for stipends, supportive
services, and job placement
for formerly incarcerated
veterans.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Boys & Girls Club of Greater 2,200,000
Administration. Lowell, Inc., Lowell, MA for
workforce development
activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Boys & Girls Club San Fernando 500,000
Administration. Valley, Pacoima, CA for a
youth workforce development
initiative and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Bright Star Community Outreach, 175,000
Administration. Chicago, IL for workforce
development activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Bronx Community College of the 150,000
Administration. City University of New York,
Bronx, NY for health care job
training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Building and Construction 1,000,000
Administration. Trades Council of Alameda
County, Oakland, CA for the
Retention Apprenticeship
Mentoring Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training CAMBA, Inc., Brooklyn, NY for 590,000
Administration. career navigation, job
placement services, and
supportive services for youth.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training CASA, Baltimore, MD for job 573,045
Administration. skills training, job placement
services, stipends, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Center for the Women of New 1,000,000
Administration. York, Kew Gardens, NY for
career skills and job
counseling.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Center for Urban Families, 750,000
Administration. Baltimore, MD for job
readiness programs and job
placement.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Chemeketa Community College, 340,000
Administration. Salem, OR for a commercial
truck driving program and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Dearborn, MI for a 1,000,000
Administration. training program for women who
have been underrepresented in
the workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Houston, TX for job 1,000,000
Administration. training in the home recovery
and construction industries.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Jersey City, NJ for an 750,000
Administration. apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Los Angeles Youth 640,108
Administration. Development Department, Los
Angeles, CA for workforce
development activities and
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Stockton, CA for the 1,000,000
Administration. Youth Workforce Development
Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Colorado Building and 500,000
Administration. Construction Trades Council,
Denver, CO for workforce
training and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Community College of Baltimore 721,130
Administration. County, Baltimore, MD to
expand their CDL training
program and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Community Learning Partnership, 351,000
Administration. Cupertino, CA for job skills
training and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Consortium for Early Learning 1,000,000
Administration. Services, Moreno Valley, CA
for early care and education
workforce development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trade Workforce 1,000,000
Administration. Initiative, Oakland, CA for an
apprenticeship program and
curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000
Administration. Initiative, Fremont, CA for
construction trades
apprenticeship programs and
curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000
Administration. Initiative, Oakland, CA for a
construction apprenticeship
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000
Administration. Initiative, Oakland, CA for an
apprenticeship readiness
program focused on
construction trades.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000
Administration. Initiative, Oakland, CA for
apprenticeship readiness
programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Corporation to Develop 1,862,625
Administration. Communities of Tampa, Inc.,
Tampa, FL for a pre-
apprenticeship program,
apprenticeship program, and
job training services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training County of Delaware, Media, PA 1,988,635
Administration. for the Prison-to-Community
Workforce Development
Initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training County of Los Angeles 2,000,000
Administration. Alternatives to Incarceration
Office (CEO), Los Angeles, CA
for a youth job training
program and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Covenant House Washington, 329,750
Administration. Washington, DC for workforce
development activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Cuyahoga Community College 1,220,000
Administration. District, Cleveland, OH for
smart manufacturing workforce
training, equipment, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Dallas College, Dallas, TX for 500,000
Administration. a teaching residency
apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Delta Veterans Group, Antioch, 100,000
Administration. CA for job readiness
activities supporting veterans.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Des Moines Area Community 339,000
Administration. College, Ankeny, IA for a
workforce development
initiative and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Downriver Community Conference, 703,700
Administration. Southgate, MI for skills
training, job placement, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Easter Seals North Georgia, 200,000
Administration. Inc., Clarkston, GA for early
childhood workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Economic Development and 1,000,000
Administration. Industrial Corporation of
Boston, Boston, MA for
workforce development programs
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Energy Coordinating Agency of 925,000
Administration. Philadelphia, Inc.,
Philadelphia, PA for skill
training in high demand
occupations.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training EntreNous Youth Empowerment 575,000
Administration. Services, Compton, CA for
vocational training and
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fairfax County Government, 2,000,000
Administration. Fairfax, VA for medical
professional workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fairfax County, Fairfax, VA for 2,100,000
Administration. career readiness and job
training for youth.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fresno County Economic 500,000
Administration. Opportunities Commission,
Fresno, CA for vocational
training and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Future Plans Inc., Chagrin 1,000,000
Administration. Falls, OH for the Great Lakes
Career Corridor Project.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Future Plans, Inc., Chagrin 1,995,000
Administration. Falls, OH for a career
planning and community
engagement initiative,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Golden Triangle Resource 1,000,000
Administration. Conservation and Development
Council, Dawson, GA for heavy
equipment training, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Green City Force, Brooklyn, NY 750,000
Administration. to expand their workforce
development program and
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Guilford Child Development, 300,000
Administration. Greensboro, NC for a child
development associate
apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hampton Roads Workforce 850,000
Administration. Council, Norfolk, VA for
maritime workforce development
activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hartford Communities That Care, 1,322,539
Administration. Hartford, CT for a job
training program to address
the need for violence
prevention professionals.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hatzalah Chicago, Lincolnwood, 525,000
Administration. IL for workforce training
activities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Homeboy Industries, Los 1,959,451
Administration. Angeles, CA for job training
for culinary and hospitality
careers and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Howard County Autism Society, 440,000
Administration. Columbia, MD for the Autism
Hiring Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Jewish Community Centers of 1,504,329
Administration. South Broward, Inc., Davie, FL
for employment training for
individuals with IDD.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Jewish Family Service of 550,000
Administration. Atlantic County, Inc.,
Margate, NJ for job skills
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Jobs for America's Graduates of 350,000
Administration. Pennslyvania, Inc.,
Philadelphia, PA to expand
career readiness programs and
skill training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Kean University, Union, NJ for 1,000,000
Administration. workforce development
activities and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training LaGuardia Community College, 404,774
Administration. Long Island City, NY to expand
vocational training for the
underemployed.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Latin American Association, 300,000
Administration. Inc, Atlanta, GA for
employment training, support
services, and a workforce
development initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Latina Coalition of Silicon 376,000
Administration. Vally, San Jose, CA for
workforce development programs
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Laurel Highlands Workforce and 445,000
Administration. Opportunity Center,
Greensburg, PA for a workforce
support program, including
supplies and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Los Angeles Brotherhood 1,000,000
Administration. Crusade--Black United Fund
Inc., CA for youth workforce
development and job placement.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Los Angeles Conservation Corps, 272,000
Administration. Los Angeles, CA, for job
training and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Los Angeles World Airports, Los 1,000,000
Administration. Angeles, CA for an aviation
workforce development program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Mahoning County Career and 285,000
Administration. Technical Center, Canfield, OH
for an energy and technology
workforce training center
project, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Maricopa County Community 1,000,000
Administration. College District, Tempe, AZ
for workforce development
activities and curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training McAllen Independent School 200,000
Administration. District, McAllen, TX for
private pilot and remote drone
license training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Mercy Hospital dba Northern 1,000,000
Administration. Light Mercy Hospital,
Portland, ME for workforce
training and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Michigan Early Childhood 2,000,000
Administration. Investment Corporation,
Lansing, MI for the
development of a child care
workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training MorseLife Health System, West 500,000
Administration. Palm Beach, FL for job
training of underserved
populations and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New Immigrant Community 500,000
Administration. Empowerment, Jackson Heights,
NY to expand a construction
industry workforce development
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New Mexico Highlands 750,000
Administration. University, Las Vegas, NM for
the development of
professional social workers.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New York State Energy Research 3,000,000
Administration. and Development Authority,
Albany, NY for clean energy
workforce development and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Northeast Community College, 1,000,000
Administration. Norfolk, NE for a commercial
driver's license program,
including the purchase of
equipment and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Northwest Arkansas Community 355,000
Administration. College, Bentonville, AR for a
commercial driver's license
program, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Northwest New Mexico Council of 750,000
Administration. Governments, Gallup, NM to
transition and re-skill
workers into the industrial
industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training OCHIN, Inc., Portland, OR for 2,001,642
Administration. health information technology
training and professional
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Opportunity Junction, Antioch, 470,000
Administration. CA for a job training program
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Pasadena Independent School 2,200,000
Administration. District, Pasadena, TX for job
skill training and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Pee Dee Healthy Start Inc., 1,000,000
Administration. Florence, SC for workforce
training and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Plattsburgh-North County 500,000
Administration. Chamber of Commerce,
Plattsburgh, NY for a job
training and assistance
program, including support
services and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Portland Community College, 910,000
Administration. Portland, OR for semiconductor
and advanced manufacturing
workforce development
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Primary Care Coalition of 1,300,000
Administration. Montgomery County, Inc.,
Silver Spring, MD for health
care professionals' workforce
development and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Prince George's County Memorial 2,200,000
Administration. Library System, Largo, MD for
a mobile job readiness unit.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Prince George's County, Largo, 3,000,000
Administration. MD for the Youth@Work program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Promise Neighborhoods of Lehigh 1,549,360
Administration. Valley, Allentown, PA to
expand their workforce
development skills program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Reading and Beyond, Fresno, CA 484,047
Administration. for employment and training
services and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Rockdale County Georgia, 300,000
Administration. Conyers, GA for a workforce
development initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Bernadino Valley College 1,500,000
Administration. Foundation, San Bernadino, CA
for clean energy workforce
development and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Diego Community College 1,000,000
Administration. District, San Diego, CA for
the Gateway to College and
Career program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Diego Workforce 800,000
Administration. Partnership, San Diego, CA for
the TechHire Program..
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Gabriel Valley Council of 2,000,000
Administration. Governments, Alhambra, CA for
a workforce development
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Santa Clara County, San Jose, 3,000,000
Administration. CA for workforce development,
stipends, and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Seattle Jobs Initiative, 1,000,000
Administration. Seattle, WA for green
stormwater infrastructure
workforce development,
stipends, and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Service! Relief Effort for 475,000
Administration. Hospitality Workers, Columbus,
OH for job skills training and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Society for the Advancement of 212,000
Administration. Chicanos/Hispanics and Native
Americans in Science, San
Jose, CA to create a pipeline
from community colleges into
the STEM workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training South Bay Workforce Investment 500,000
Administration. Board Inc., Hawthorne, CA for
occupation training and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training South Texas College, McAllen, 1,000,000
Administration. TX for healthcare workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training St. Clair County 950,000
Administration. Intergovernmental Grants
Department, Belleville, IL for
an advanced manufacturing
program, including support
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training St. Joseph Center, Venice, CA 898,053
Administration. for job skills training and
supportive services to those
experiencing homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Stanislaus Business Alliance 410,000
Administration. dba Opportunity Stanislaus,
Modesto, CA for a logistics
industry focused training
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training State of Maine, Governor's 2,750,000
Administration. Energy Office, Augusta, ME for
job training, job placement
services, stipends, equipment,
and curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Suburban Emergency Medical 247,949
Administration. Services, Palmer, PA for
healthcare workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Suffolk County Community 1,435,000
Administration. College, Selden, NY for a
cybersecurity program,
including the purchase of
equipment and related
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Taller San Jose Hope Builders, 500,000
Administration. Santa Ana, CA for skills
training and employment
placement services for low-
income young adults facing
significant barriers.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Texas Trees Foundation, Dallas, 400,000
Administration. TX for supportive services and
job placement of at-risk young
adults into the green jobs
industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Indianapolis Private 1,000,000
Administration. Industry Council, Inc.,
Indianapolis, IN for youth job
training and a work-based
learning program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Sanneh Foundation, Saint 1,000,000
Administration. Paul, MN for a youth workforce
development program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Torres-Martinez Desert 250,000
Administration. Cahuilla Indian Tribe,
Thermal, CA for a workforce
development program and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The TransLatin@ Coalition, Los 750,000
Administration. Angeles, CA for workforce
development programs and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The WorkPlace, Inc., 1,000,000
Administration. Bridgeport, CT for skills
training, workforce readiness,
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training UAW Labor Employment and 1,000,000
Administration. Training Corporation, St.
Louis, MO for job training in
the automotive services
industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United Way of Greater 1,000,000
Administration. Greensboro, Inc., Greensboro,
NC for job counseling, career
training, and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United We Heal Training Trust 892,000
Administration. dba Oregon AFSCME Training
Trust, Portland, OR for pre-
apprenticeship education and
training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United We Heal, Portland, OR 892,000
Administration. for pre-apprenticeship and
apprenticeship programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training University of California, San 1,600,000
Administration. Diego, La Jolla, CA for job
skills development and
supportive services for a
child care worker and
providers pipeline.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training University of Georgia, Athens, 3,000,000
Administration. GA for the Archway Partnership.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Unloop, Seattle, WA for job 486,781
Administration. training in the tech industry
and supportive services for
those with conviction
histories.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Urban League of Long Island, 1,145,820
Administration. Inc, Plainview, NY for
workforce development
activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Urban League of Louisiana, New 1,200,000
Administration. Orleans, LA for the Career
Pathways Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training US HART CARES A NJ NONPROFIT 1,000,000
Administration. CORPORATION, Atlantic City, NJ
for cyber job training
program, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Valley of the Sun Young Men's 1,000,000
Administration. Christian Association,
Phoenix, AZ for expanding a
current youth workforce
development program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Variety Boys and Girls Club of 250,000
Administration. Queens, Inc., Long Island
City, NY for job readiness and
supportive services for teens.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Virginia Commonwealth 1,000,000
Administration. University Health System
Authority, Richmond, VA for
healthcare workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Watts Labor Community Action 783,067
Administration. Committee, Los Angeles, CA for
job training, workforce
development activities, and
job placement services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Wayne Community College, 651,000
Administration. Goldsboro, NC to expand its
apprenticeship training
programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Workforce Connections, Las 800,000
Administration. Vegas, NV for workforce
development programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Workforce Inc. dba 1,000,203
Administration. Recycleforce, Indianapolis, IN
to expand job training and job
placement programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Young Men's and Young Women's 1,000,000
Administration. Hebrew Association of
Washington Heights and Inwood,
New York, NY for vocational
training, workforce
development, and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Young Women's Christian 690,449
Administration. Association of Yonkers, Inc.,
Yonkers, NY for a workforce
development initiative and
support services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and 100 Suits for 100 Men, 750,000
Services Families. Laurelton, NY for a youth
employment training program,
including for the purchase of
food and equipment, to serve
vulnerable families and
seniors and improve economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and A New Way of Life Reentry 1,000,000
Services Families. Project, Los Angeles, CA for
housing, legal clinics,
educational opportunities and
supportive services to improve
outcomes and economic
opportunities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Action for a Better Community, 517,000
Services Families. Inc., Rochester, NY for
employment advancement,
benefit and eligibility
mapping, and other services to
help individuals and families
move towards financial
sustainability.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Adoptions Together, Calverton, 750,639
Services Families. MD for trauma-informed care
training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Alfond Youth and Community 500,000
Services Families. Center, Waterville, ME for
targeted support services to
children and families in need.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and All Star Children's Foundation, 1,500,000
Services Families. Sarasota, FL for a foster care
program, including behavioral
health services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Big Brothers Big Sisters Lone 300,000
Services Families. Star, Irving, TX for a youth
mentoring program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Bivona Child Advocacy Center, 306,000
Services Families. Rochester, NY for child abuse
prevention training and
programs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Boys & Girls Clubs of America, 2,000,000
Services Families. Atlanta, GA for increasing
support services and abuse
prevention resources to
recognize and reduce abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Bucks County Opportunity 1,000,000
Services Families. Council, Doylestown, PA for a
self-sufficiency program,
including supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Center for Pan Asian Community 300,000
Services Families. Services, Inc., Atlanta, GA
for survivor-centered, trauma-
informed services for women
and families to work towards
self-reliance.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Childhelp Inc., Scottsdale, AZ 1,000,000
Services Families. for outreach, education
materials and programming to
reduce and prevent child abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Children's Home of Stockton, 973,552
Services Families. Stockton, CA for supportive
housing, services, supplies,
transportation expenses, and
goods, including the purchase
of food, to help establish
self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Christus Santa Rosa Health Care 472,699
Services Families. Corporation, San Antonio, TX
for training and education to
reduce and prevent child abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Circle of Brotherhood, Miami, 2,000,000
Services Families. FL for a social services hub
focused on assistance to low
income families to improve
life and economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and City of Boston, MA for housing, 1,000,000
Services Families. educational and support
services for children and
families, and to provide
parents with opportunities to
reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and City of Jersey City, NJ for 500,000
Services Families. expanding domestic violence
intervention services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and City of Leander, TX for a child 500,000
Services Families. abuse prevention and treatment
program, including the
purchase of information
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and City of Los Angeles, CA for 982,045
Services Families. operating costs and community
services, including motel
vouchers and the purchase of
food, to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and City of Mount Vernon, NY for 999,000
Services Families. services to support at-risk
girls and to improve
employment opportunities and
economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and City of Richmond, VA for social 797,329
Services Families. services and a one-stop shop
to help families and
individuals working to
establish financial self-
sufficiency and for social
service providers working to
reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and City of Rochester, NY for youth 500,000
Services Families. employment services and young
adult workforce development to
increase self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Columbus Metropolitan Housing 1,000,000
Services Families. Authority, Columbus, OH for
informational and financial
resources to assist residents
and achieve economic self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Community Action Network, Ann 500,000
Services Families. Arbor, MI for educational and
social-emotional services to
achieve self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Community Help Center DBA 333,000
Services Families. Muslim Women Resource Center,
Chicago, IL for the purchase
of equipment to help achieve
self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and County of San Diego, CA for 220,000
Services Families. training and materials for
child welfare programs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Court Appointed Special 175,000
Services Families. Advocates (CASA) of Ocean
County, Toms River, NJ for
increasing volunteers to
advocate for foster care
children.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Court Appointed Special 40,000
Services Families. Advocates of Mercer County,
Ewing, NJ for expanding
services for, and increasing
the number of volunteers
available to work with,
children aging out of foster
care.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Eastern Shore Coalition Against 250,000
Services Families. Domestic Violence, Onancock,
VA for staffing, children's
programming, and supplies to
support survivors of abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Eastmont Community Center, Los 100,000
Services Families. Angeles, CA for equipment and
services for low income
families to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Elite Learners, Brooklyn, NY 750,000
Services Families. for promoting financial
literacy and management
services to increase self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Father Flanagan's Boys' Home, 1,000,000
Services Families. Boys Town, NE for an at-risk
youth program, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and First 5 Contra Costa Children 150,000
Services Families. and Families Commission,
Concord, CA for a workforce
compensation assessment to
build a pipeline for more to
attain economic stability.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Food Bank of Eastern Michigan, 2,000,000
Services Families. Flint, MI for the purchase of
equipment and food to support
mobile food distributions.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Foodbank of Southeastern 447,600
Services Families. Virginia and the Eastern
Shore, Norfolk, VA for
staffing costs and the
purchase of food and
equipment, for mobile food
distribution.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and FoodCycle Food Recovery 652,500
Services Families. Network, Los Angeles, CA for
services and the purchase of
equipment for a hub to improve
access to food resources to
combat hunger and reduce
poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Georgia Center for Child 200,000
Services Families. Advocacy, Atlanta, GA for
services, education and
outreach to support families
affected by abuse or trauma.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Georgia State University, 700,000
Services Families. Atlanta, GA for services and
the purchase of equipment to
improve emotional and economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Goodness Village, Livermore, CA 1,000,000
Services Families. for housing support and
services to improve self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Guardian House, San Antonio, TX 483,963
Services Families. for a parenting education
program to reduce and prevent
child abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Hellenic American Neighborhood 500,000
Services Families. Action Committee INC, New
York, NY for education and
language services to improve
employment and economic
outcomes and reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Helping Mamas, Inc., Norcross, 195,475
Services Families. GA for products and services,
including the purchase of
equipment and goods, for a
mobile distribution project to
support long-term financial
security.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Higher Ground A Resource 1,088,768
Services Families. Center, Tucson, AZ for
coordinating resources and
services to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Houston Area Women's Center 1,000,000
Services Families. (HAWC), Houston, TX for
services to support children
and families affected by
violence.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Individuals Aiding in 50,000
Services Families. Emergencies Foundation, Aston,
PA for products and services
for low-income individuals to
reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and IU Health Foundation, 600,000
Services Families. Indianapolis, IN for services
to improve health and
nutrition of vulnerable
individuals and provide job
training and new employment to
improve outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Kids' Voice of Indiana, 185,000
Services Families. Indianapolis, IN for services
to children and families who
are survivors of violence,
abuse, or neglect.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Knoxville-Knox County Community 575,000
Services Families. Action Committee, Knoxville,
TN for a Head Start program,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and La Jornada LTD, Flushing, NY 250,000
Services Families. for expanding educational
supports and workshops for
families in poverty to promote
healthy living and improve
economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Labor Community Services of Los 600,000
Services Families. Angeles (LCS) , Los Angeles,
CA for services, and transport
and purchase of goods,
including food, to reduce
poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Larkin Street Youth Services, 1,550,000
Services Families. San Francisco, CA for safe,
stable housing with wraparound
case management, education and
employment support to reduce
poverty and improve economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Long Island Cares, Hauppauge, 360,100
Services Families. NY for the purchase of food
and social services, to
connect individuals to
referral and benefits programs
and reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Long Island Cares, Inc., 400,000
Services Families. Hauppauge, NY for the purchase
of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Make the Road New York, 800,000
Services Families. Brooklyn, NY for adult
literacy programs and
services, including the
purchase of equipment, to
improve economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Make the Road New York, 400,000
Services Families. Brooklyn, NY for education and
services, including for the
purchase of equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Make the Road New York, 400,000
Services Families. Brooklyn, NY for equipment and
services, including the
purchase of technology, to
reduce poverty and create
opportunities for economic
advancement.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Maternal and Family Health 2,150,000
Services Families. Service, Inc., Wilkes-Barre,
PA for improving access to
social services for at-risk
and low-income women, children
and families.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and McMahon Ryan Child Advocacy 125,000
Services Families. Center, Syracuse, NY for a
child abuse prevention and
education program, including
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Metropolitan Council on Jewish 1,000,000
Services Families. Poverty, New York, NY for anti-
poverty services and
assistance, including for the
purchase of food, to create
pathways to self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Metropolitan Council on Jewish 2,000,000
Services Families. Poverty, New York, NY for
supplying pantries with
essential products, including
food, formula, diapers and
diapering supplies, menstrual
and hygiene products, to meet
the essential needs of women
and infants to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Michigan State University Child 2,187,500
Services Families. Development Laboratories, East
Lansing, MI for staffing and
training, including equipment,
to serve at-risk children and
improve economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Mitzvah Circle Foundation, 300,000
Services Families. Norristown, PA for products
and services to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Mott Community College, Flint, 2,064,000
Services Families. MI for increasing access to
high quality language
education materials for
families and young children to
improve economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Muslim Community Center (MCC) -- 250,000
Services Families. East Bay, Pleasanton, CA for
services including rental
assistance, to assist refugees
as they work towards self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Neighborhood Legal Services of 817,006
Services Families. Los Angeles County, Glendale,
CA for advocates to partner
with justice-involved
individuals to identify and
address barriers to self-
sufficiency and family well-
being.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Newark Emergency Services for 1,107,500
Services Families. Families, Inc., Newark, NJ for
services and the purchase of
equipment and goods, including
food, for fresh food
distribution, healthy cooking
workshops, and art therapy
classes for children and
families.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Next Door Solutions to Domestic 125,000
Services Families. Violence, San Jose, CA for
violence prevention and
intervention services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Office of the Mayor, New York 2,000,000
Services Families. City, NY for improving
coordination between social
agencies to support children
and families.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and One Nation Dream Makers, 2,000,000
Services Families. Livermore, CA for services
including the purchase of food
and equipment to distribute
food to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Oregon Community Programs, 1,000,000
Services Families. Eugene, OR for supporting
foster youth and families and
improving the administration
of the foster care program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Plaza Comunitaria Sinaloa, 800,000
Services Families. Mission Hills, CA for
expanding educational programs
and implementing workforce
development programs to
provide low-income individuals
with access to better job
opportunities to improve
economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Safe Space, Inc., Louisburg, NC 197,800
Services Families. for culturally-specific child
abuse prevention services for
at-risk families.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Samuel Field YM-YWHA dba 1,000,000
Services Families. Commonpoint Queens, Little
Neck, NY for workforce and
wraparound services to improve
economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and San Diego County, CA for 500,000
Services Families. outreach and recruitment of
foster care families to
support children.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Sanctuary of Hope, Los Angeles, 749,920
Services Families. CA for expanded navigation and
support services to improve
employment, education, and
economic opportunities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Save the Children Federation, 1,080,764
Services Families. Inc., Fairfield, CT for
programs, workshops, services
and goods, including the
purchase of food and
equipment, to reduce poverty
and improve outcomes for
children and families.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and South Central LAMP, Los 100,000
Services Families. Angeles, CA for support
services for children and
families.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Southwest Georgia Children's 367,362
Services Families. Alliance, Inc., Americus, GA
for child abuse treatment and
prevention programs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Spectrum Youth and Family 225,000
Services Families. Services, Burlington, VT for
services and direct assistance
to improve self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and The Center for Hope and 505,813
Services Families. Healing, Inc., Lowell, MA for
services and supplies to
establish financial stability
and security through job
training and soft skills
development.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and The Children's Home Society of 631,500
Services Families. New Jersey, Trenton, NJ for
employment training and
related expenses for low
income women to improve health
and economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and The Early Excellence Project, 600,000
Services Families. Pittsburgh, PA for expanding
educational opportunities and
improving economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Today is a Good Day, Flourtown, 332,275
Services Families. PA for personal and financial
supports for families.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and UCAN, Chicago, IL for expanding 1,000,000
Services Families. programs and social services
supporting foster youth to
improve economic outcomes and
community well-being.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and United Jewish Organizations of 1,200,000
Services Families. Williamsburg Inc., Brooklyn,
NY for a social services
initiative connecting families
to assistance to reduce
poverty and improve economic
independence.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and United Way of Central and 150,000
Services Families. Northeastern Connecticut,
Hartford, CT for training and
outreach programs, services,
and literacy supports for
under-resourced communities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and United Way of Greater 255,000
Services Families. Cleveland, Cleveland, OH for
the 2-1-1 system, including
the purchase of information
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and United Way of Greater Union 100,000
Services Families. County, Elizabeth, NJ for
addressing food insecurity,
access to transportation and
healthcare, and financial
stability.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and United Way of Southern Nevada, 1,000,000
Services Families. Las Vegas, NV for programs
that improve self-sufficiency
and reduce poverty for the non-
English proficient community.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and UnLocal, Inc., New York, NY for 1,000,000
Services Families. services, education and
outreach to help financial
self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Volunteers of America Delaware 479,100
Services Families. Valley, Camden, NJ for
partnerships to promote human
trafficking victimization
education and awareness and
prevent abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Wellroot Family Services, 286,500
Services Families. Tucker, GA for housing and
services and supplies,
including the purchase of
food, to improve economic
outcomes of young adults
transitioning out of foster
care or experiencing
homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Wellspring Living, Inc, 245,560
Services Families. Atlanta, GA for workforce
services for victims of sexual
exploitation and violence to
increase employment
opportunities and improve
economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and WestCare Ohio, Inc., Dayton, OH 1,000,000
Services Families. for community services
programming, including
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and White Pony Express, Pleasant 105,000
Services Families. Hill, CA for services, and the
purchase of food and equipment
to support low income children.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and Willow Domestic Violence Center 325,000
Services Families. of Greater Rochester, Inc.,
Rochester, NY for services and
training to support survivors
of abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Children and YMCA of Greater Louisville, 200,000
Services Families. Louisville, KY, for model
service improvement,
information dissemination, and
technical assistance to
address and prevent child
abuse and neglect.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community A Kid Again, Columbus, OH for 510,000
Services Living. increasing access to
therapeutic events for
children, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community AIDS Foundation of Chicago, 250,000
Services Living. Chicago, IL for training and
services to better support
seniors living with HIV.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Alpha Phi Alpha Senior Citizens 154,000
Services Living. Center, Inc., Cambria Heights,
NY for assisted transportation
services, including for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Alzheimer's Foundation of 250,000
Services Living. America, Amityville, NY for an
Alzheimer's education,
training, and supportive
services center, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community APNA Brooklyn Community Center, 670,902
Services Living. Inc., Brooklyn, NY for
expanding senior services,
including for the purchase of
food and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Arc of Prince George's County 819,500
Services Living. Inc., Largo, MD for expanding
services for individuals with
disabilities to prepare them
for employment and independent
living.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community BakerRipley, Houston, TX for 1,000,000
Services Living. increasing access to food and
other services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Bancroft, Cherry Hill, NJ for 500,000
Services Living. increasing independent living,
including for the purchase of
equipment, including
technology and devices.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Central Massachusetts Agency on 1,200,000
Services Living. Aging, Inc., Worcester, MA for
increasing services and
resources for grandparents
raising grandchildren.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Charter Township of Commerce, 235,050
Services Living. Commerce Township, MI for
increasing senior reading and
independence including for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Choice in Aging, Pleasant Hill, 500,000
Services Living. CA for increasing access to
and awareness of community-
based alternatives to nursing
homes.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community City of Ontario, CA for 439,094
Services Living. expanding wellness programs,
meal services, and
transportation services for
seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Clausen House, Oakland, CA for 1,058,408
Services Living. an adult transition services
program to improve employment,
educational, life skills and
supports for individuals with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Community Action of Greater 100,000
Services Living. Indianapolis, Indianapolis, IN
for services, outreach,
events, transportation
expenses, and supplies to
increase the number of senior
volunteers in their
communities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Community Services Inc. of 270,475
Services Living. Ocean County, Manahawkin, NJ
for increasing food delivery
to seniors, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Creative Enterprises, Inc, 612,320
Services Living. Lawrenceville, GA for
expanding access and
increasing opportunities for
employment and community
inclusion, including the
purchase of equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Designated Exceptional Services 85,000
Services Living. for Independence (DESI), Los
Angeles, CA for expanding
access to and delivery of food
for seniors, including for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community DOROT, Inc., New York, NY for 551,210
Services Living. expanding intergenerational
programming to increase social
enrichment services for older
adults.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Endeavor Forward, Inc, 300,000
Services Living. Marianna, FL for a transition
program for adults with autism.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Fairfax County, VA for services 1,000,000
Services Living. and purchase of equipment,
including technology, to
increase access to technology
and community engagement.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Friendship Circle, West 364,009
Services Living. Bloomfield Township, MI for
expanding developmental
learning opportunities to
promote independence of
students with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Hawaii Public Health Institute, 1,800,000
Services Living. Honolulu, HI for support
navigator services for seniors
and caregivers.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Health Care District of Palm 1,000,000
Services Living. Beach County, West Palm Beach,
FL for falls and injury
prevention programs, outreach,
and education.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community India Home, Inc., Jamaica, NY 500,000
Services Living. for an outreach program to
promote and incentivize senior
health.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Island Harvest, Brentwood, NY 1,100,000
Services Living. for a nutrition program,
including the purchase of
food, supplies and equipment,
and information technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Jewish Service for the 760,000
Services Living. Developmentally Disabled
(JSDD), Livingston, NJ for
equipment and support to
expand access to technology
for individuals with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Lighthouse for the Visually 600,000
Services Living. Impaired and Blind of Pasco,
Hernando and Citrus Counties,
New Port Richey, FL for an
education, training, and
support services program for
seniors with visual impairment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Metropolitan Council on Jewish 1,000,000
Services Living. Poverty, New York, NY for food
and services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Metropolitan Council on Jewish 1,000,000
Services Living. Poverty, New York, NY for food
and services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Metropolitan Council on Jewish 1,000,000
Services Living. Poverty, New York, NY for
increasing senior access to
and delivery of food.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Minute Man Arc for Human 331,110
Services Living. Services, Concord, MA for
increasing community
integration, access to social
services, and benefits
assistance resources.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Ocean Community Economic Action 55,000
Services Living. Now, Inc., Toms River, NJ for
transportation and outreach
activities to expand seniors'
access to community living and
supports.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Pathlights Human Services, 100,000
Services Living. Palos Heights, IL for
expanding access to and
delivery of meals for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community People Inc., Williamsville, NY 2,035,139
Services Living. for improving access to health
services, including for health
staffing, purchase of
equipment and technology
expenses.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Regional Aid for Interim Needs, 800,000
Services Living. Incorporated, Bronx, NY for
wraparound and case management
support services to support
older adults.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Scranton Neighborhood Housing 1,000,000
Services Living. Services, Inc., Scranton, PA
for services including home
repairs and modifications to
support aging in place.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Senior Services of Snohomish 250,400
Services Living. County DBA Homage, Lynnwood,
WA for a rural transportation
project, including the
purchase of equipment, to
increase access to services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Shepherd Center Inc., Atlanta, 800,000
Services Living. GA for the purchase of
equipment, including
information technology, and
training expenses to increase
the independence of people
with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Tennessee State University, 500,000
Services Living. Nashville, TN for a new
program to expand
opportunities for students to
attend college and prepare for
independent living and
employment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community The City of Dover, DE for 500,000
Services Living. improving opportunities for
children, youth and adults who
have physical and intellectual
disabilities, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community The Monmouth Ocean Foundation 400,000
Services Living. for Children (MOFFC), Tinton
Falls, NJ for an autism
education, training, and
support services program,
including the purchase of
information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community The Rosalynn Carter Institute 1,020,047
Services Living. for Caregivers, Americus, GA
for expanding and increasing
awareness of programs for
caregivers.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community The University of Texas at San 492,370
Services Living. Antonio, San Antonio, TX for
an evaluation and research
center to improve access to
care and quality of life
outcomes for individuals
living with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Wesley Community Services, 1,322,415
Services Living. Inc., Johnston, IA for
expanding access to and
delivery of senior services,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community West Bloomfield Parks and 85,000
Services Living. Recreation Commission, West
Bloomfield, MI for social
workers and expansion of
social services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Westchester Residential 500,000
Services Living. Opportunities, Inc., White
Plains, NY for home repairs
and modifications to support
aging in place and enable
healthy living.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community Yellow House Community 250,000
Services Living. Services, Inc., Middlebury, VT
for housing and services for
individuals with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Administration for Community YWCA Greater Los Angeles, Los 375,000
Services Living. Angeles, CA for expanding
senior empowerment services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Abide Women's Health Services, 290,261
Services Administration. Dallas, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services About Sojourners with Healing 167,500
Services Administration. Hearts, West Palm Beach, FL
for a cancer screening
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Adapt, Inc., Roseburg, OR for 1,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Adult & Teen Challenge USA, 750,000
Services Administration. Ozark, MO for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services AdventHealth Durand, West 916,000
Services Administration. Durand, WI for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services AdventHealth for Children, 1,000,000
Services Administration. Orlando, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Adventist Health/Central Valley 1,250,000
Services Administration. Network, Hanford, CA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Adventist HealthCare Fort 1,000,000
Services Administration. Washington Medical Center,
Inc., Fort Washington, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Adventist Healthcare Inc., 500,000
Services Administration. Gaithersburg, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Advocate Health and Hospitals 2,940,000
Services Administration. Corporation, Downers Grove, IL
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Advocates for a Health 2,000,000
Services Administration. Community DBA Jordan Valley
Community Health Center,
Springfield, MO for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Advocates Inc., Framingham, MA 500,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Alivio Medical Center, Chicago, 3,000,000
Services Administration. IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Allegheny Health Network, 1,400,000
Services Administration. Pittsburgh, PA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services AltaMed Health Services, Los 255,000
Services Administration. Angeles, CA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services AltaMed Health Services, Los 2,346,186
Services Administration. Angeles, CA for equipment and
operational costs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services AMAAD Institute, Los Angeles, 935,000
Services Administration. CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services American Indian Health & Family 1,500,000
Services Administration. Services of Southeastern
Michigan, Inc., Detroit, MI
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Americana Community Center 2,000,000
Services Administration. Inc., Louisville, KY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Anna Maria College, Paxton, MA 1,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services APLA Able Arts, Long Beach, CA 500,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Arts and Services for the 980,000
Services Administration. Disabled, Inc. dba Able ARTS
Work, Long Beach, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services ARUP Laboratories, Inc., Salt 3,000,000
Services Administration. Lake City, UT for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Ashtabula County Medical 3,000,000
Services Administration. Center, Ashtabula, OH for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Asian American Drug Abuse 2,230,000
Services Administration. Prevention, Inc., Los Angeles,
CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Asian American Health Coalition- 1,300,000
Services Administration. HOPE Clinic, Houston, TX for
equipment and operational
costs for an oral health
program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Aspire Health Partners, 310,000
Services Administration. Orlando, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Association for Individual 3,000,000
Services Administration. Development, Aurora, IL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Atlantic Health System, 1,000,000
Services Administration. Morristown, NJ for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Auburn Community Hospital, 2,000,000
Services Administration. Auburn, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Aunt Martha's Health and 450,000
Services Administration. Wellness, Olympia Fields, IL
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Aurora Community Mental Health 2,000,000
Services Administration. Center, Aurora, CO for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Ballad Health, Johnson City, TN 605,000
Services Administration. for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Ballad Health, Johnson City, TN 500,000
Services Administration. for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Banyan Community Health Center, 2,500,000
Services Administration. Miami, FL for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Baptist Health Deaconess 515,000
Services Administration. Madisonville, Inc.,
Madisonville, KY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Barton Hose Company No 1. Inc., 1,875,000
Services Administration. Barton, MD for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Bay Area Community Health, 700,000
Services Administration. Fremont, CA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Bay Area Community Health, San 1,000,000
Services Administration. Jose, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Bay County Health Department, 2,000,000
Services Administration. Bay City, MI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Baylor Scott & White Medical 3,000,000
Services Administration. Center--Round Rock, Round
Rock, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Beloved Community Family 2,000,000
Services Administration. Wellness Center, Chicago, IL
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Beth Israel Deaconess Hospital-- 2,000,000
Services Administration. Plymouth, Inc., Plymouth, MA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Block Island Health Services, 2,000,000
Services Administration. New Shoreham, RI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Bobby Benson Center, Kahuku, HI 1,200,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Bon Secours Charity Health 1,000,000
Services Administration. System, Suffern, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Boone Memorial Hospital, Inc., 3,000,000
Services Administration. Madison, WV for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Bread for the City, Washington, 3,000,000
Services Administration. DC for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Brockton Neighborhood Health 1,000,000
Services Administration. Center, Brockton, MA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Bronx Community Health Network, 2,001,503
Services Administration. Bronx, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Brooks County Independent 1,500,000
Services Administration. School District, Falfurrias,
TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Brownsville Community 2,200,000
Services Administration. Development Corporation,
Brooklyn, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cabell Huntington Hospital, 3,000,000
Services Administration. Inc., Huntington, WV for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services California State University, 2,000,000
Services Administration. San Bernardino, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services CalvertHealth Medical Center, 950,000
Services Administration. Prince Frederick, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cambridge Public Health 1,000,000
Services Administration. Commission (dba Cambridge
Health Alliance), Cambridge,
MA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Campbell City School District, 2,000,000
Services Administration. Campbell, OH for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Caridad Center, Inc., Boynton 1,000,000
Services Administration. Beach, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cedar Riverside People's 1,000,000
Services Administration. Center, Minneapolis, MN for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Center for Addiction Treatment, 500,000
Services Administration. Cincinnati, OH for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Centerstone, Bradenton, FL for 1,200,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Central Pennsylvania Institute 2,000,000
Services Administration. of Science and Technology,
Bellefonte, PA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Central Piedmont Community 575,000
Services Administration. College, Charlotte, NC for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Central Vermont Medical Center, 735,560
Services Administration. Berlin, VT for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Central Washington University, 1,000,000
Services Administration. Ellensburg, WA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services CentraState Medical Center, 615,000
Services Administration. Inc. , Freehold, NJ for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Centro del Barrio, Inc., San 1,000,000
Services Administration. Antonio, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Centro Hispano Daniel Torres 635,713
Services Administration. Inc., Reading, PA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Charles River Community Health 247,000
Services Administration. Center, Waltham, MA for an
electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Charlotte Community Health 600,000
Services Administration. Clinic, Inc., Charlotte, NC
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Chattanooga-Hamilton County 2,000,000
Services Administration. Hospital Authority d/b/a
Erlanger Health System,
Chattanooga, TN for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cherry Creek School District, 1,500,000
Services Administration. Greenwood Village, CO for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cherry Hill Free Clinic, Cherry 440,905
Services Administration. Hill, NJ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Children's Health Clinical 1,000,000
Services Administration. Operations, Dallas, TX for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Children's Hospital Los 1,500,000
Services Administration. Angeles, Los Angeles, CA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Children's Clinic dba TCC 575,000
Services Administration. Family Health, Long Beach, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Children's Health Clinical 1,000,000
Services Administration. Operations, Dallas, TX for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Children's Health of Orange 1,000,000
Services Administration. County, Orange, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Children's Hospital Medical 2,000,000
Services Administration. Center of Akron, OH for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Chinatown Service Center, 215,000
Services Administration. Monterey Park, CA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Chinese Culture and Community 1,000,000
Services Administration. Service Center, Inc.,
Gaithersburg, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Chiricahua Community Health 983,265
Services Administration. Centers, Inc., Douglas, AZ for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services ChristianaCare Health System, 900,000
Services Administration. Wilmington, DE for a nutrition
program for pregnant women.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services CHRISTUS Ochsner Health 1,000,000
Services Administration. Southwestern Louisiana -- St.
Patrick Hospital, Lake
Charles, LA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services CHRISTUS St. Frances Cabrini 775,000
Services Administration. Hospital, Alexandria, LA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cincinnati Children's Hospital 630,000
Services Administration. Medical Center, Cincinnati, OH
for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services City of Albuquerque, NM for 2,200,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services City of Berea, KY for equipment 350,000
Services Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services City of Greenville, MS for 2,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services City of Guin, AL for facilities 150,000
Services Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services City of Hope National Medical 150,000
Services Administration. Center, Duarte, CA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services City of Houston--Houston Health 1,000,000
Services Administration. Department, Houston, TX for a
vision health program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services City of West Hollywood, CA for 300,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Clay County Healthcare 1,500,000
Services Administration. Authority, Ashland, AL for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cleveland Clinic, Cleveland, OH 905,000
Services Administration. for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cleveland Clinic, Cleveland, OH 615,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Clinica Msr. Oscar A. Romero, 1,000,000
Services Administration. Los Angeles, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cold Spring Harbor Laboratory, 1,000,000
Services Administration. Cold Spring Harbor, NY for
equipment and operational
costs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services College of Southern Nevada, 750,000
Services Administration. North Las Vegas Campus, North
Las Vegas, NV for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services CommuniCare Health Centers, 1,500,000
Services Administration. West Sacramento, CA for an
electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Bridges, Inc., Mesa, 1,000,000
Services Administration. AZ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Care Clinic of 575,000
Services Administration. Franklin, Inc., Franklin, NC
for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Consolidated School 1,000,000
Services Administration. District 21, Wheeling, IL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Foundation of Greater 3,000,000
Services Administration. Muscatine, Muscatine, IA for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Health Partnership, 175,000
Services Administration. San Jose, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Medical Centers, 500,000
Services Administration. Stockton, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Medical Centers, 950,000
Services Administration. Stockton, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Community Regional Medical 1,500,000
Services Administration. Center, Fresno, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Compass Health, Inc., St. 1,000,000
Services Administration. Peters, MO for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Comprehensive Community Action, 1,000,000
Services Administration. Inc., Cranston, RI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Connecticut Hospice, Inc., 1,940,000
Services Administration. Branford, CT for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Connecticut Institute For 2,000,000
Services Administration. Communities, Inc., Danbury, CT
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cook County Health, Chicago, IL 1,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cooperman Barnabas Medical 1,000,000
Services Administration. Center, Livingston, NJ for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cornerstone Family Healthcare, 2,800,000
Services Administration. Cornwall, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cortland County, NY for 2,995,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Bernalillo, 422,031
Services Administration. Albuquerque, NM for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Clark, Las Vegas, NV 1,330,000
Services Administration. for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Clark, Las Vegas, NV 1,600,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Culpeper, VA for 324,494
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Delaware, Media, PA 1,750,000
Services Administration. for an electronic health
records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Fairfax, VA for 1,700,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Lane, Eugene, OR for 1,500,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Montgomery, 3,000,000
Services Administration. Rockville, MD for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Northampton, Easton, 1,000,000
Services Administration. PA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Oakland, Pontiac, MI 1,200,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Orange, Santa Ana, CA 3,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Riverside--Riverside 1,000,000
Services Administration. University Health System,
Moreno Valley, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Riverside--Riverside 1,000,000
Services Administration. University Health System,
Riverside, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of San Mateo, CA for an 1,000,000
Services Administration. electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Taos, NM for 2,200,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services County of Wake, Raleigh, NC for 2,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Covenant Community Care, Inc., 500,000
Services Administration. Detroit, MI for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cowlitz Indian Tribe, Longview, 765,000
Services Administration. WA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cowlitz Indian Tribe, Longview, 1,000,000
Services Administration. WA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Crouse Health, Syracuse, NY for 1,010,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cullman Regional Medical 1,585,000
Services Administration. Center, Inc., Cullman, AL for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Cumberland University, Lebanon, 750,000
Services Administration. TN for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Denver Health and Hospital 2,200,000
Services Administration. Authority, Denver, CO for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Desert AIDS Project, Palm 2,000,000
Services Administration. Springs, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Division of Infectious 500,000
Services Administration. Diseases, University of Miami
Miller School of Medicine,
Miami, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Downtown Emergency Service 985,000
Services Administration. Center, Seattle, WA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Doylestown Health Foundation 1,000,000
Services Administration. D.B.A. Doylestown Health,
Doylestown, PA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Duncan Regional Hospital, Inc., 750,000
Services Administration. Duncan, OK for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Duquesne University, 2,200,000
Services Administration. Pittsburgh, PA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services East Bay Community Action 513,600
Services Administration. Program, Newport, RI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services East Tennessee Children's 2,500,000
Services Administration. Hospital, Knoxville, TN for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Easterseals of Oak Hill, 1,874,000
Services Administration. Hartford, CT for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Edward M. Kennedy Community 1,000,000
Services Administration. Health Center, Inc.,
Worcester, MA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Edward M. Kennedy Health 3,000,000
Services Administration. Center, Inc., Boston, MA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Eisner Health, Los Angeles, CA 610,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services El Centro de Corazon, Houston, 3,000,000
Services Administration. TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services El Paso Children's Hospital, El 595,000
Services Administration. Paso, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services El Proyecto del Barrio Inc., 1,000,000
Services Administration. Winnetka, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Ellis County Coalition for 3,000,000
Services Administration. Health Options, Inc., dba Hope
Clinic, Waxahachie, TX for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Erie Family Health Centers, 1,173,900
Services Administration. Chicago, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Escambia County Health Care 655,000
Services Administration. Authority dba Atmore Community
Hospital, Atmore, AL for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Fair Haven Community Health 3,000,000
Services Administration. Clinic, Inc., New Haven, CT
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Family Centers Inc., Stamford, 1,000,000
Services Administration. CT for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Family Christian Health Center, 353,441
Services Administration. Harvey, IL for equipment and
operational costs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Family Health Services 1,550,000
Services Administration. Corporation, Twin Falls, ID
for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Ferd & Gladys Alpert Jewish 700,000
Services Administration. Family & Children's Service of
Palm Beach County, Inc., West
Palm Beach, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Figgers Foundation, Lauderhill, 2,200,000
Services Administration. FL for a telehealth initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Finkelstein Memorial Library, 2,000,000
Services Administration. Spring Valley, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services First Nations Community 1,000,000
Services Administration. HealthSource, Albuquerque, NM
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Flaget Memorial Hospital 635,000
Services Administration. Foundation, Bardstown, KY for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Florida International 3,000,000
Services Administration. University, Miami, FL for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Florida State University, 2,490,000
Services Administration. Tallahassee, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Franciscan Missionaries of Our 1,935,000
Services Administration. Lady University, Baton Rouge,
LA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Frederick County Government, 698,083
Services Administration. Frederick, MD for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Freedom Rain Incorporated dba 2,000,000
Services Administration. The Lovelady Center,
Birmingham, AL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Fresno Center, Fresno, CA for 1,500,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Friends of Youth, Kirkland, WA 1,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Friendship House, Scranton, PA 1,500,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Gardner Family Health Network, 500,000
Services Administration. Incorporated, Alviso, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Gardner Family Health Network, 1,000,000
Services Administration. Incorporated, San Jose, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Garfield Health Center, 480,000
Services Administration. Monterey Park, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Garrett Regional Medical 650,000
Services Administration. Center, Oakland, MD, for an
electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Gateway Community Health 1,997,000
Services Administration. Center, Inc., Laredo, TX for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services George Corley Wallace State 1,143,018
Services Administration. Community College, Demopolis,
AL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services George Mason University, 820,000
Services Administration. Fairfax, VA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services George Washington University, 1,190,000
Services Administration. Washington, DC for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Germanna Community College 251,000
Services Administration. Educational Foundation Inc.,
Locust Grove, VA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Gillette Children's Specialty 1,500,000
Services Administration. Healthcare, St. Paul, MN for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Grace Health, Battle Creek, MI 525,000
Services Administration. for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Grand View Hospital d/b/a Grand 1,000,000
Services Administration. View Health, Sellersville, PA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Grant County Public Hospital 2,500,000
Services Administration. District No 1, dba Samaritan
Healthcare, Moses Lake, WA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Great Basin College, Elko, NV 940,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Great Salt Plains Health 2,180,000
Services Administration. Center, Inc., Cherokee, OK for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Greater Baden Medical Services, 3,000,000
Services Administration. Inc., Brandywine, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Greene County Hospital and 521,100
Services Administration. Nursing Home, Eutaw, AL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Grover C. Dils Medical Center, 3,000,000
Services Administration. Caliente, NV for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Gundersen Tri-County Hospital, 1,000,000
Services Administration. Whitehall, WI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services H. Lee Moffitt Cancer Center 3,000,000
Services Administration. and Research Institute, Inc.,
Tampa, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services H. Lee Moffitt Cancer Center 1,000,000
Services Administration. and Research Institute, Inc.,
Tampa, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Hackensack Meridian Health, 1,000,000
Services Administration. Edison, NJ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Hamakua-Kohala Health Center, 2,000,000
Services Administration. Honokaa, HI for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Hamilton Community Health 1,000,000
Services Administration. Network, Flint, MI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Harris County Precinct 2, 3,000,000
Services Administration. Houston, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Havana Community Development 1,967,328
Services Administration. Corp., Inc., Havana, FL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Health and Hospital Corporation 1,385,487
Services Administration. of Marion County,
Indianapolis, IN for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Health Care Authority 1,000,000
Services Administration. Corporation of the City of
Thomasville, AL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Health Service Alliance- 300,000
Services Administration. Montclair Community Health
Center, Montclair, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Health Unit on Davidson Avenue 281,200
Services Administration. (The HUDA Clinic), Detroit, MI
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services HealthFirst Family Center, 450,000
Services Administration. Franklin, NH for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services HealthPoint, Renton, WA for 2,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services HealthRIGHT 360, San Francisco, 2,500,000
Services Administration. CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Healthy Mothers, Healthy Babies 305,313
Services Administration. Coalition of Palm Beach
County, Inc., Greenacres, FL
for a doula training program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Henderson County Rural Health 517,783
Services Administration. Center, Inc., dba Eagle View
Community Health System,
Oquawka, IL for health clinic
operational costs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Hendry County, LaBelle, FL for 700,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Henry J. Austin Health Center, 813,600
Services Administration. Trenton, NJ for a mobile
health unit and staffing.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Henry Mayo Newhall Hospital 1,115,000
Services Administration. Foundation, Valencia, CA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Heritage Heights at Lake 800,000
Services Administration. Chelan, WA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Highlands Hospital dba Penn 1,000,000
Services Administration. Highlands Connellsville
(PHCV), a subsidiary of Penn
Highlands Healthcare (PHH),
Connellsville, PA for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Hillsdale Community Health 345,000
Services Administration. Center, Hillsdale, MI for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services His Branches, Inc., Rochester, 819,312
Services Administration. NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Howard Brown Health, Chicago, 1,110,400
Services Administration. IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Hyndman Area Health Center, 425,000
Services Administration. Inc, Bedford, PA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services I. M. Sulzbacher Center for the 2,000,000
Services Administration. Homeless, Inc., Jacksonville,
FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Illinois College of Optometry, 445,000
Services Administration. Chicago, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Illinois Community College 300,000
Services Administration. District #519 (Highland
Community College), Freeport,
IL for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Illinois State University, 2,000,000
Services Administration. Mennonite College of Nursing,
Normal, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Inner City Health Center, 183,486
Services Administration. Denver, CO for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Interfaith Medical Center 3,000,000
Services Administration. Campus, Brooklyn, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services J. Paul Jones Hospital, Camden, 595,041
Services Administration. AL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jackson Parish Hospital, 2,000,000
Services Administration. Jonesboro, LA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jamaica Hospital Medical 1,905,000
Services Administration. Center, Jamaica, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jamaica Hospital Medical 2,400,000
Services Administration. Center, Jamaica, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jawonio Inc., New City, NY for 1,300,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jersey Community Hospital 2,000,000
Services Administration. District, Jerseyville, IL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jessie Trice Community Health 3,000,000
Services Administration. System, Inc., Miami, FL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jewish Community Free Clinic, 200,000
Services Administration. Santa Rosa, CA for an
electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jewish Foundation for Group 750,000
Services Administration. Homes, Rockville, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Joseph P. Addabbo Family Health 325,000
Services Administration. Center, Inc., New York, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Josselyn Center, Northfield, IL 1,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Jurupa Unified, Jurupa Valley, 1,623,000
Services Administration. CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Kern County Hospital Authority, 3,000,000
Services Administration. Bakersfield, CA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Kern County Hospital Authority, 3,000,000
Services Administration. Bakersfield, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Keryx Ministries, Inc., Macon, 400,000
Services Administration. GA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Keystone Valley Fire 29,385
Services Administration. Department, Parkesburg, PA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Kids' Community Clinic of 1,200,000
Services Administration. Burbank, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services KidsPeace, Orefield, PA for 1,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services King Lunalilo Trust and Home, 1,740,550
Services Administration. Honolulu, HI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Kings County Hospital Center, 2,200,000
Services Administration. Brooklyn, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Klingberg Family Centers, 1,000,000
Services Administration. Incorporated, New Britain, CT
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services La Maestra Family Clinic Inc., 751,681
Services Administration. San Diego, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lake County Free Clinic, 100,000
Services Administration. Painesville, OH for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lakewood Community Services 1,000,000
Services Administration. Corporation, Lakewood, NJ for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lana'i Community Health Center, 1,538,000
Services Administration. Lana'i City, HI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lansing Fire Department, 1,000,000
Services Administration. Lansing, MI for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services LaSalle General Hospital, Jena, 1,065,000
Services Administration. LA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lawrence General Hospital, 1,000,000
Services Administration. Lawrence, MA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Le Bonheur Children's Hospital, 970,000
Services Administration. Memphis, TN for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Legacy Community Health, 1,000,000
Services Administration. Houston, TX for an electronic
health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Legacy Community Health, 300,000
Services Administration. Houston, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Leyden Family Service & Mental 266,059
Services Administration. Health Center, Hoffman
Estates, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services LifeCare Alliance, Columbus, OH 975,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lighthouse Youth Services, 1,850,000
Services Administration. Inc., Cincinnati, OH for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lions Eye Institute for 1,000,000
Services Administration. Transplant and Research
Foundation, Tampa, FL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Livingston County Emergency 1,169,950
Services Administration. Management Services, Howell,
MI for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Loma Linda University Medical 2,000,000
Services Administration. Center- Murrieta, Murrieta, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Long Island Jewish Forest 1,000,000
Services Administration. Hills, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Los Angeles County Fire 201,834
Services Administration. Department, Los Angeles, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Louisiana Children's Medical 2,000,000
Services Administration. Center, New Orleans, LA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Louisiana State University 2,350,000
Services Administration. Health Sciences Center--New
Orleans, LA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Loveland Fire Rescue Authority, 500,000
Services Administration. Loveland, CO for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lower Bucks Hospital, Bristol, 1,200,000
Services Administration. PA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lower Elwha Tribal Community, 1,911,875
Services Administration. Port Angeles, WA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services LTSC Community Development 1,000,000
Services Administration. Corporation, Los Angeles, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Lynn Community Health Center, 1,000,000
Services Administration. Lynn, MA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Madison County Fiscal Court, 390,000
Services Administration. Richmond, KY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Main Line Hospitals, Inc., 1,000,000
Services Administration. Radnor, PA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Maine Department of Defense, 3,000,000
Services Administration. Veterans and Emergency
Management, Augusta, ME for
facilities and equipment, and
operational costs for a rural
health project.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services MaineHealth dba Western Maine 1,642,000
Services Administration. Health/Stephens Memorial
Hospital, Norway, ME for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Makah Indian Tribe, Neah Bay, 3,000,000
Services Administration. WA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Marian Regional Medical Center, 1,000,000
Services Administration. Santa Maria, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Marshall University Research 3,000,000
Services Administration. Corporation, Huntington, WV
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Mary Free Bed Rehabilitation 3,000,000
Services Administration. Hospital, Grand Rapids, MI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Matthew Walker Comprehensive 480,000
Services Administration. Health Center Inc., Nashville,
TN for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services McLaren Central Michigan, Grand 850,000
Services Administration. Blanc, MI for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services MedStar Curtis National Hand 1,500,000
Services Administration. Center, Baltimore, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services MedStar St. Mary's Hospital, 975,000
Services Administration. Leonardtown, MD for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Melvin & Claire Levine Jewish 825,000
Services Administration. Residential and Family
Service, West Palm Beach, FL
for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Metropolitan Government of 2,200,000
Services Administration. Nashville and Davidson County,
Nashville, TN for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Mid-Coast Health Net Inc. dba 2,105,000
Services Administration. Knox Clinic, Rockland, ME for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Mid-State Health Center, 750,000
Services Administration. Plymouth, NH for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Mid-Valley Healthcare, Inc., 1,000,000
Services Administration. Lebanon, OR for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Milwaukee Health Services, 2,983,000
Services Administration. Inc., Milwaukee, WI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Molokai Community Health 1,664,000
Services Administration. Center, Kaunakakai, HI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Morehead State University, 3,000,000
Services Administration. Morehead, KY for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Morehouse School of Medicine, 950,000
Services Administration. Atlanta, GA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services MossRehab-Albert Einstein 210,000
Services Administration. Healthcare Network, Elkins
Park, PA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Mount Sinai Hospital, Chicago, 2,000,000
Services Administration. IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Mountain Park Health Center, 3,000,000
Services Administration. Phoenix, AZ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services MRIGlobal, Kansas City, MO for 1,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services MyMichigan Medical Center 2,000,000
Services Administration. Midland, Midland, MI for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Native American Community 1,000,000
Services Administration. Clinic, Minneapolis, MN for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Native American Health Center, 1,000,000
Services Administration. Inc., Oakland, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services NATIVE HEALTH, Inc., Phoenix, 650,000
Services Administration. AZ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Natrona County, Casper, WY for 1,500,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Navajo Nation Division of 3,000,000
Services Administration. Social Services, Window Rock,
AZ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Navajo Nation Division of 2,000,000
Services Administration. Social Services, Window Rock,
AZ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Near North Health Service 2,000,000
Services Administration. Corporation, Chicago, IL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Nehalem Bay Health District, 1,000,000
Services Administration. Wheeler, OR for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Neighborhood Health Association 1,000,000
Services Administration. of Toledo, Inc., Toledo, OH
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Neighborhood Healthcare Inc, 575,000
Services Administration. Menifee, CA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Neighborhood Medical Center, 1,650,000
Services Administration. Incorporated, Tallahassee, FL
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New Destiny Treatment Center, 1,500,000
Services Administration. Clinton, OH for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New Directions for Youth, Inc., 1,000,000
Services Administration. North Hollywood, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New England College, Henniker, 2,000,000
Services Administration. NH for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New Paths, Inc., Flint, MI for 1,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New York City Health and 3,000,000
Services Administration. Hospitals--Lincoln Medical and
Mental Health Center, Bronx,
NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New York City Health and 2,000,000
Services Administration. Hospitals Corporation, New
York, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New York City Health and 1,000,000
Services Administration. Hospitals/Elmhurst, Queens, NY
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New York Community Hospital, 2,200,000
Services Administration. Brooklyn, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services New York Medical College, 1,900,000
Services Administration. Valhalla, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Newark Community Health 1,000,000
Services Administration. Centers, Inc. , Newark, NJ for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Newport County Community Mental 1,000,000
Services Administration. Health Center Inc.,
Middletown, RI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Next Steps of O'Connor 645,695
Services Administration. Foundation dba Next Steps
Chicago, Chicago, IL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services NextStep Orlando, Inc., 533,499
Services Administration. Altamonte Springs, FL for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Nicholas H. Noyes Memorial 1,500,000
Services Administration. Hospital, Dansville, NY for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Niscasa, Round Lake, IL for 2,100,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services North Broward Hospital District 3,000,000
Services Administration. dba Broward Health, Fort
Lauderdale, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services North Carolina Central 643,750
Services Administration. University, Durham, NC for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services North Central Michigan College, 2,000,000
Services Administration. Petoskey, MI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services North Memorial Health Care, 1,000,000
Services Administration. Robbinsdale, MN for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Northeast Iowa Community 375,000
Services Administration. College, Peosta, IA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Northeast Valley Health 1,655,000
Services Administration. Corporation, San Fernando, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Northern Marianas College, 1,000,000
Services Administration. Saipan, NP for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Northern Nevada HOPES, Reno, NV 2,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Northwest Indian College, 2,000,000
Services Administration. Bellingham, WA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Northwest Medical Foundation 1,000,000
Services Administration. Tillamook, OR for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Northwest Technical Institute, 2,000,000
Services Administration. Springdale, AR for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services NYU Langone Health, New York, 2,000,000
Services Administration. NY for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Odyssey House Louisiana Inc., 1,000,000
Services Administration. New Orleans, LA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Oklahoma Blood Institute, 1,250,000
Services Administration. Oklahoma City, OK for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Oklahoma Medical Research 1,755,000
Services Administration. Foundation, Oklahoma City, OK
for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Oklahoma Medical Research 2,000,000
Services Administration. Foundation, Oklahoma City, OK
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Olathe Fire Department 660,000
Services Administration. Administration, Olathe, KS for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services OLE Health, Napa, CA for 1,796,139
Services Administration. equipment, for an electronic
health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Oneida Health Systems Inc., 1,000,000
Services Administration. Oneida, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Orange County Board of County 239,059
Services Administration. Commissioners, Orlando, FL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Orange County Health Authority 2,000,000
Services Administration. (dba CalOptima), Orange, CA
for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Orange County Health Authority, 1,000,000
Services Administration. Orange, CA for a health
information technology
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Oregon Association of Relief 5,055,844
Services Administration. Nurseries, Newberg, OR for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Oregon Health & Science 800,000
Services Administration. University, Portland, OR for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Ozark Tri-County Healthcare 1,500,000
Services Administration. Consortium, DBA ACCESS Family
Care, Neosho, MO for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Park West Health System, 1,000,000
Services Administration. Baltimore, MD for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Parkland College, Champaign, IL 320,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services People Coordinated Services of 1,162,000
Services Administration. Southern California, Los
Angeles, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services People's Community Clinic, 850,000
Services Administration. Austin, TX for an electronic
health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Personal Enrichment through 2,000,000
Services Administration. Mental Health Services, Inc.,
Pinellas Park, FL for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Perspectives Inc., St. Louis 3,000,000
Services Administration. Park, MN for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Pikeville Medical Center, Inc., 3,000,000
Services Administration. Pikeville, KY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Plymouth Housing, Seattle, WA 1,000,000
Services Administration. for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Portsmouth Community Health 807,137
Services Administration. Center, Inc., dba Hampton
Roads Community Health Center,
Portsmouth, VA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Potomac Valley Hospital, 1,100,000
Services Administration. Keyser, WV for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Power4STL, St. Louis, MO for 3,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Presbyterian Hospital DBA 216,200
Services Administration. Novant Health Presbyterian
Medical Center, Charlotte, NC
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Presbyterian Villages of 140,000
Services Administration. Michigan, Southfield, MI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Presbyterian Villages of 115,000
Services Administration. Michigan, Southfield, MI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Primary Care Health Services, 2,200,000
Services Administration. Inc., Pittsburgh, PA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Prince William County 2,000,000
Services Administration. Government, Prince William, VA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Project Angel Food, Los 913,500
Services Administration. Angeles, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Promise Fund of Florida, Inc., 900,100
Services Administration. Palm Beach, FL for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Promise Fund of Florida, Inc., 894,100
Services Administration. Palm Beach, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Promise Fund of Florida, Inc., 951,500
Services Administration. Palm Beach, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Providence Holy Cross Medical 750,000
Services Administration. Center, Mission Hills, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Rappahannock Area Health 400,000
Services Administration. District, Fredericksburg, VA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Rappahannock-Rapidan Community 1,000,000
Services Administration. Services, Culpeper, VA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Red Oak Behavioral Health, 2,000,000
Services Administration. Akron, OH for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Redwoods Rural Health Center, 775,000
Services Administration. Redway, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Regional One Health, Memphis, 2,000,000
Services Administration. TN for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Research Institute at 1,000,000
Services Administration. Nationwide Children's
Hospital, Columbus, OH for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Resources for Human 1,000,000
Services Administration. Development, Philadelphia, PA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Riverside Community Health 2,000,000
Services Administration. Foundation, Riverside, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Riverside Medical Center, 1,000,000
Services Administration. Kankakee, IL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Roanoke Chowan Community Health 1,300,000
Services Administration. Center, Ahoskie, NC for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Roanoke College, Salem, VA for 505,000
Services Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Rockland Community College, 3,000,000
Services Administration. Suffern, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Roxbury Volunteer Emergency 257,000
Services Administration. Services, Inc., New York, NY
for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Rutgers Biomedical and Health 950,650
Services Administration. Sciences, Newark, NJ for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Sacramento Native American 1,000,000
Services Administration. Health Center, Sacramento, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Saint Anselm College, 2,200,000
Services Administration. Manchester, NH for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Saint Anthony Hospital, 1,000,000
Services Administration. Chicago, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Saint Francis University, 500,000
Services Administration. Loretto, PA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Saint Xavier University, 106,885
Services Administration. Chicago, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services San Francisco Community Clinic 2,200,000
Services Administration. Consortium, San Francisco, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services San Gorgonio Memorial Hospital, 452,000
Services Administration. Banning, CA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services San Joaquin Health Centers, 1,810,929
Services Administration. Stockton, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services San Juan County, Monticello, UT 515,000
Services Administration. for cancer screening.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Sea Mar Community Health 2,200,000
Services Administration. Centers, Seattle, WA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Seattle Indian Health Board, 3,000,000
Services Administration. Seattle, WA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Self Help Movement, Inc., 1,500,000
Services Administration. Philadelphia, PA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Seton Hall University, South 1,140,000
Services Administration. Orange, NJ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Shands Jacksonville Medical 2,000,000
Services Administration. Center, Inc., Jacksonville, FL
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Shepherd's Hope, Winter Park, 395,500
Services Administration. FL for facilities and
equipment, including equipment
related to telehealth.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Siena College, Loudonville, NY 496,541
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Sight For All United, 550,000
Services Administration. Struthers, OH for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Sinclair Community College, 2,000,000
Services Administration. Dayton, OH for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Singing River Health System, 2,800,000
Services Administration. Ocean Springs, MS for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Siskin Hospital for Physical 2,500,000
Services Administration. Rehabilitation, Inc.,
Chattanooga, TN for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Sisters of Charity Hospital of 2,377,172
Services Administration. Buffalo, New York,
Cheektowaga, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Solano County Public Health 1,000,000
Services Administration. Department's Family Health
Services, Fairfield, CA for an
electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services South Boston Community Health 2,000,000
Services Administration. Center, Inc., South Boston, MA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services South Central Family Health 707,414
Services Administration. Center, Cudahy, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services South Shore Hospital 2,000,000
Services Administration. Corporation, Chicago, IL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services South Ward Alliance dba South 2,000,000
Services Administration. Ward Promise Neighborhood,
Newark, NJ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Southeast Council on Alcoholism 915,000
Services Administration. and Drug Dependence, Inc.,
Lebanon, CT for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Southwest Community Health 2,000,000
Services Administration. Center, Inc., Bridgeport, CT
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Southwestern Vermont Medical 250,000
Services Administration. Center, Bennington, VT for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services SSM Health--St. Mary's 1,000,000
Services Administration. Hospital--St. Louis, MO for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services St. Catherine Hospital, Inc., 1,500,000
Services Administration. East Chicago, IN for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services St. Francis Medical Center, 2,000,000
Services Administration. Monroe, LA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services St. John's Episcopal Hospital, 3,000,000
Services Administration. Episcopal Health Services
Inc., Far Rockaway, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services St. John's Riverside Hospital, 1,000,000
Services Administration. Yonkers, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services St. Joseph Regional Health 1,000,000
Services Administration. Network, Reading, PA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services St. Joseph's Medical Center, 4,000,000
Services Administration. Stockton, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services State University of New York 900,000
Services Administration. Upstate Medical University,
Syracuse, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Stockbridge Community Schools, 2,500,000
Services Administration. Stockbridge, MI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Sun River Health, Inc. dba 2,000,000
Services Administration. Hudson River HealthCare,
Peekskill, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Sun River Health, Peekskill, NY 1,800,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Susannah's House, Inc., 500,000
Services Administration. Knoxville, TN for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services TCC Family Health, Long Beach, 375,000
Services Administration. CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Tennyson Center for Children, 1,000,000
Services Administration. Denver, CO for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Texas A&M University College of 940,000
Services Administration. Dentistry, Dallas, TX for an
oral health care initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Texas A&M University- San 1,945,000
Services Administration. Antonio, San Antonio, TX for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Texas Children's Hospital, 2,000,000
Services Administration. Houston, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Texas Tech University Health 2,600,000
Services Administration. Science Center (TTUHSC)
Odessa, Odessa, TX for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Texas Tech University Health 3,000,000
Services Administration. Sciences Center El Paso, TX
for an initiative related to
health information technology
and telehealth.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Texas Tech University Health 2,000,000
Services Administration. Sciences Center, Dallas, TX
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services The Floating Hospital, Inc., 1,040,489
Services Administration. Long Island City, NY for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services The Foodbank, Inc., Dayton, OH 2,000,000
Services Administration. for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services The Good Samaritan Hospital of 590,000
Services Administration. Cincinnati, OH for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services TidalHealth Nanticoke, Seaford, 1,000,000
Services Administration. DE for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Town of Geraldine, AL for 375,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Township of Brick, NJ for 250,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Township of Edison, NJ for 3,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Township of Mount Olive, Budd 1,982,500
Services Administration. Lake, NJ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Tri-Area Community Health, 600,000
Services Administration. Laurel Fork, VA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Trinity Health System, 2,000,000
Services Administration. Steubenville, OH for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Tri-State Memorial Hospital, 2,500,000
Services Administration. Clarkston, WA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Tucson Indian Center, Tucson, 588,059
Services Administration. AZ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services UMass Memorial Health-- 450,000
Services Administration. HealthAlliance--Clinton
Hospital, Leominster, MA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services UMass Memorial Medical Center, 1,000,000
Services Administration. Worcester, MA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Union Community Health Center, 675,000
Services Administration. Inc., Bronx, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services United Neighborhood Health 750,000
Services Administration. Services dba Neighborhood
Health, Nashville, TN for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University at Buffalo, NY for 933,800
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Community Health 2,000,000
Services Administration. Services, Inc., Nashville, TN
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Health System (UHS) 1,250,000
Services Administration. d/b/a University of Tennessee
Medical Center, Knoxville, TN
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Health System (UHS) 750,000
Services Administration. d/b/a University of Tennessee
Medical Center, Knoxville, TN
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Health System (UHS), 1,000,000
Services Administration. d/b/a/ University of Tennessee
Medical Center, Knoxville, TN
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Hospital, Newark, NJ 3,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Hospitals Cleveland 855,000
Services Administration. Medical Center, Cleveland, OH
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Hospitals, 1,145,520
Services Administration. Cleveland, OH for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Hospitals, 1,500,000
Services Administration. Cleveland, OH for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University Muslim Medical 158,000
Services Administration. Association Inc. (UMMA
Community Clinic), Huntington
Park, CA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of California, San 1,095,000
Services Administration. Diego, La Jolla, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Hawaii--Office of 1,000,000
Services Administration. Strategic Health Initiatives,
Honolulu, HI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Kansas Medical 2,594,226
Services Administration. Center, Kansas City, KS for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Kansas Medical 2,956,507
Services Administration. Center, Kansas City, KS for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Kansas Medical 1,000,000
Services Administration. Center, Kansas City, KS for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Louisville, KY 2,000,000
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Massachusetts 3,000,000
Services Administration. Boston, MA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Miami Leonard M. 500,000
Services Administration. Miller School of Medicine,
Miami, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Miami, Miami, FL 800,000
Services Administration. for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Mississippi 2,000,000
Services Administration. Medical Center, Jackson, MS
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Nevada Las Vegas, 1,000,000
Services Administration. NV for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Rochester, NY for 1,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of South Alabama, 1,500,000
Services Administration. Mobile, AL for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of South Florida, 2,000,000
Services Administration. Sarasota, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of South Florida, 1,000,000
Services Administration. Tampa, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Texas at Dallas, 1,500,000
Services Administration. Richardson, TX for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Texas Health 1,000,000
Services Administration. Science Center at Houston, TX
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Texas Health 1,000,000
Services Administration. Science Center at San Antonio,
TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Texas Rio Grande 1,000,000
Services Administration. Valley, Edinburg, TX for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Texas School of 1,000,000
Services Administration. Public Health San Antonio, TX
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Texas 1,500,000
Services Administration. Southwestern Medical Center,
Dallas, TX for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Toledo, OH for 1,000,000
Services Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Utah, Salt Lake 3,000,000
Services Administration. City, UT for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services University of Wisconsin- 1,000,000
Services Administration. Madison, WI for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services UPMC Altoona, Altoona, PA for 250,000
Services Administration. facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Urban Health Plan, Inc., Bronx, 2,106,950
Services Administration. NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Urban Health Plan, Inc., 3,000,000
Services Administration. Corona, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Valley Health Services, Inc., 2,000,000
Services Administration. Herkimer, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Valley Health System, 1,500,000
Services Administration. Winchester, VA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Valley Hospital, Ridgewood, NJ 608,860
Services Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Valparaiso University, 1,000,000
Services Administration. Valparaiso, IN for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Van Buren County Hospital, 1,845,000
Services Administration. Keosauqua, IA for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Variety Care, Inc., Oklahoma 3,000,000
Services Administration. City, OK for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Variety Children's Hospital DBA 450,000
Services Administration. Nicklaus Children's Hospital,
Miami, FL for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Variety Children's Hospital DBA 1,000,000
Services Administration. Nicklaus Children's Hospital,
Miami, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Venice Family Clinic, Venice, 500,000
Services Administration. CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Vera French Community Mental 1,885,000
Services Administration. Health Center, Davenport, IA
for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Via Care Community Health 389,000
Services Administration. Center, East Los Angeles, CA
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services View Point Health, 900,000
Services Administration. Lawrenceville, GA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Virgin Islands Diabetes Center 995,000
Services Administration. of Excellence, St. Croix, VI
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Virgin Islands Fire Services, 1,897,000
Services Administration. St. Thomas, VI for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Virtua Health, Camden, NJ for 2,000,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Virtua Health, Inc., Marlton, 1,000,000
Services Administration. NJ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Vision Urbana, Inc., New York, 1,000,000
Services Administration. NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services VNA Health Care, Aurora, IL for 500,000
Services Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services W.A. Foote Memorial Hospital, 310,000
Services Administration. Inc., Jackson, MI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Waimanalo Health Center, 2,000,000
Services Administration. Waimanalo, HI for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services WakeMed Health & Hospitals, 6,000,000
Services Administration. Raleigh, NC for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Washington County Healthcare 1,845,000
Services Administration. Authority, INC dba Washington
County Hospital and Nursing
Home, Chatom, AL for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Watts Healthcare Corporation, 2,000,000
Services Administration. Los Angeles, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Wayside House, Inc., Delray 1,000,000
Services Administration. Beach, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Weber State University, Ogden, 1,500,000
Services Administration. UT for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services West County Health Centers, 901,575
Services Administration. Inc., Guerneville, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services West Virginia School of 325,000
Services Administration. Osteopathic Medicine,
Lewisburg, WV for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Westchester Sickle Cell 500,000
Services Administration. Outreach, Inc., White Plains,
NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Western Nevada College, Carson 2,000,000
Services Administration. City, NV for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services White Memorial Community Health 1,000,000
Services Administration. Center, Los Angeles, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Whitman County Public Hospital 3,000,000
Services Administration. District Number 1-A, Pullman,
WA for an electronic health
records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Whitman-Walker Health, 250,000
Services Administration. Washington, DC for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Wilmington Community Clinic, 200,000
Services Administration. Wilmington, CA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Wilson Community College, 3,000,000
Services Administration. Wilson, NC for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services WINGS Program, Inc., Rolling 200,000
Services Administration. Meadows, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Winston-Salem State University, 1,342,840
Services Administration. Winston-Salem, NC for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Wintersville Volunteer Fire 110,000
Services Administration. Department, Wintersville, OH
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Worry Free Community, Glendale 144,800
Services Administration. Heights, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Worry Free Community, Glendale 1,000,000
Services Administration. Heights, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services Wyckoff Heights Medical Center, 2,000,000
Services Administration. Brooklyn, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Health Resources and Services YMCA of Central Florida, 1,000,000
Services Administration. Orlando, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health A Safe Haven Foundation, 2,000,000
Services Services Administration. Chicago, IL for behavioral
health, substance use
disorder, and peer support
services, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health AABR, Inc., College Point, NY 382,174
Services Services Administration. for behavioral health services
and training, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health AboutFace-USA, Inc., Cumming, 1,280,000
Services Services Administration. GA for mental health treatment
and services for veterans,
including equipment and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Alliance for Healthy 800,000
Services Services Administration. Communities, Inc., New Port
Richey, FL for a substance use
prevention, treatment, and
recovery services, and
resources center, including
the purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Amistad, Inc., Portland, ME for 535,000
Services Services Administration. behavioral health services and
recovery housing.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Anaheim Community Foundation, 1,000,000
Services Services Administration. Anaheim, CA for mental health
and related support services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Apna Ghar, Chicago, IL for a 300,000
Services Services Administration. mobile mental health advocacy
unit, including training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Arab-American Family Support 1,800,453
Services Services Administration. Center, Brooklyn, NY for
mental health services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Ashley Addiction Treatment 420,000
Services Services Administration. Center, Havre de Grace, MD for
behavioral health services and
youth education programs.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Asian Health Services, Oakland, 1,000,000
Services Services Administration. CA for mental health and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Bay Area Community Health, San 1,000,000
Services Services Administration. Jose, CA for behavioral health
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Baylor College of Medicine, 1,000,000
Services Services Administration. Houston, TX for substance use
disorder services and
treatment for people
experiencing homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Baylor College of Medicine, 1,200,000
Services Services Administration. Houston, TX to provide
substance use disorder
services and treatment,
including minor facility
repairs, improvements, and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Beit T'Shuvah, Los Angeles, CA 301,649
Services Services Administration. for behavioral health,
recovery, and other supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Boys & Girls Clubs of Delaware, 250,000
Services Services Administration. Wilmington, DE for mental
health and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Boys & Girls Clubs of the 1,000,000
Services Services Administration. Valley, Phoenix, AZ for the
Whole Child Approach Program
to provide mental health and
other supportive services for
children.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health BPSOS Center for Community 300,000
Services Services Administration. Advancement, Westminster, CA
for behavioral health services
and training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Cenikor Foundation, Waco, TX 640,000
Services Services Administration. for a substance use treatment
and recovery program,
including behavioral health
services and support services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Champions In Service, Pacoima, 722,223
Services Services Administration. CA for mental health and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Child and Family Agency of 693,437
Services Services Administration. Southeastern CT, Inc., New
London, CT for mental health
and related services for
youth, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Children's Health Clinical 915,000
Services Services Administration. Operations, Dallas, TX for
training, education, and
pediatric mental health
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Children's Health Clinical 500,000
Services Services Administration. Operations, Dallas, TX for
youth behavioral health
services and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Children's Hospital Colorado, 668,313
Services Services Administration. Aurora, CO to enhance access
to mental health care
services, including training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Children's Hospital of The 1,000,000
Services Services Administration. King's Daughters, Norfolk, VA
for mental health services and
treatment, including outreach
and programming.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Chinese-American Planning 500,000
Services Services Administration. Council, Inc., New York, NY
for mental health services and
treatment, outreach,
education, and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Austin, TX for 2,000,420
Services Services Administration. substance use prevention,
awareness, and education
activities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Hermosa Beach, CA for 1,000,000
Services Services Administration. mobile mental health crisis
response teams.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Monroe, WA for mental 480,804
Services Services Administration. health crisis support
services, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Moreno Valley, CA for 1,000,000
Services Services Administration. the Homeless to Work program
to provide behavioral health
services, including equipment
and outreach.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Norco, CA for a 800,000
Services Services Administration. homelessness services program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of North Las Vegas, NV for 875,000
Services Services Administration. a mental health crisis
response unit.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Pasadena, CA for the 900,000
Services Services Administration. Pasadena Outreach Response
Team to provide behavioral
health and related services to
people experiencing
homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Pittsburg, PA for the 1,000,000
Services Services Administration. Reaching Out On The Streets
(ROOTS) Overdose and Support
Teams to provide behavioral
health services, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of San Fernando, CA for 800,000
Services Services Administration. mental health crisis response
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health City of Santa Monica, CA for 1,500,000
Services Services Administration. behavioral health and other
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Clark County, Nevada, Las 1,709,594
Services Services Administration. Vegas, NV for behavioral
health and other support
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Community Health Connections, 2,500,000
Services Services Administration. Inc., Fitchburg, MA for youth
mental health services and
treatment, including training
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Community Hero Action Group, 450,000
Services Services Administration. King of Prussia, PA for the
Black Health Matters
initiative to provide mental
health services, and other
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Community Medical Wellness 2,000,000
Services Services Administration. Centers, USA, Long Beach, CA
for behavioral health and
substance use disorder
services, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Compass LGBTQ Youth and Family 523,345
Services Services Administration. Services, Lake Worth Beach, FL
for behavioral health and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Contact Community Services, 135,000
Services Services Administration. Inc., Syracuse, NY for a
crisis call center upgrade,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health County of San Diego, CA for 4,480,000
Services Services Administration. mobile behavioral health
crisis response teams.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Court Appointed Special 600,000
Services Services Administration. Advocates Program, Inc. of
Contra Costa, Concord, CA for
mental health services for
youth and education
programming.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Douglas County, Castle Rock, CO 629,970
Services Services Administration. for mental and behavioral
health services and treatment,
including technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health DuPage County Health 1,000,000
Services Services Administration. Department, Wheaton, IL for
mental health and substance
use disorder services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health East Bay Agency for Children, 477,000
Services Services Administration. Oakland, CA for student and
teacher mental health services
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health El Futuro, Inc., Durham, NC for 192,371
Services Services Administration. mental health training and
curriculum development.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health EmblemHealth, Inc., New York, 450,000
Services Services Administration. NY for mental health services,
education, and other related
activities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Emory University, Atlanta, GA 500,000
Services Services Administration. for a hospital-based violence
intervention program to
provide behavioral health
services and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Family and Children's 790,817
Services Services Administration. Association, Garden City, NY
for the Senior Safety Net
Program to provide behavioral
health and wraparound
services, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Family and Children's Center 450,000
Services Services Administration. Wisconsin, La Crosse, WI to
expand behavioral health
services, including outreach,
education, equipment, and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health FosterHope Sacramento, 600,000
Services Services Administration. Sacramento, CA for mental
health and associated support
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Friends of the Children- 150,000
Services Services Administration. Detroit, Detroit, MI for
mental health and other
supportive services, including
training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health GAAMHA Inc., Gardner, MA for 200,000
Services Services Administration. behavioral health and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health George Mason University, 1,037,519
Services Services Administration. Fairfax, VA for substance use
services, treatment, and
associated support services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health George Mason University, 943,983
Services Services Administration. Fairfax, VA for youth mental
health services, including
training and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Grafton City Hospital, Grafton, 995,000
Services Services Administration. WV for a substance use
treatment and recovery
program, including the
purchase of supplies,
equipment, and information
technology, and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Harris County Public Health, 1,000,000
Services Services Administration. Houston, TX for ACCESS Harris
to provide behavioral health
and wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Harris County Public Health, 1,431,174
Services Services Administration. Houston, TX for behavioral
health and supportive services
for parents and infants.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Healthier Kids Foundation, San 644,000
Services Services Administration. Jose, CA for mental and
behavioral health services for
youth.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Hope for Heroes Horsemanship 70,000
Services Services Administration. Center, Yelm, WA for suicide
prevention and mental health
awareness training and
treatment programming,
including postvention services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Hope of the Valley Rescue 2,000,000
Services Services Administration. Mission, North Hills, CA for
mental health and substance
use disorder services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Ibn Sina Foundation, Inc., 1,600,000
Services Services Administration. Houston, TX for mental health
and substance use disorder
services and treatment,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Identity, Inc., Rockville, MD 121,000
Services Services Administration. for the Encuentros program to
provide mental health and
supportive services, including
curriculum and training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Indian Health Center of Santa 914,000
Services Services Administration. Clara Valley, San Jose, CA for
behavioral health and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Jewish Adoption and Family Care 250,000
Services Services Administration. Options, Sunrise, FL for
mental health and trauma
prevention services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Julia Dyckman Andrus Memorial, 802,583
Services Services Administration. Incorporated, Yonkers, NY to
expand mental health services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health LCH Health and Community 605,000
Services Services Administration. Services, Oxford, PA for
behavioral health services and
treatment, including minor
facility repairs and
improvements.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health LIFE Camp, Inc., Jamaica, NY 800,000
Services Services Administration. for mental health, grief
counseling, and other
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Loma Linda University Medical 542,597
Services Services Administration. Center, Loma Linda, CA for a
mental health outreach
demonstration program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Long Island Council on 150,000
Services Services Administration. Alcoholism and Drug
Dependence, Inc., Westbury, NY
for the Student Assistance
Program 2.0 to provide mental
health and substance use
disorder services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Long Island Gay and Lesbian 500,000
Services Services Administration. Youth, Inc., Hauppauge, NY for
substance use prevention and
mental health services for
youth.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Maimonides Medical Center, 1,650,000
Services Services Administration. Brooklyn, NY for behavioral
health services, workforce
training, and care
coordination.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Massachusetts General Hospital 1,150,000
Services Services Administration. Center for Immigrant Health,
Boston, MA for mental health
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Massachusetts General Hospital, 1,000,000
Services Services Administration. Boston, MA for behavioral
health and supportive services
for adults and youth.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Mental Health Association, 513,000
Services Services Administration. Inc., Springfield, MA for
mental health services,
including technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Minnesota Psychiatric 500,000
Services Services Administration. Information and Outreach, St.
Paul, MN for behavioral health
educational materials,
training, and peer support
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Mosaic Georgia, Inc., Duluth, 1,027,200
Services Services Administration. GA for behavioral health
workforce and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Muslim Community and Health 290,000
Services Services Administration. Center, Milwaukee, WI to
expand mental health services,
including outreach and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health National Runaway Switchboard, 375,000
Services Services Administration. Chicago, IL for the Teen
Suicide Prevention Line to
provide mental health
services, including
technology, public awareness,
training, and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Nevada State College, 1,337,000
Services Services Administration. Henderson, NV for behavioral
health and support services,
including technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health New Age Services Corporation, 600,000
Services Services Administration. Chicago, IL to expand
substance use disorder and
mental health services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health New Mexico Human Services 2,800,000
Services Services Administration. Department, Behavioral Health
Services Division, Santa Fe,
NM for mobile mental health
crisis response teams.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Northville Township Police 135,359
Services Services Administration. Department, Northville, MI to
expand mobile crisis response
and related services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health NYC Health + Hospitals/ Jacobi, 845,026
Services Services Administration. Bronx, NY for the Stand Up to
Violence program to provide
youth mental health and
substance use treatment
services, and other support
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Ohio Fire and Emergency 200,000
Services Services Administration. Services Foundation,
Worthington, OH for a mental
health training program.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Oklahoma Children's Hospital, 2,115,000
Services Services Administration. Oklahoma City, OK for a
behavioral health program,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Operation New Hope, 100,000
Services Services Administration. Jacksonville, FL for mental
health services and trainings.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Orange County Asian and Pacific 805,000
Services Services Administration. Islander Community Alliance,
Inc., Garden Grove, CA for
mental health and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Overdose Lifeline, Inc., 87,000
Services Services Administration. Indianapolis, IN for Camp
Mariposa-Aaron's Place Youth
Prevention Program to provide
behavioral health and related
services to youth.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Partnership to End Addiction, 293,000
Services Services Administration. New York, NY for telehealth
and mobile behavioral health
services, outreach, and
awareness activities.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Philadelphia Mural Arts 500,000
Services Services Administration. Advocates, Philadelphia, PA
for behavioral health and
other support services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Pinebrook Family Answers, 197,477
Services Services Administration. Allentown, PA for suicide
prevention and mental health
services, including training,
technology, and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Polk County, FL for behavioral 1,000,000
Services Services Administration. health and mobile crisis
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Primo Center for Women and 800,000
Services Services Administration. Children, Chicago, IL for
trauma-informed behavioral
health and other supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Public Defender Association, 1,500,000
Services Services Administration. Seattle, WA for behavioral
health and wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health RefugeeOne, Chicago, IL for 546,859
Services Services Administration. mental health and recovery
support services for refugee
communities, including
training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Reimagining Justice Inc., 1,000,000
Services Services Administration. Paterson, NJ for mental health
and wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health San Francisco General Hospital 1,000,000
Services Services Administration. Foundation, San Francisco, CA
for behavioral health programs
and services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health San Gabriel Valley Council of 1,500,000
Services Services Administration. Governments, Alhambra, CA for
mental health crisis response
services and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Santa Cruz County Office of 1,000,000
Services Services Administration. Education, Santa Cruz, CA for
behavioral health services and
treatment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Sheppard Pratt Health System, 1,500,000
Services Services Administration. Inc., Baltimore, MD for mental
health services and treatment,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Sheppard Pratt Health System, 1,000,000
Services Services Administration. Inc., Baltimore, MD for the
Zero Suicide Initiative to
provide mental health services
and treatment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Sheppard Pratt Health System, 1,000,000
Services Services Administration. Inc., Hagerstown, MD to expand
mental health services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Stanislaus County Behavioral 711,690
Services Services Administration. Health and Recovery Services,
Modesto, CA to expand mobile
behavioral health crisis
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Temple University--Of The 750,000
Services Services Administration. Commonwealth System of Higher
Education, Philadelphia, PA
for mental and behavioral
health services to communities
in crisis, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Texas A&M Engineering Extension 500,000
Services Services Administration. Service, College Station, TX
for a mental health program
for first responders.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Texas State University, San 1,000,000
Services Services Administration. Marcos, TX for mental health
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health The Beebe Medical Foundation, 381,406
Services Services Administration. Lewes, DE for a community harm
reduction program to provide
mental health and substance
use disorder services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health The Center for Great 500,000
Services Services Administration. Expectations, Somerset, NJ for
mental health services and
treatment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health The Centre for Women, Inc., 1,205,394
Services Services Administration. Tampa, FL for mental health
and related services,
including minor facility
repairs and improvements.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health The Institute for Family Health 411,381
Services Services Administration. at 17th Street, New York, NY
for substance use disorder
services and treatment,
including a mobile harm
reduction unit.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health The Marion and Aaron Gural JCC, 300,000
Services Services Administration. Cedarhurst, NY for the
Resilient Impactful Sustaining
Empowerment Project to provide
mental health and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health The Nemours Foundation, 1,500,000
Services Services Administration. Jacksonville, FL for pediatric
mental health therapists,
trainings, and other support
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health The Welcome Project PA, 226,500
Services Services Administration. Hatboro, PA for mental health
services, case management,
training, and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Turning Point Behavioral Health 650,000
Services Services Administration. Care Center, Skokie, IL for
the Living Room program to
provide behavioral health
crisis and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health UCAN, Chicago, IL for 95,000
Services Services Administration. behavioral health and
supportive services for youth,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health United Way of Greater LaPorte 100,000
Services Services Administration. County, Michigan City, IN for
mental health and substance
use disorder services,
including community outreach
and education.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health United Way of Will County, 883,395
Services Services Administration. Joliet, IL for the Resilient
Youth program to provide
behavioral health services,
including training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health University of California, 1,509,543
Services Services Administration. Davis, Sacramento, CA for
behavioral health services and
treatment, including
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health University of North Carolina 230,000
Services Services Administration. System, Chapel Hill, NC for
mental health training and
services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Unlawful Narcotics 1,400,000
Services Services Administration. Investigations, Treatment, and
Education, Inc., London, KY
for a substance use
prevention, treatment, and
recovery program, including
the purchase of equipment and
housing assistance, and
education programming.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health UTOPIA Washington, Kent, WA for 500,000
Services Services Administration. mental health and substance
use disorder services,
including training and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Valley Health System, 500,000
Services Services Administration. Winchester, VA for behavioral
health training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Variety Boys and Girls Club of 502,250
Services Services Administration. Queens, Inc., Astoria, NY for
mental health and supportive
services, including outreach.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Washington State University, 500,000
Services Services Administration. Spokane, WA for a mental and
behavioral health services
program for rural and
underserved communities,
including student stipends.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Wendt Center for Loss and 94,444
Services Services Administration. Healing, Washington, DC for
behavioral health crisis
response services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Western Michigan University, 1,820,000
Services Services Administration. Kalamazoo, MI for a mental and
behavioral health initiative,
including teacher and student
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Wyandotte County Public Health 750,000
Services Services Administration. Department, Kansas City, KS
for mental and behavioral
health services, including
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health YMCA of Honolulu, HI for the 270,000
Services Services Administration. Youth Wellness Program for
Mental Health to provide
mental health services,
including equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Youth Shelter Program of 1,600,000
Services Services Administration. Westchester, Mount Vernon, NY
for the YouthHEAL Integrated
Network project to provide
behavioral health services,
including equipment and
training.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health Youth Visionaries Youth 733,533
Services Services Administration. Leadership Academy, San
Bernardino, CA for the
Empowering Youth Resilience
and Promoting Social Emotional
Healing project to provide
mental health and other
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Substance Use And Mental Health YWCA Pierce County, Tacoma, WA 151,000
Services Services Administration. for behavioral health and
supportive services, including
training.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Abyssinian Development 1,000,000
Education. Corporation, New York, NY for
SEL programming and
professional development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Admiral Peary Area Vocational 1,005,000
Education. Technical School, Ebensburg,
PA for an instructional
program, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Adrienne Arsht Center Trust, 500,000
Education. Miami, FL for arts education
through theater production and
performance.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary American Association of 491,000
Education. Caregiving Youth, Boca Raton,
FL for supportive services for
caregiving youth.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary An Achievable Dream, Newport 1,594,355
Education. News, VA for student
enrichment and academic
support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Anaheim Union High School 2,000,000
Education. District, Anaheim, CA for a
theater and performing arts
program, including equipment
and technology installation.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Austin Independent School 2,015,750
Education. District, Austin, TX for
outdoor learning experiences,
including equipment and
furniture for outdoor
classrooms and exhibits.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Baldwin Union Free School 3,000,000
Education. District, Baldwin, NY for SEL
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Beasley-Brown Community 2,280,000
Education. Development Corporation, San
Antonio, TX for community-
based learning centers.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Best Buddies International, 100,000
Education. Baltimore, MD for school-based
programs that promote
inclusion.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Best Buddies International, 100,000
Education. Baltimore, MD for school-based
programs that promote
inclusion.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Best Buddies International, 100,000
Education. Houston, TX for inclusion
support for students with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Big Brothers Big Sisters Lone 250,000
Education. Star, Irving, TX for a youth
mentoring program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Big Brothers Big Sisters of 1,000,000
Education. Essex, Hudson & Union
Counties, Newark, NJ for
mentoring and student support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Big Sister Association of 250,000
Education. Greater Boston, MA for student
mentoring and enrichment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Big Thought, Dallas, TX for out- 1,000,000
Education. of-school learning, digital
credentialing, and learning
systems.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Birch Family Services, New 201,096
Education. York, NY for communication
systems for nonverbal children
and families.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Black Hawk College, Kewanee, IL 1,000,000
Education. for a manufacturing training
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Black Spectrum Theatre Co., 1,275,750
Education. Jamaica, NY for an African
American history program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys & Girls Club of Monmouth 500,000
Education. County, Asbury Park, NJ for
trauma-informed interventions
to address adverse childhood
experiences.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys & Girls Clubs of Southern 750,000
Education. Nevada, Las Vegas, NV for STEM
and SEL programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys & Girls Clubs of the Los 1,000,000
Education. Angeles Harbor, San Pedro, CA
for developing a digital
program for student support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys and Girls Club of Metro 400,861
Education. Atlanta, Chamblee, GA for
academic enrichment and
tutoring.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys and Girls Club of Metro 549,374
Education. Denver, CO for afterschool and
summer programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys and Girls Club of Metro 1,212,062
Education. Denver, CO for afterschool
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys and Girls Club of Pharr, 1,753,812
Education. TX for equipment and supplies
for youth development services.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Boys and Girls Clubs of Benton 1,500,000
Education. Harbor, Benton Harbor, MI for
educational, mentoring, and
tutoring program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Breakthrough of Greater 500,000
Education. Philadelphia, PA for a
teaching fellows program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Bridgewater State University, 1,358,000
Education. Bridgewater, MA for an
aviation education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Bristol Community College, Fall 1,000,000
Education. River, MA for workforce
education access and credit
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Brooklyn Bridge Park 1,025,000
Education. Conservancy, Brooklyn, NY for
academic enrichment programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Broward County Public Schools, 525,000
Education. Fort Lauderdale, FL for visual
arts and computer science
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Cambodia Town, Long Beach, CA 56,950
Education. for language access programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Cameron Community Ministries, 200,000
Education. Rochester, NY for afterschool
and summer enrichment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Cape Cod Community College, 1,000,000
Education. Barnstable, MA for a dental
hygiene program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Capitol Hill Arts Workshop, 250,000
Education. Washington, DC for youth
engagement through arts
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Career Technical Education 200,000
Education. Foundation Sonoma County,
Santa Rosa, CA for whole-
school transformation efforts.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Catholic Big Brothers and Big 500,000
Education. Sisters of Los Angeles, CA for
a postsecondary student
support program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Centro Cultural Aztlan, San 95,000
Education. Antonio, TX for arts education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Chapman University, Orange, CA 2,200,000
Education. for computational clusters,
lab infrastructure, and
postsecondary research
activities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Chicago Public Schools, 500,000
Education. Chicago, IL for arts
education, including equipment
and supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Chicago Public Schools, 500,000
Education. Chicago, IL for arts
education, including equipment
and supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Chicago Public Schools, 500,000
Education. Chicago, IL for arts
education, including equipment
and supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Chinese American Social 105,000
Education. Services Center, Brooklyn, NY
for academic and arts
programs, including support
for English learners.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary City of Greenacres, FL for 1,000,000
Education. youth programs, services, and
curricula, including
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary City of Indianapolis Department 1,000,000
Education. of Parks and Recreation,
Indianapolis, IN for an
afterschool physical education
enrichment program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary City of Indianapolis Department 1,000,000
Education. of Parks and Recreation,
Indianapolis, IN for arts and
environmental education access
in afterschool and summer
learning settings.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary City School District of New 2,000,000
Education. Rochelle, NY for afterschool
programs and summer learning.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Clayton State University, 750,000
Education. Morrow, GA for environmental
studies research, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Clearwater Marine Aquarium, 976,000
Education. Clearwater, FL for science
education and a mobile
classroom, including a vehicle.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Commonwealth of the Northern 311,939
Education. Mariana Islands Public School
System, Saipan, MP for
language immersion curriculum
and programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Connecticut Historical Society 1,000,000
Education. Museum and Library, Hartford,
CT for civics education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary CUNY Dominican Studies 809,092
Education. Institute, New York, NY for
historical curricula and
enrichment programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Dance Institute of Washington, 1,000,000
Education. DC for arts education and
dance training, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Dearborn Heights Libraries, 206,000
Education. Dearborn Heights, MI for
student mobile library
services, including a vehicle.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Dr. Carter G. Woodson African 3,000,000
Education. American History Museum, St.
Petersburg, FL for an African
American history program,
including technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Drew Child Development 143,000
Education. Corporation, Lynwood, CA for
an early childhood education
program, including
installation of an outdoor
science lab and learning space.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary El Paso Independent School 2,000,000
Education. District, El Paso, TX for
afterschool enrichment and
STEAM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Empowering Success Now, 532,500
Education. Fontana, CA for afterschool
and tutoring programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Encompass: Resources for 700,000
Education. Learning, Rochester, NY for
student academic and
wraparound services, including
transportation.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary End Hunger Calvert County, 300,000
Education. Huntingtown, MD for a pre-
apprentice skills program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Fairfax County, VA for early 1,500,000
Education. childhood development and
learning.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Fine Arts Work Center in 400,000
Education. Provincetown, MA for arts
education and cultural
programming for community
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Flint Institute of Science and 1,905,421
Education. History, Flint, MI for
afterschool programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Food Literacy Center, 1,050,000
Education. Sacramento, CA for science and
nutrition education, including
the development of a student
garden.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Foundation Communities, Austin, 1,107,925
Education. TX for learning center
programs, including enrichment
and literacy support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Foundation for the Advancement 750,000
Education. of Music & Education, Bowie,
MD for music education
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Freeport Union Free School 173,923
Education. District, Freeport, NY for a
college and career center,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Friendship Foundation, Redondo 1,000,000
Education. Beach, CA for inclusive
programs for students with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Georgia Institute of 215,000
Education. Technology, Atlanta, GA for
educational services for
children of military families,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Girl Scouts of Eastern 70,000
Education. Missouri, St. Louis, MO for
student mental health and anti-
violence programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Girl Scouts of Northeast Texas, 920,000
Education. Dallas, TX for programming to
develop skills and
competencies in STEM,
leadership development, and
financial empowerment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Glen Ellyn School District 41, 250,000
Education. Glen Ellyn, IL for school-
based mental health services
for students and families.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Grand Valley State University, 1,000,000
Education. Allendale, MI for a student
development program, including
the purchase of supplies and
student stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Greater New York Councils, Boy 50,000
Education. Scouts of America, New York,
NY for a youth scouting
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Guadalupe Cultural Arts Center, 102,250
Education. San Antonio, TX for student
literacy programs and access
to culturally relevant texts.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Guilford County Schools, 2,200,000
Education. Greensboro, NC for wraparound
services, academic supports,
and learning hubs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Haitian Americans United for 364,558
Education. Progress, Hollis, NY for youth
leadership and youth workforce
programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Harris County Public Library, 139,212
Education. Houston, TX for student access
to texts, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Hawaii Agriculture Foundation, 372,000
Education. Honolulu, HI for STEM programs
that incorporate innovative
agriculture technologies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Henry County Board of 40,000
Education. Education, McDonough, GA for
afterschool enrichment and
STEM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Hillsborough County Public 1,986,353
Education. Schools, Tampa, FL for arts
education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Hillsborough County Public 1,000,000
Education. Schools, Tampa, FL for career
and technical education in
construction and medical
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Hispanic Counseling Center, 128,468
Education. Hempstead, NY for afterschool
programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Holocaust Memorial Center, 605,000
Education. Farmington Hills, MI for a
Holocaust education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Holocaust Memorial Center, 550,000
Education. Farmington Hills, MI for a
Holocaust education program,
including support for English
learners and students with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Houston Independent School 1,975,000
Education. District, Houston, TX for
family and community
engagement programs for
students.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Houston Public Library, 2,000,347
Education. Houston, TX for digital
literacy resources.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Iowa Jobs for America's 250,000
Education. Graduates, Des Moines, IA for
career pathways and counseling
supports.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Ivy Tech Community College, 500,000
Education. Indianapolis, IN for early
childhood education programs,
including furniture, minor
repairs, and classroom
upgrades.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Jobs for Arizona's Graduates, 167,700
Education. Phoenix, AZ for targeted
student support programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Kennedy King Memorial 100,000
Education. Initiative, Indianapolis, IN
for human rights education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Kennedy Krieger Institute, 2,000,000
Education. Baltimore, MD for services to
students with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Kula No Na Poe Hawaii, 1,800,000
Education. Honolulu, HI for academic
supports and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Lenape Regional High School 593,663
Education. District, Shamong, NJ for post-
graduation student success
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Leo High School, Chicago, IL 250,000
Education. for a parent engagement
center, including equipment
and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary LGBT Center of Greater Reading, 113,520
Education. PA for wraparound services and
support for at-risk youth.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary LIFT, Detroit, MI for a 1,250,000
Education. manufacturing technician
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Long Beach Day Nursery, Long 250,000
Education. Beach, CA for early childhood
learning.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Long Beach Latino Civic 50,000
Education. Association, Long Beach, NY
for student support,
mentoring, and enrichment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Massachusetts Women of Color 416,275
Education. Coalition, Worcester, MA for a
summer learning program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Michigan's Own, Inc. dba-- 215,000
Education. Michigan Heroes Museum,
Frankenmuth, MI for
curriculum, exhibit, website
development, and educational
programming, including
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Milwaukee Public Library, 241,250
Education. Milwaukee, WI for child
literacy programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Monmouth College, Monmouth, IL 750,000
Education. for rural teacher preparation
and development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Museum of Science and Industry, 1,022,000
Education. Chicago, IL for STEM
education, including teacher
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Museums at Mitchel Doing 75,000
Education. Business As Cradle of Aviation
Museum, Garden City, NY for
STEM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary NAACP--Hayward/South Alameda 285,000
Education. County, Hayward, CA for a
parent engagement and student
success program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary National Aquarium, Baltimore, 401,615
Education. MD for STEM education and
professional development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary National Center for Families 500,000
Education. Learning, Louisville, KY for a
family engagement and
immersive technology program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary National Children's Museum, 1,000,000
Education. Washington, DC for student
educational exhibits and
programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary National World War II Museum, 2,000,000
Education. New Orleans, LA, for a
historical education project,
including technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary New York Hall of Science, 750,000
Education. Corona, NY for science
programming for preschool
students, including exhibits.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary New York Sun Works, New York, 800,000
Education. NY for a hydroponic farm STEM
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary New York Sun Works, New York, 800,000
Education. NY for hydroponic STEM
classrooms, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary New York Sun Works, New York, 500,000
Education. NY for hydroponic STEM
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary NH Jobs for America's 300,000
Education. Graduates, Manchester, NH for
programs to develop student
academic skills, including
supplies and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Norwalk La-Mirada Unified 2,200,000
Education. School District, Norwalk, CA
for career and technical
education pathways, dual
enrollment programs, and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Norwalk Public Schools, 1,323,660
Education. Norwalk, CT for marine science
pathways.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Ontario-Montclair School 272,077
Education. District, Ontario, CA for
STEAM programs, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Open Door Preschools, Austin, 824,900
Education. TX for preschool programs,
including outdoor learning
spaces, and wraparound
supports for at-risk families.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Optimist Boys' Home & Ranch, 270,000
Education. Inc. dba Optimist Youth Homes
& Family Services, Los
Angeles, CA for a tutoring
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Oregon Institute of Technology, 700,000
Education. Wilsonville, OR for a
healthcare career pathways
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Orlando Community & Youth 100,000
Education. Trust, Orlando, FL for student
enrichment through dragon
boating.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Pace Center for Girls, Inc., 500,000
Education. Jacksonville, FL for an
educational services,
counseling, and training
program, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Pace Center for Girls, Inc., 500,000
Education. Jacksonville, FL for
curriculum, technology, and
training program, including
the purchase of information
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Pace Center for Girls, 500,000
Education. Jacksonville, FL for
curriculum development and
support services.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Pace Center for Girls, 500,000
Education. Jacksonville, FL for student
support programs, including
SEL resources and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Pascua Yaqui Tribe, Tucson, AZ 862,813
Education. for academic programs,
curricula, and teacher
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Penumbra Theatre, Saint Paul, 1,000,000
Education. MN for the development,
testing, and implementation of
curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Pima County School 252,000
Education. Superintendent's Office,
Tucson, AZ for curricula,
resources, and professional
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Pinellas County Education 1,225,000
Education. Foundation, Inc., Largo, FL
for an early learning
initiative, including teacher
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Providence After School 350,000
Education. Alliance, Providence, RI for a
summer learning STEAM program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Research Foundation of the City 191,160
Education. University of New York,
Brooklyn, NY for a literacy
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Riverside County Office of 1,000,000
Education. Education, Riverside, CA for
early childhood education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Rock and Roll Hall of Fame and 1,000,000
Education. Museum, Cleveland, OH for arts
education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Roosevelt Union Free School 525,000
Education. District, Roosevelt, NY for
homework and tutoring support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary San Diego State University, San 524,972
Education. Diego, CA for school-based
behavioral health training and
supports.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Santa Ana College, Santa Ana, 2,000,000
Education. CA for CTE pathways to
certificate and degree
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Santa Clara County Office of 1,000,000
Education. Education, San Jose, CA for
student broadband access,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary School District of Borough of 850,000
Education. Morrisville, PA for a
curriculum, instruction, and
technology program, including
the purchase of information
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary School District of Osceola 953,000
Education. County, FL for a youth
entrepreneurship program,
including support for student
internships, a vehicle, and
capital for student businesses.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Seed St. Louis, MO for STEM 380,000
Education. education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Seminole County Public Schools, 526,692
Education. Sanford, FL for high school
health careers programs,
including medical equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Shedd Aquarium, Chicago, IL for 595,025
Education. STEAM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Soulsville Foundation, Memphis, 1,150,000
Education. TN for an afterschool music
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Soundscapes, Newport News, VA 677,000
Education. for expanding access to arts
education, including a
feasibility study for growth.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary South City Foundation, 2,000,000
Education. Tallahassee, FL for an early
childhood education program,
including technology upgrades.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Southland Career and Technical 1,740,000
Education. Education Center, Matteson, IL
for classroom design and
curricula for career and
technical education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Springfield Public Schools, 385,000
Education. Springfield, OR for a career
and technical cosmetology
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary St. Louis Public Schools, St. 252,713
Education. Louis, MO for CTE programs in
construction trades, including
scholarships for technical
college programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Stars of New York Dance, 500,000
Education. Brooklyn, NY for arts
education enrichment programs,
including student scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Start Lighthouse, New York, NY 205,500
Education. for literacy and learning
spaces in schools.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Strategic Human Services, 832,140
Education. Chicago, IL for communication
and journalism education,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Tacoma Public School District, 555,000
Education. Tacoma, WA for career
preparation and internship
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary TECH CORPS, Columbus, OH for 300,000
Education. computer science education,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Tennessee Technological 400,000
Education. University, Cookeville, TN for
lending library programs,
including purchase of
supplies, information
technology, and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Texas A&M University San 300,000
Education. Antonio, TX for a mobile unit
offering school-based autism
services and educational
supports.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Texas State University -- Round 1,000,000
Education. Rock, Round Rock, TX for a
STEM educational and
professional development
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary The Bridge Teen Center, Orland 500,000
Education. Park, IL for afterschool
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary The Brotherhood Sister Sol, New 1,000,000
Education. York, NY for afterschool
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary The Center for the Innovative 2,000,000
Education. Training of Youth STEM NOLA,
New Orleans, LA for STEM
learning and career readiness
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary The Garage Community and Youth 100,000
Education. Center, Avondale, PA for
afterschool youth development
programs, including a vehicle.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary The Noel Pointer Foundation, 414,500
Education. Brooklyn, NY for music
instruction programs,
including student scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary The Regents of the University 1,125,360
Education. of California; University of
California San Diego, La
Jolla, CA for summer math
academies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary The West Virginia Chamber 200,000
Education. Foundation Corporation,
Charleston, WV for a drop-out
prevention and school-to-work
transition program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Toledo Tomorrow, Toledo, OH for 1,050,000
Education. an early childhood reading
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Town of Randolph, MA for mobile 524,000
Education. library and STEM programming,
including vehicle and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Trumbull County Educational 650,000
Education. Service Center, Niles, OH for
STEM education, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary United Way of Wyoming Valley, 2,200,000
Education. Wilkes-Barre, PA for
wraparound services and
academic supports, including
pre-K tuition stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary University of California 1,000,000
Education. Berkeley, CA for a social
science research and
postdoctoral pipeline program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary University of Connecticut 1,000,000
Education. Health Center, Farmington, CT
for K-12 STEM education
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary University of Mississippi, 1,000,000
Education. University, MS for a
professional development
program and writing initiative.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary University of Nebraska System, 2,000,000
Education. Lincoln, NE for a science,
technology, engineering, and
mathematics program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary University of Washington 811,061
Education. Bothell, WA for pathways
toward environment and
sustainability degree
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Upper Darby Arts & Education 115,000
Education. Foundation, Drexel Hill, PA
for creative arts programs for
students with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Virgin Islands Department of 2,200,000
Education. Education, St. Thomas, VI for
electric vehicle classes,
career and technical college
programs, and STEM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Washtenaw Community College, 1,000,000
Education. Ann Arbor, MI for an electric
battery and charging station
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Waterbury Public Schools, 2,265,000
Education. Waterbury, CT for education
technology equipment,
including computers.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Watts Labor Community Action 922,000
Education. Committee, Los Angeles, CA for
afterschool programming and
arts education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Waukegan to College, Waukegan, 315,000
Education. IL for mentoring, tutoring,
and academic advising programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary West Chester University, West 715,770
Education. Chester, PA for STEM education
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary Winston-Salem/Forsyth County 301,548
Education. Schools, Winston-Salem, NC for
teacher academy programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary YMCA of Greater New York, NY 1,000,000
Education. for youth support and
enrichment programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary YMCA of Memphis and the Mid- 1,000,000
Education. South, Cordova, TN for
educational programs before
and after school.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary YMCA of Metropolitan Chicago, 666,366
Education. IL for afterschool programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary YMCA of Metropolitan Los 1,500,000
Education. Angeles, CA for empowerment
learning pods.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Secondary YMCA of Metropolitan Los 2,000,000
Education. Angeles, Van Nuys, CA for
STEAM and civics education.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Adoption Rhode Island, 201,639
Providence, RI for an adoption
and foster care certificate
program, including
scholarships and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Agnes Scott College, Decatur, 1,024,940
GA for digital skill building
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Albany Technical College, 1,000,000
Albany, GA for allied health
programs, including equipment,
a vehicle, and scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Aliento Education Fund, 300,000
Phoenix, AZ for first-
generation college student
access and success programs,
including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... AltaSea at the Port of Los 1,000,000
Angeles, San Pedro, CA for
postsecondary ocean-based
research, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Alvernia University Reading 2,000,000
Collegetowne, Reading, PA for
a health science program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Alvernia University, Reading, 1,000,000
PA for the purchase of
information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Angelo State University, San 2,000,000
Angelo, TX for equipment,
scholarships, and stipends for
an aviation degree program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Aquinas College, Grand Rapids, 185,000
MI for a professional
development and curriculum
development for a teaching
center.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Arkansas Tech University, 730,000
Russellville, AR for purchase
of lab equipment and
technology for agricultural
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... AUC Consortium, Atlanta, GA for 2,000,000
programs promoting career
pathways into government
service, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Augusta University, Augusta, GA 1,000,000
for a telemedicine education
initiative, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Aurora University, Aurora, IL 955,000
for an emerging technologies
learning lab, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Austin Community College 2,830,000
District, Austin, TX for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Austin Community College, 1,467,542
Austin, TX for cybersecurity
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Austin Independent School 1,862,600
District for college and
career preparation, including
transportation.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Bay Path University, 1,000,000
Longmeadow, MA for wraparound
academic and student support
services.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Baylor University, Waco, TX for 1,500,000
a cybersecurity program,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Birmingham-Southern College, 500,000
Birmingham, AL for
experimental learning and
civic engagement.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Bluegrass Community and 1,570,000
Technical College, Lexington,
KY for a health professions
program, including the
purchase of equipment and
supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Boys & Girls Club of the West 450,000
Valley, Canoga Park, CA for
afterschool programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Cabrillo College, Aptos, CA for 163,539
science learning, including
learning lab furniture and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... California State University-- 1,681,720
Stanislaus, Turlock, CA for a
mental health workforce
program, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... California State University 550,800
Channel Islands, Camarillo, CA
for a cybersecurity degree
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... California State University, 1,000,000
Northridge, CA for arts,
media, and communications
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Campbellsville University, 950,000
Campbellsville, KY for
information technology and
equipment upgrades.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Chabot--Las Positas Community 1,000,000
College District, Dublin, CA
for student support programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Chicago State University, 1,600,000
Chicago, IL for communication
and media career development
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... City College of New York, NY 2,200,000
for an infrastructure
workforce training program and
center.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... City Colleges of Chicago Malcom 1,000,000
X College, Chicago, IL for an
emergency medical technician
student success program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Coahoma Community College, 1,664,100
Clarksdale, MS for campus
safety, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Collaborative for Higher 2,000,000
Education Shared Services,
Santa Fe, NM for a
cybersecurity shared services
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Connecticut Historical Society 1,000,000
Museum and Library, Hartford,
CT for the use of community
history in postsecondary
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Contra Costa Community College 1,000,000
District, Martinez, CA for an
open educational resources
project.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... CUNY Mexican Studies Institute, 1,246,080
Bronx, NY for a literacy and
language skills program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... CUNY York College, Queens, NY 1,267,500
for geology and environmental
science programs, including
student stipends and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... CUNY York College, Queens, NY 850,000
for pharmaceutical science
workforce training, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Cyber Security Range at Union 3,000,000
Station, Springfield, MA for a
cybersecurity program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Cypress College, Cypress, CA 500,000
for veteran and military-
connected student pathways,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Dallas College, Dallas, TX for 500,000
a teaching residency
apprenticeship program,
including stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Davenport University, Grand 1,325,000
Rapids, MI for a dual language
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Davenport University, Grand 760,000
Rapids, MI for a teacher
training program, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Desert Research Institute, Las 1,000,000
Vegas, NV for partnerships
between STEM and education
majors, including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Dominican Women's Development 1,000,000
Center, New York, NY for
afterschool, STEM education,
and postsecondary access
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... East Central College, Union, MO 1,000,000
for the purchase of distance
learning equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Eastern Gateway Community 914,000
College, Steubenville, OH for
electric vehicle technology
training, including
installation of equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Eckerd College, St. Petersburg, 1,000,000
FL for a marine science
laboratory space, including
the installation of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Edmonds College, Lynnwood, WA 1,300,000
for marine and AI robotics
pathways programs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Elgin Community College, Elgin, 936,000
IL for a mechatronics
certificate program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Elms College, Chicopee, MA for 1,000,000
social sciences and education
curriculum and programming,
including scholarships and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Emory University, Atlanta, GA 500,000
for a nursing apprenticeship
program, including stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Folsom Lake College, Folsom, CA 950,000
for a prison and reentry
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... FoodTEC, Newburgh, NY for a 1,125,000
workforce development program,
including scholarships for
daycare facilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Franklin Pierce University, 825,000
Rindge, NH for rural health
care education and training,
including technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... George Mason University, 1,000,000
Fairfax, VA for a
cybersecurity and IT
modernization program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Georgia State University, 400,000
Atlanta, GA for programs to
expand access to postsecondary
education, including English
language proficiency support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Glendale College Foundation, 1,250,000
Glendale, CA for student basic
needs support, including
rental assistance.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Goodwin University, East 2,200,000
Hartford, CT for a mobile
manufacturing and nursing
program, including equipment
and scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Goucher College, Towson, MD for 1,255,800
life and health sciences
teaching labs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Grambling State University, 2,500,000
Grambling, LA for a
cybersecurity initiative,
including scholarships,
stipends and purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hamline University, Saint Paul, 1,000,000
MN for academic internship
programs, including student
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hampton University, Hampton, VA 2,200,000
for an allied health services
and workforce development
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Harper College Aviation 500,000
Maintenance Program, Palatine,
IL for an aviation technical
training program, including
scholarships and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Harris County Public Library, 578,000
Houston, TX for college and
career guidance programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hispanic Federation, Orlando, 200,000
FL for college preparatory
support for middle and high
school students, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hostos Community College of the 1,000,000
City University of New York,
The Bronx, NY, for community
college articulation agreement
support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hudson County Community 2,200,000
College, Jersey City, NJ for
technological enhancements to
student learning, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hudson Valley Community 2,065,000
College, Troy, NY for STEM and
healthcare workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Husson University, Bangor, ME 725,491
for science laboratory
programming, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Joan B Kroc School of Peace 580,000
Studies at the University of
San Diego, CA for a research
lab program to combat
violence, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Johnson & Wales University, 1,012,000
Providence, RI for
cybersecurity training for
teachers, including stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Kirkwood Community College, 360,000
Cedar Rapids, IA for the
purchase of aviation
information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Lehman College of the City 500,000
University of New York, Bronx,
NY for a digital equity
initiative, including
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Local 212 MATC Believe in 250,000
Students FAST Fund, Milwaukee,
WI for financial assistance to
low-income students.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Loisaida, New York, NY for an 300,000
environmental and community
science program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Los Angeles Community College 1,000,000
District, Los Angeles, CA for
mobile work-based workforce
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Los Angeles Mission College, 2,000,000
Sylmar, CA for allied health
programs and STEM services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Louisiana Delta Community 1,555,000
College, Monroe, LA for a
health science and education
program, including
scholarships, purchase of
equipment, and support
services.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Louisiana State University of 990,000
Alexandria, Alexandria, LA for
a teacher education program,
including scholarships and
tuition reimbursement.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Manor College, Jenkintown, PA 1,275,667
for wraparound services,
advising, and basic needs
supports for at-risk student
populations, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Maria College, Albany, NY for 770,088
nursing programs, including
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Marquette University, 799,500
Milwaukee, WI for college
readiness and STEM pipeline
services.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Maryville College, Maryville, 645,000
TN for a STEM project,
including scholarships,
stipends, and purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Marywood University, Scranton, 2,607,464
PA for healthcare workforce
expansion programs, including
equipment and scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Mass. Bay Community College, 400,000
Wellesley, MA for a center for
health sciences, early
education, and human services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Massachusetts College of 620,000
Liberal Arts, North Adams, MA
for a nursing program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... McLennan Community College, 1,100,000
Waco, TX for the purchase of
information technology and
equipment for healthcare
training programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Mid-America Christian 555,000
University, Oklahoma City, OK
for the purchase of STEM lab
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Middlesex College, Edison, NJ 1,000,000
for adult and justice-impacted
learner support, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Midlands Technical College, 1,000,000
Columbia, SC for a skilled
trades training program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... MiraCosta Community College 1,000,000
District, Oceanside, CA for
accelerated skills-based
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Modesto Junior College, 2,000,000
Modesto, CA for regional fire
science training programs,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Montgomery County Community 100,000
College, Blue Bell, PA for
early college programs,
including equipment and
tuition support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Moorpark College, Moorpark, CA 300,000
for a work-based learning
cybersecurity program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Moraine Valley Community 500,000
College, Palos Hills, IL for
non-destructive testing
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Nevada State College, 1,624,294
Henderson, NV for a career
advancement and training
center, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Nevada State College, 611,968
Henderson, NV for a nursing
program, including equipment
and scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... New Hampshire Technical 767,000
Institute, Concord, NH for
dental training program
modernization, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Niagara University, NY for 750,000
study and research in
scientific disciplines,
including equipment and
materials.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Nichols College, Dudley, MA for 680,000
an intelligent business
automation program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Normandale Community College, 188,875
Bloomington, MN for health
sciences education.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northampton County Community 2,729,288
College, Bethlehem, PA for
healthcare and workforce
development programs,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northeastern University, 1,000,000
Boston, MA for an associate's
to master's degree accelerator
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northern Illinois University, 1,500,000
DeKalb, IL for microchip
research and training,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northern Virginia Community 685,000
College, Annandale, VA for a
diesel technology certificate
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northern Virginia Community 2,200,000
College, Annandale, VA for a
nursing program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Nova Southeastern University, 2,000,000
Fort Lauderdale, FL for a
spatial computing and robotics
program, including equipment
and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Nova Southeastern University, 2,500,000
Fort Lauderdale, FL for
cybersecurity research,
including equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Oklahoma State University-- 3,000,000
Oklahoma City, Oklahoma City,
OK for an education program,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Oxnard College, Oxnard, CA for 628,600
faculty professional
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Palm Beach State College, Lake 1,000,000
Worth, FL for an artificial
intelligence workforce
development program, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Pasadena Community College 500,000
District, Pasadena, CA for a
family resource center,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Pierce College, Woodland Hills, 2,000,000
CA for biotech baccalaureate
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Pima Community College 1,000,000
District, Tucson, AZ for a
building and construction
technology program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Pima County Community College 1,000,000
District, Tucson, AZ for a
building and construction
technology program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Prairie State College, Chicago 1,000,000
Heights, IL for a dental
hygiene program, including
enhancements and the
installation of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Prairie View A&M University, 2,400,000
Prairie View, TX for the
purchase of science and
engineering lab equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Ready to Succeed, Santa Monica, 1,000,000
CA for support for college-
going foster youth, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Research Foundation of the City 534,982
University of New York,
Brooklyn, NY for a pre-law
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Research Foundation of the City 792,000
University of New York, NY for
a learning hub for the study
of history and culture,
including equipment and space
furnishings.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Riverside Community College 3,000,000
District, Riverside, CA for a
military articulation platform
expansion, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Riverside Community College 3,000,000
District, Riverside, CA for
career training programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rust College, Holly Springs, MS 500,000
for a leadership development
program, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rutgers University-Camden, NJ 1,404,800
for community partnership
centers.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Saint Augustine's University, 490,000
Raleigh, NC for public health
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Salt Lake Community College, 390,000
Salt Lake City, UT for an
educational program, including
student scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... San Diego Community College 1,200,000
District, San Diego, CA for
centers to support LGBT
students.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... San Diego Community College 1,200,000
District, San Diego, CA for
student support services for
DACA recipients.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... San Joaquin Delta College, 3,800,000
Stockton, CA for nursing
programs, including equipment
and technology for simulation
labs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Santa Clarita Community College 1,000,000
District -- College of the
Canyons, Santa Clarita, CA for
the purchase of robotics
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Seminole State College of 404,114
Florida, Sanford, FL for a
fire science program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Siena Heights University, 1,000,000
Adrian, MI for student
scholarships and the purchase
of lab equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Simmons College of Kentucky, 602,500
Louisville, KY for academic
support programs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Snead State Community College, 1,000,000
Boaz, AL for the purchase of
information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Social Enterprise Center, 1,500,000
Albuquerque, NM for computing
infrastructure and workforce
development, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... St. Francis College, Brooklyn, 1,500,000
NY for nursing programs,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... St. Joseph's College New York, 754,000
Brooklyn, NY for a
cybersecurity lab program,
including equipment
installation, furnishings, and
refurbishments.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Stevens Institute of 960,000
Technology, Hoboken, NJ for
computer science programs,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Sustainable Cities Institute, 1,156,695
Eugene, OR for a
sustainability and student
support program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Tennessee Technological 3,000,000
University, Cookeville, TN for
the purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Texas A&M International 1,000,000
University, Laredo, TX for a
center to combat human
trafficking, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Texas A&M Transportation 1,600,000
Institute, Bryan, TX for an
electric vehicle program,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Texas A&M University, College 1,500,000
Station, TX for a forensic
science education program,
including student support for
fellowships and internships
and the purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Texas A&M University-Commerce, 516,614
Dallas, TX for a teacher
certification program,
including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Texas Wesleyan University, Fort 1,439,695
Worth, TX for STEM education
programs, including lab
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... The National Veteran Memorial 204,800
and Museum Operating
Corporation, Columbus, OH for
graduate-level instruction to
veterans, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... The Ohio State University, 1,045,000
Columbus, OH for a quantum
network research program,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... The University of North 399,952
Georgia, Dahlonega, GA for a
teacher candidate residency
program, including equipment
and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... The University of Texas at 3,000,000
Dallas, Richardson, TX for
semiconductor workforce
development programs,
including equipment
infrastructure and
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Towson University, Towson, MD 950,000
for a teacher workforce
pipeline program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of California 1,000,000
Riverside, CA for agricultural
innovation programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of California, 1,205,967
Davis, CA for wildfire smoke
research, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of California-San 2,160,000
Diego, La Jolla, CA for
pipelines into STEM careers.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Central Florida, 500,000
Orlando, FL for academic
research on Puerto Rico.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Colorado Anschutz 783,580
Medical Center, Aurora, CO for
a rural public health
certificate program, including
student project support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Colorado Anschutz 460,584
Medical Center, Aurora, CO for
an injury and violence
prevention center, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Georgia College 1,000,000
of Agricultural and
Environmental Sciences,
Athens, GA for a poultry
science program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Hawaii--Office of 1,000,000
Strategic Health Initiatives,
Honolulu, HI for an indigenous
data science hub.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of La Verne, CA for 2,200,000
a mental health practitioner
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Maryland Global 246,000
Campus, Adelphi, MD for a peer
tutoring program, including
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Nevada Las Vegas, 3,000,000
NV for advanced sports
research, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of New Hampshire, 1,000,000
Durham, NH for child study and
development education.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of North Alabama, 500,000
Florence, AL for new program
development, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of North Florida, 750,000
Jacksonville, FL for
information technology
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of North Florida, 375,000
Jacksonville, FL for the
purchase of information
technology and equipment,
including associated software.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of South Florida, 2,000,000
Sarasota, FL for a
cybersecurity program,
including the purchase of
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of the District of 1,000,000
Columbia, Washington, DC for a
math teacher training
institute, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Wisconsin -- 1,000,000
Madison, WI for STEM education
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Utah System of Higher 1,250,000
Education, Salt Lake City, UT
for the purchase of equipment
and supplies to expand
healthcare training programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Utah Tech University, St. 790,000
George, UT for a science
training program, including
purchase of equipment and
teacher stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Valdosta State University, 750,000
Valdosta, GA for an online
educational degree program,
including purchase of
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Vida Mobile Clinic, Granada 1,350,000
Hills, CA for programs to
support pre-health
postsecondary students,
including student stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Virginia Commonwealth 1,073,550
University, Richmond, VA for
pipelines into STEM
professions, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Virginia Foundation for 254,910
Community College Education,
Richmond, VA for early
childhood educator development
programs, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Virginia State University, 2,200,000
Petersburg, VA for broadband
improvement, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Virginia Union University, 2,000,000
Richmond, VA for cybersecurity
programming, including
installation and
reconfiguration of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Wake Technical Community 939,041
College, Raleigh, NC for
electric vehicle technical
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Wayne County Community College 212,400
District, Detroit, MI for an
automotive electrification and
testing program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Western Kentucky University, 460,000
Bowling Green, KY for the
purchase of applied research
and technology equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Western University of Health 100,000
Sciences, Ontario, CA for
health career student support
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Western Washington University, 450,000
Bellingham, WA for a food
security program, including
furnishing a longhouse with
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Westfield State University, 1,000,000
Westfield, MA for a nursing
and health sciences program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... William Paterson University, 1,000,000
Wayne, NJ for student support,
including scholarships.
----------------------------------------------------------------------------------------------------------------
House of Representatives Reporting Requirements
The following materials are submitted in accordance with
various requirements of the Rules of the House of
Representatives:
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, the following is a statement of
general performance goals and objectives for which this measure
authorizes funding: The Committee on Appropriations considers
program performance, including a program's success in
developing and attaining outcome-related goals and objectives,
in developing funding recommendations.
RESCISSION OF FUNDS
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following lists the rescissions
of unexpended balances included in the accompanying bill:
RESCISSIONS RECOMMENDED IN THE BILL
------------------------------------------------------------------------
Account Amount
------------------------------------------------------------------------
Department of Health and Human Services Nonrecurring $500,000,000
Expenses Fund........................................
Department of Education Pell Grants................... 221,000,000
------------------------------------------------------------------------
Disclosure of Earmarks and Congressionally Directed Spending Items
The following table is submitted in compliance with clause
9 of rule XXI, and lists the congressional earmarks (as defined
in paragraph (e) of clause 9) contained in the bill or in this
report. Neither the bill nor the report contain any limited tax
benefits or limited tariff benefits as defined in paragraphs
(f) or (g) of clause 9 of rule XXI.
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES
[Community Project Funding]
----------------------------------------------------------------------------------------------------------------
House
Agency Account Project House Amount Requestors
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Agape Child & Family Services, $1,000,000 Cohen
Administration. Memphis, TN for job training,
career placement, and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Apprentice Training for the 1,994,875 Dean
Administration. Electrical Industry,
Collegeville, PA for green job
workforce development and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Apprenticeship and Nontraditional 675,000 Smith (WA)
Administration. Employment for Women, Renton, WA
to expand construction pre-
apprenticeship programming and
CDL training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Artpreneurs, Inc. dba Arts on the 100,000 Raskin
Administration. Block, Silver Spring, MD for a
creative workforce
apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Association House of Chicago, 500,000 Garcia (IL)
Administration. Chicago, IL for workforce
development training programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Augusta University, Augusta, GA 2,000,000 Bishop (GA)
Administration. for workforce training and job
placement in the healthcare
industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Baltimore Alliance for Careers in 827,905 Sarbanes
Administration. Healthcare, Baltimore, MD for
healthcare workforce development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Baycare Health Systems Inc, 963,620 Crist
Administration. Clearwater, FL for a workforce
development program focused on
nurses and nursing support
professionals.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Bidwell Training Center, 400,000 Lamb
Administration. Pittsburgh, PA for the
development of a controlled
environment agriculture
workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Black Veterans for Social 1,000,000 Jeffries
Administration. Justice, Inc., Brooklyn, NY for
stipends, supportive services,
and job placement for formerly
incarcerated veterans.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Boys & Girls Club of Greater 2,200,000 Trahan
Administration. Lowell, Inc., Lowell, MA for
workforce development activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Boys & Girls Club San Fernando 500,000 Cardenas
Administration. Valley, Pacoima, CA for a youth
workforce development initiative
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Bright Star Community Outreach, 175,000 Rush
Administration. Chicago, IL for workforce
development activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Bronx Community College of the 150,000 Torres (NY)
Administration. City University of New York,
Bronx, NY for health care job
training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Building and Construction Trades 1,000,000 Lee (CA)
Administration. Council of Alameda County,
Oakland, CA for the Retention
Apprenticeship Mentoring Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training CAMBA, Inc., Brooklyn, NY for 590,000 Jeffries
Administration. career navigation, job placement
services, and supportive
services for youth.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training CASA, Baltimore, MD for job 573,045 Mfume
Administration. skills training, job placement
services, stipends, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Center for the Women of New York, 1,000,000 Suozzi
Administration. Kew Gardens, NY for career
skills and job counseling.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Center for Urban Families, 750,000 Mfume
Administration. Baltimore, MD for job readiness
programs and job placement.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Chemeketa Community College, 340,000 Schrader
Administration. Salem, OR for a commercial truck
driving program and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Dearborn, MI for a 1,000,000 Dingell
Administration. training program for women who
have been underrepresented in
the workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Houston, TX for job 1,000,000 Jackson Lee
Administration. training in the home recovery
and construction industries.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Jersey City, NJ for an 750,000 Sires
Administration. apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Los Angeles Youth 640,108 Schiff
Administration. Development Department, Los
Angeles, CA for workforce
development activities and
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Stockton, CA for the 1,000,000 McNerney
Administration. Youth Workforce Development
Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Colorado Building and 500,000 Perlmutter
Administration. Construction Trades Council,
Denver, CO for workforce
training and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Community College of Baltimore 721,130 Ruppersberger
Administration. County, Baltimore, MD to expand
their CDL training program and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Community Learning Partnership, 351,000 Khanna
Administration. Cupertino, CA for job skills
training and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Consortium for Early Learning 1,000,000 Takano
Administration. Services, Moreno Valley, CA for
early care and education
workforce development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trade Workforce 1,000,000 Swalwell
Administration. Initiative, Oakland, CA for an
apprenticeship program and
curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000 Khanna
Administration. Initiative, Fremont, CA for
construction trades
apprenticeship programs and
curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000 DeSaulnier
Administration. Initiative, Oakland, CA for a
construction apprenticeship
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000 Garamendi
Administration. Initiative, Oakland, CA for an
apprenticeship readiness program
focused on construction trades.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Construction Trades Workforce 1,000,000 Lee (CA)
Administration. Initiative, Oakland, CA for
apprenticeship readiness
programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Corporation to Develop 1,862,625 Castor (FL)
Administration. Communities of Tampa, Inc.,
Tampa, FL for a pre-
apprenticeship program,
apprenticeship program, and job
training services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training County of Delaware, Media, PA for 1,988,635 Scanlon
Administration. the Prison-to-Community
Workforce Development Initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training County of Los Angeles 2,000,000 Lieu
Administration. Alternatives to Incarceration
Office (CEO), Los Angeles, CA
for a youth job training program
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Covenant House Washington, 329,750 Norton
Administration. Washington, DC for workforce
development activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Cuyahoga Community College 1,220,000 Brown (OH)
Administration. District, Cleveland, OH for
smart manufacturing workforce
training, equipment, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Dallas College, Dallas, TX for a 500,000 Veasey
Administration. teaching residency
apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Delta Veterans Group, Antioch, CA 100,000 McNerney
Administration. for job readiness activities
supporting veterans.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Des Moines Area Community 339,000 Axne
Administration. College, Ankeny, IA for a
workforce development initiative
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Downriver Community Conference, 703,700 Dingell
Administration. Southgate, MI for skills
training, job placement, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Easter Seals North Georgia, Inc., 200,000 Johnson (GA)
Administration. Clarkston, GA for early
childhood workforce development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Economic Development and 1,000,000 Pressley
Administration. Industrial Corporation of
Boston, Boston, MA for workforce
development programs and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Energy Coordinating Agency of 925,000 Evans
Administration. Philadelphia, Inc.,
Philadelphia, PA for skill
training in high demand
occupations.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training EntreNous Youth Empowerment 575,000 Barragan
Administration. Services, Compton, CA for
vocational training and services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fairfax County Government, 2,000,000 Connolly
Administration. Fairfax, VA for medical
professional workforce
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fairfax County, Fairfax, VA for 2,100,000 Connolly,
Administration. career readiness and job Wexton
training for youth.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fresno County Economic 500,000 Costa
Administration. Opportunities Commission,
Fresno, CA for vocational
training and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Future Plans Inc., Chagrin Falls, 1,000,000 Kaptur
Administration. OH for the Great Lakes Career
Corridor Project.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Future Plans, Inc., Chagrin 1,995,000 Johnson (OH)
Administration. Falls, OH for a career planning
and community engagement
initiative, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Golden Triangle Resource 1,000,000 Bishop (GA)
Administration. Conservation and Development
Council, Dawson, GA for heavy
equipment training, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Green City Force, Brooklyn, NY to 750,000 Jeffries
Administration. expand their workforce
development program and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Guilford Child Development, 300,000 Manning
Administration. Greensboro, NC for a child
development associate
apprenticeship program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hampton Roads Workforce Council, 850,000 Scott (VA)
Administration. Norfolk, VA for maritime
workforce development activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hartford Communities That Care, 1,322,539 Larson (CT)
Administration. Hartford, CT for a job training
program to address the need for
violence prevention
professionals.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hatzalah Chicago, Lincolnwood, IL 525,000 Schakowsky
Administration. for workforce training
activities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Homeboy Industries, Los Angeles, 1,959,451 Gomez
Administration. CA for job training for culinary
and hospitality careers and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Howard County Autism Society, 440,000 Sarbanes
Administration. Columbia, MD for the Autism
Hiring Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Jewish Community Centers of South 1,504,329 Wasserman
Administration. Broward, Inc., Davie, FL for Schultz
employment training for
individuals with IDD.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Jewish Family Service of Atlantic 550,000 Van Drew
Administration. County, Inc., Margate, NJ for
job skills program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Jobs for America's Graduates of 350,000 Boyle,
Administration. Pennslyvania, Inc., Brendan F.
Philadelphia, PA to expand
career readiness programs and
skill training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Kean University, Union, NJ for 1,000,000 Payne
Administration. workforce development activities
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training LaGuardia Community College, Long 404,774 Maloney,
Administration. Island City, NY to expand Carolyn B.
vocational training for the
underemployed.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Latin American Association, Inc, 300,000 Bourdeaux
Administration. Atlanta, GA for employment
training, support services, and
a workforce development
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Latina Coalition of Silicon 376,000 Lofgren
Administration. Vally, San Jose, CA for
workforce development programs
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Laurel Highlands Workforce and 445,000 Reschenthaler
Administration. Opportunity Center, Greensburg,
PA for a workforce support
program, including supplies and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Los Angeles Brotherhood Crusade-- 1,000,000 Bass
Administration. Black United Fund Inc., CA for
youth workforce development and
job placement.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Los Angeles Conservation Corps, 272,000 Barragan
Administration. Los Angeles, CA, for job
training and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Los Angeles World Airports, Los 1,000,000 Waters
Administration. Angeles, CA for an aviation
workforce development program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Mahoning County Career and 285,000 Johnson (OH)
Administration. Technical Center, Canfield, OH
for an energy and technology
workforce training center
project, including the purchase
of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Maricopa County Community College 1,000,000 Stanton
Administration. District, Tempe, AZ for
workforce development activities
and curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training McAllen Independent School 200,000 Gonzalez,
Administration. District, McAllen, TX for Vicente
private pilot and remote drone
license training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Mercy Hospital dba Northern Light 1,000,000 Pingree
Administration. Mercy Hospital, Portland, ME for
workforce training and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Michigan Early Childhood 2,000,000 Lawrence
Administration. Investment Corporation, Lansing,
MI for the development of a
child care workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training MorseLife Health System, West 500,000 Cherfilus-
Administration. Palm Beach, FL for job training McCormick
of underserved populations and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New Immigrant Community 500,000 Ocasio-Cortez
Administration. Empowerment, Jackson Heights, NY
to expand a construction
industry workforce development
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New Mexico Highlands University, 750,000 Leger
Administration. Las Vegas, NM for the Fernandez
development of professional
social workers.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New York State Energy Research 3,000,000 Ocasio-Cortez
Administration. and Development Authority,
Albany, NY for clean energy
workforce development and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Northeast Community College, 1,000,000 Smith (NE)
Administration. Norfolk, NE for a commercial
driver's license program,
including the purchase of
equipment and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Northwest Arkansas Community 355,000 Womack
Administration. College, Bentonville, AR for a
commercial driver's license
program, including the purchase
of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Northwest New Mexico Council of 750,000 Leger
Administration. Governments, Gallup, NM to Fernandez
transition and re-skill workers
into the industrial industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training OCHIN, Inc., Portland, OR for 2,001,642 Bonamici
Administration. health information technology
training and professional
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Opportunity Junction, Antioch, CA 470,000 DeSaulnier
Administration. for a job training program and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Pasadena Independent School 2,200,000 Garcia (TX)
Administration. District, Pasadena, TX for job
skill training and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Pee Dee Healthy Start Inc., 1,000,000 Clyburn
Administration. Florence, SC for workforce
training and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Plattsburgh-North County Chamber 500,000 Stefanik
Administration. of Commerce, Plattsburgh, NY for
a job training and assistance
program, including support
services and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Portland Community College, 910,000 Bonamici
Administration. Portland, OR for semiconductor
and advanced manufacturing
workforce development initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Primary Care Coalition of 1,300,000 Raskin
Administration. Montgomery County, Inc., Silver
Spring, MD for health care
professionals' workforce
development and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Prince George's County Memorial 2,200,000 Brown (MD)
Administration. Library System, Largo, MD for a
mobile job readiness unit.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Prince George's County, Largo, MD 3,000,000 Brown (MD)
Administration. for the Youth@Work program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Promise Neighborhoods of Lehigh 1,549,360 Wild
Administration. Valley, Allentown, PA to expand
their workforce development
skills program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Reading and Beyond, Fresno, CA 484,047 Costa
Administration. for employment and training
services and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Rockdale County Georgia, Conyers, 300,000 Johnson (GA)
Administration. GA for a workforce development
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Bernadino Valley College 1,500,000 Aguilar
Administration. Foundation, San Bernadino, CA
for clean energy workforce
development and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Diego Community College 1,000,000 Peters
Administration. District, San Diego, CA for the
Gateway to College and Career
program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Diego Workforce Partnership, 800,000 Peters
Administration. San Diego, CA for the TechHire
Program..
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training San Gabriel Valley Council of 2,000,000 Napolitano,
Administration. Governments, Alhambra, CA for a Sanchez
workforce development program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Santa Clara County, San Jose, CA 3,000,000 Khanna
Administration. for workforce development,
stipends, and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Seattle Jobs Initiative, Seattle, 1,000,000 Jayapal
Administration. WA for green stormwater
infrastructure workforce
development, stipends, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Service! Relief Effort for 475,000 Beatty
Administration. Hospitality Workers, Columbus,
OH for job skills training and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Society for the Advancement of 212,000 Lofgren
Administration. Chicanos/Hispanics and Native
Americans in Science, San Jose,
CA to create a pipeline from
community colleges into the STEM
workforce.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training South Bay Workforce Investment 500,000 Waters
Administration. Board Inc., Hawthorne, CA for
occupation training and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training South Texas College, McAllen, TX 1,000,000 Gonzalez,
Administration. for healthcare workforce Vicente
development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training St. Clair County 950,000 Bost
Administration. Intergovernmental Grants
Department, Belleville, IL for
an advanced manufacturing
program, including support
services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training St. Joseph Center, Venice, CA for 898,053 Lieu
Administration. job skills training and
supportive services to those
experiencing homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Stanislaus Business Alliance dba 410,000 Harder (CA)
Administration. Opportunity Stanislaus, Modesto,
CA for a logistics industry
focused training program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training State of Maine, Governor's Energy 2,750,000 Pingree
Administration. Office, Augusta, ME for job
training, job placement
services, stipends, equipment,
and curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Suburban Emergency Medical 247,949 Wild
Administration. Services, Palmer, PA for
healthcare workforce development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Suffolk County Community College, 1,435,000 Zeldin
Administration. Selden, NY for a cybersecurity
program, including the purchase
of equipment and related
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Taller San Jose Hope Builders, 500,000 Correa
Administration. Santa Ana, CA for skills
training and employment
placement services for low-
income young adults facing
significant barriers.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Texas Trees Foundation, Dallas, 400,000 Johnson (TX)
Administration. TX for supportive services and
job placement of at-risk young
adults into the green jobs
industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Indianapolis Private Industry 1,000,000 Carson
Administration. Council, Inc., Indianapolis, IN
for youth job training and a
work-based learning program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Sanneh Foundation, Saint 1,000,000 McCollum
Administration. Paul, MN for a youth workforce
development program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Torres-Martinez Desert 250,000 Ruiz
Administration. Cahuilla Indian Tribe, Thermal,
CA for a workforce development
program and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The TransLatin@ Coalition, Los 750,000 Gomez
Administration. Angeles, CA for workforce
development programs and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The WorkPlace, Inc., Bridgeport, 1,000,000 Himes
Administration. CT for skills training,
workforce readiness, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training UAW Labor Employment and Training 1,000,000 Bush
Administration. Corporation, St. Louis, MO for
job training in the automotive
services industry.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United Way of Greater Greensboro, 1,000,000 Manning
Administration. Inc., Greensboro, NC for job
counseling, career training, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United We Heal Training Trust dba 892,000 Bonamici
Administration. Oregon AFSCME Training Trust,
Portland, OR for pre-
apprenticeship education and
training.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United We Heal, Portland, OR for 892,000 Schrader
Administration. pre-apprenticeship and
apprenticeship programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training University of California, San 1,600,000 Jacobs (CA)
Administration. Diego, La Jolla, CA for job
skills development and
supportive services for a child
care worker and providers
pipeline.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training University of Georgia, Athens, GA 3,000,000 McBath
Administration. for the Archway Partnership.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Unloop, Seattle, WA for job 486,781 Jayapal
Administration. training in the tech industry
and supportive services for
those with conviction histories.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Urban League of Long Island, Inc, 1,145,820 Rice (NY)
Administration. Plainview, NY for workforce
development activities.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Urban League of Louisiana, New 1,200,000 Carter (LA)
Administration. Orleans, LA for the Career
Pathways Program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training US HART CARES A NJ NONPROFIT 1,000,000 Van Drew
Administration. CORPORATION, Atlantic City, NJ
for cyber job training program,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Valley of the Sun Young Men's 1,000,000 Gallego
Administration. Christian Association, Phoenix,
AZ for expanding a current youth
workforce development program.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Variety Boys and Girls Club of 250,000 Maloney,
Administration. Queens, Inc., Long Island City, Carolyn B.
NY for job readiness and
supportive services for teens.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Virginia Commonwealth University 1,000,000 McEachin
Administration. Health System Authority,
Richmond, VA for healthcare
workforce development.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Watts Labor Community Action 783,067 Waters
Administration. Committee, Los Angeles, CA for
job training, workforce
development activities, and job
placement services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Wayne Community College, 651,000 Butterfield
Administration. Goldsboro, NC to expand its
apprenticeship training programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Workforce Connections, Las Vegas, 800,000 Lee (NV)
Administration. NV for workforce development
programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Workforce Inc. dba Recycleforce, 1,000,203 Carson
Administration. Indianapolis, IN to expand job
training and job placement
programs.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Young Men's and Young Women's 1,000,000 Espaillat
Administration. Hebrew Association of Washington
Heights and Inwood, New York, NY
for vocational training,
workforce development, and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Young Women's Christian 690,449 Bowman
Administration. Association of Yonkers, Inc.,
Yonkers, NY for a workforce
development initiative and
support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for 100 Suits for 100 Men, Laurelton, 750,000 Meng
and Human Services Children and Families. NY for a youth employment
training program, including for
the purchase of food and
equipment, to serve vulnerable
families and seniors and improve
economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for A New Way of Life Reentry 1,000,000 Bass
and Human Services Children and Families. Project, Los Angeles, CA for
housing, legal clinics,
educational opportunities and
supportive services to improve
outcomes and economic
opportunities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Action for a Better Community, 517,000 Morelle
and Human Services Children and Families. Inc., Rochester, NY for
employment advancement, benefit
and eligibility mapping, and
other services to help
individuals and families move
towards financial sustainability.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Adoptions Together, Calverton, MD 750,639 Brown (MD)
and Human Services Children and Families. for trauma-informed care
training.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Alfond Youth and Community 500,000 Pingree
and Human Services Children and Families. Center, Waterville, ME for
targeted support services to
children and families in need.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for All Star Children's Foundation, 1,500,000 Buchanan
and Human Services Children and Families. Sarasota, FL for a foster care
program, including behavioral
health services.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Big Brothers Big Sisters Lone 300,000 Van Duyne
and Human Services Children and Families. Star, Irving, TX for a youth
mentoring program.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Bivona Child Advocacy Center, 306,000 Morelle
and Human Services Children and Families. Rochester, NY for child abuse
prevention training and programs.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Boys & Girls Clubs of America, 2,000,000 Williams (GA)
and Human Services Children and Families. Atlanta, GA for increasing
support services and abuse
prevention resources to
recognize and reduce abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Bucks County Opportunity Council, 1,000,000 Fitzpatrick
and Human Services Children and Families. Doylestown, PA for a self-
sufficiency program, including
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Center for Pan Asian Community 300,000 Bourdeaux
and Human Services Children and Families. Services, Inc., Atlanta, GA for
survivor-centered, trauma-
informed services for women and
families to work towards self-
reliance.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Childhelp Inc., Scottsdale, AZ 1,000,000 Kirkpatrick
and Human Services Children and Families. for outreach, education
materials and programming to
reduce and prevent child abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Children's Home of Stockton, 973,552 McNerney
and Human Services Children and Families. Stockton, CA for supportive
housing, services, supplies,
transportation expenses, and
goods, including the purchase of
food, to help establish self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Christus Santa Rosa Health Care 472,699 Castro (TX)
and Human Services Children and Families. Corporation, San Antonio, TX for
training and education to reduce
and prevent child abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Circle of Brotherhood, Miami, FL 2,000,000 Wilson (FL)
and Human Services Children and Families. for a social services hub
focused on assistance to low
income families to improve life
and economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Boston, MA for housing, 1,000,000 Pressley
and Human Services Children and Families. educational and support services
for children and families, and
to provide parents with
opportunities to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Jersey City, NJ for 500,000 Payne
and Human Services Children and Families. expanding domestic violence
intervention services.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Leander, TX for a child 500,000 Carter (TX)
and Human Services Children and Families. abuse prevention and treatment
program, including the purchase
of information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Los Angeles, CA for 982,045 Schiff
and Human Services Children and Families. operating costs and community
services, including motel
vouchers and the purchase of
food, to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Mount Vernon, NY for 999,000 Bowman
and Human Services Children and Families. services to support at-risk
girls and to improve employment
opportunities and economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Richmond, VA for social 797,329 McEachin
and Human Services Children and Families. services and a one-stop shop to
help families and individuals
working to establish financial
self-sufficiency and for social
service providers working to
reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Rochester, NY for youth 500,000 Morelle
and Human Services Children and Families. employment services and young
adult workforce development to
increase self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Columbus Metropolitan Housing 1,000,000 Beatty
and Human Services Children and Families. Authority, Columbus, OH for
informational and financial
resources to assist residents
and achieve economic self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Community Action Network, Ann 500,000 Dingell
and Human Services Children and Families. Arbor, MI for educational and
social-emotional services to
achieve self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Community Help Center DBA Muslim 333,000 Schakowsky
and Human Services Children and Families. Women Resource Center, Chicago,
IL for the purchase of equipment
to help achieve self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for County of San Diego, CA for 220,000 Jacobs (CA)
and Human Services Children and Families. training and materials for child
welfare programs.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Court Appointed Special Advocates 175,000 Kim (NJ)
and Human Services Children and Families. (CASA) of Ocean County, Toms
River, NJ for increasing
volunteers to advocate for
foster care children.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Court Appointed Special Advocates 40,000 Kim (NJ)
and Human Services Children and Families. of Mercer County, Ewing, NJ for
expanding services for, and
increasing the number of
volunteers available to work
with, children aging out of
foster care.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Eastern Shore Coalition Against 250,000 Luria
and Human Services Children and Families. Domestic Violence, Onancock, VA
for staffing, children's
programming, and supplies to
support survivors of abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Eastmont Community Center, Los 100,000 Roybal-Allard
and Human Services Children and Families. Angeles, CA for equipment and
services for low income families
to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Elite Learners, Brooklyn, NY for 750,000 Jeffries
and Human Services Children and Families. promoting financial literacy and
management services to increase
self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Father Flanagan's Boys' Home, 1,000,000 Bacon
and Human Services Children and Families. Boys Town, NE for an at-risk
youth program, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for First 5 Contra Costa Children and 150,000 DeSaulnier
and Human Services Children and Families. Families Commission, Concord, CA
for a workforce compensation
assessment to build a pipeline
for more to attain economic
stability.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Food Bank of Eastern Michigan, 2,000,000 Kildee
and Human Services Children and Families. Flint, MI for the purchase of
equipment and food to support
mobile food distributions.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Foodbank of Southeastern Virginia 447,600 Luria
and Human Services Children and Families. and the Eastern Shore, Norfolk,
VA for staffing costs and the
purchase of food and equipment,
for mobile food distribution.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for FoodCycle Food Recovery Network, 652,500 Schiff
and Human Services Children and Families. Los Angeles, CA for services and
the purchase of equipment for a
hub to improve access to food
resources to combat hunger and
reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Georgia Center for Child 200,000 McBath
and Human Services Children and Families. Advocacy, Atlanta, GA for
services, education and outreach
to support families affected by
abuse or trauma.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Georgia State University, 700,000 Williams (GA)
and Human Services Children and Families. Atlanta, GA for services and the
purchase of equipment to improve
emotional and economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Goodness Village, Livermore, CA 1,000,000 Swalwell
and Human Services Children and Families. for housing support and services
to improve self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Guardian House, San Antonio, TX 483,963 Castro (TX)
and Human Services Children and Families. for a parenting education
program to reduce and prevent
child abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Hellenic American Neighborhood 500,000 Maloney,
and Human Services Children and Families. Action Committee INC, New York, Carolyn B.
NY for education and language
services to improve employment
and economic outcomes and reduce
poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Helping Mamas, Inc., Norcross, GA 195,475 Bourdeaux
and Human Services Children and Families. for products and services,
including the purchase of
equipment and goods, for a
mobile distribution project to
support long-term financial
security.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Higher Ground A Resource Center, 1,088,768 Grijalva
and Human Services Children and Families. Tucson, AZ for coordinating
resources and services to reduce
poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Houston Area Women's Center 1,000,000 Garcia (TX)
and Human Services Children and Families. (HAWC), Houston, TX for services
to support children and families
affected by violence.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Individuals Aiding in Emergencies 50,000 Scanlon
and Human Services Children and Families. Foundation, Aston, PA for
products and services for low-
income individuals to reduce
poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for IU Health Foundation, 600,000 Carson
and Human Services Children and Families. Indianapolis, IN for services to
improve health and nutrition of
vulnerable individuals and
provide job training and new
employment to improve outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Kids' Voice of Indiana, 185,000 Carson
and Human Services Children and Families. Indianapolis, IN for services to
children and families who are
survivors of violence, abuse, or
neglect.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Knoxville-Knox County Community 575,000 Burchett
and Human Services Children and Families. Action Committee, Knoxville, TN
for a Head Start program,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for La Jornada LTD, Flushing, NY for 250,000 Meng
and Human Services Children and Families. expanding educational supports
and workshops for families in
poverty to promote healthy
living and improve economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Labor Community Services of Los 600,000 Schiff
and Human Services Children and Families. Angeles (LCS) , Los Angeles, CA
for services, and transport and
purchase of goods, including
food, to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Larkin Street Youth Services, San 1,550,000 Pelosi
and Human Services Children and Families. Francisco, CA for safe, stable
housing with wraparound case
management, education and
employment support to reduce
poverty and improve economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Long Island Cares, Hauppauge, NY 360,100 Meeks
and Human Services Children and Families. for the purchase of food and
social services, to connect
individuals to referral and
benefits programs and reduce
poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Long Island Cares, Inc., 400,000 Garbarino
and Human Services Children and Families. Hauppauge, NY for the purchase
of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Make the Road New York, Brooklyn, 800,000 Velazquez
and Human Services Children and Families. NY for adult literacy programs
and services, including the
purchase of equipment, to
improve economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Make the Road New York, Brooklyn, 400,000 Ocasio-Cortez
and Human Services Children and Families. NY for education and services,
including for the purchase of
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Make the Road New York, Brooklyn, 400,000 Jones
and Human Services Children and Families. NY for equipment and services,
including the purchase of
technology, to reduce poverty
and create opportunities for
economic advancement.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Maternal and Family Health 2,150,000 Cartwright
and Human Services Children and Families. Service, Inc., Wilkes-Barre, PA
for improving access to social
services for at-risk and low-
income women, children and
families.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for McMahon Ryan Child Advocacy 125,000 Katko
and Human Services Children and Families. Center, Syracuse, NY for a child
abuse prevention and education
program, including information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Metropolitan Council on Jewish 1,000,000 Maloney,
and Human Services Children and Families. Poverty, New York, NY for anti- Carolyn B.
poverty services and assistance,
including for the purchase of
food, to create pathways to self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Metropolitan Council on Jewish 2,000,000 Meng
and Human Services Children and Families. Poverty, New York, NY for
supplying pantries with
essential products, including
food, formula, diapers and
diapering supplies, menstrual
and hygiene products, to meet
the essential needs of women and
infants to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Michigan State University Child 2,187,500 Slotkin
and Human Services Children and Families. Development Laboratories, East
Lansing, MI for staffing and
training, including equipment,
to serve at-risk children and
improve economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Mitzvah Circle Foundation, 300,000 Dean
and Human Services Children and Families. Norristown, PA for products and
services to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Mott Community College, Flint, MI 2,064,000 Kildee
and Human Services Children and Families. for increasing access to high
quality language education
materials for families and young
children to improve economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Muslim Community Center (MCC) -- 250,000 Swalwell
and Human Services Children and Families. East Bay, Pleasanton, CA for
services including rental
assistance, to assist refugees
as they work towards self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Neighborhood Legal Services of 817,006 Cardenas
and Human Services Children and Families. Los Angeles County, Glendale, CA
for advocates to partner with
justice-involved individuals to
identify and address barriers to
self-sufficiency and family well-
being.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Newark Emergency Services for 1,107,500 Payne
and Human Services Children and Families. Families, Inc., Newark, NJ for
services and the purchase of
equipment and goods, including
food, for fresh food
distribution, healthy cooking
workshops, and art therapy
classes for children and
families.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Next Door Solutions to Domestic 125,000 Lofgren
and Human Services Children and Families. Violence, San Jose, CA for
violence prevention and
intervention services.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Office of the Mayor, New York 2,000,000 Bowman
and Human Services Children and Families. City, NY for improving
coordination between social
agencies to support children and
families.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for One Nation Dream Makers, 2,000,000 Swalwell
and Human Services Children and Families. Livermore, CA for services
including the purchase of food
and equipment to distribute food
to reduce poverty.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Oregon Community Programs, 1,000,000 Bonamici
and Human Services Children and Families. Eugene, OR for supporting foster
youth and families and improving
the administration of the foster
care program.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Plaza Comunitaria Sinaloa, 800,000 Cardenas
and Human Services Children and Families. Mission Hills, CA for expanding
educational programs and
implementing workforce
development programs to provide
low-income individuals with
access to better job
opportunities to improve
economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Safe Space, Inc., Louisburg, NC 197,800 Price (NC)
and Human Services Children and Families. for culturally-specific child
abuse prevention services for at-
risk families.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Samuel Field YM-YWHA dba 1,000,000 Meng
and Human Services Children and Families. Commonpoint Queens, Little Neck,
NY for workforce and wraparound
services to improve economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for San Diego County, CA for outreach 500,000 Vargas
and Human Services Children and Families. and recruitment of foster care
families to support children.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Sanctuary of Hope, Los Angeles, 749,920 Bass
and Human Services Children and Families. CA for expanded navigation and
support services to improve
employment, education, and
economic opportunities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Save the Children Federation, 1,080,764 Kilmer
and Human Services Children and Families. Inc., Fairfield, CT for
programs, workshops, services
and goods, including the
purchase of food and equipment,
to reduce poverty and improve
outcomes for children and
families.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for South Central LAMP, Los Angeles, 100,000 Roybal-Allard
and Human Services Children and Families. CA for support services for
children and families.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Southwest Georgia Children's 367,362 Bishop (GA)
and Human Services Children and Families. Alliance, Inc., Americus, GA for
child abuse treatment and
prevention programs.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Spectrum Youth and Family 225,000 Welch
and Human Services Children and Families. Services, Burlington, VT for
services and direct assistance
to improve self-sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for The Center for Hope and Healing, 505,813 Trahan
and Human Services Children and Families. Inc., Lowell, MA for services
and supplies to establish
financial stability and security
through job training and soft
skills development.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for The Children's Home Society of 631,500 Watson
and Human Services Children and Families. New Jersey, Trenton, NJ for Coleman
employment training and related
expenses for low income women to
improve health and economic
outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for The Early Excellence Project, 600,000 Lamb
and Human Services Children and Families. Pittsburgh, PA for expanding
educational opportunities and
improving economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Today is a Good Day, Flourtown, 332,275 Dean
and Human Services Children and Families. PA for personal and financial
supports for families.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for UCAN, Chicago, IL for expanding 1,000,000 Davis, Danny
and Human Services Children and Families. programs and social services K.
supporting foster youth to
improve economic outcomes and
community well-being.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for United Jewish Organizations of 1,200,000 Velazquez
and Human Services Children and Families. Williamsburg Inc., Brooklyn, NY
for a social services initiative
connecting families to
assistance to reduce poverty and
improve economic independence.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for United Way of Central and 150,000 Hayes
and Human Services Children and Families. Northeastern Connecticut,
Hartford, CT for training and
outreach programs, services, and
literacy supports for under-
resourced communities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for United Way of Greater Cleveland, 255,000 Gonzalez (OH)
and Human Services Children and Families. Cleveland, OH for the 2-1-1
system, including the purchase
of information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for United Way of Greater Union 100,000 Watson
and Human Services Children and Families. County, Elizabeth, NJ for Coleman
addressing food insecurity,
access to transportation and
healthcare, and financial
stability.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for United Way of Southern Nevada, 1,000,000 Titus
and Human Services Children and Families. Las Vegas, NV for programs that
improve self-sufficiency and
reduce poverty for the non-
English proficient community.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for UnLocal, Inc., New York, NY for 1,000,000 Torres (NY)
and Human Services Children and Families. services, education and outreach
to help financial self-
sufficiency.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Volunteers of America Delaware 479,100 Norcross
and Human Services Children and Families. Valley, Camden, NJ for
partnerships to promote human
trafficking victimization
education and awareness and
prevent abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Wellroot Family Services, Tucker, 286,500 Johnson (GA)
and Human Services Children and Families. GA for housing and services and
supplies, including the purchase
of food, to improve economic
outcomes of young adults
transitioning out of foster care
or experiencing homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Wellspring Living, Inc, Atlanta, 245,560 McBath
and Human Services Children and Families. GA for workforce services for
victims of sexual exploitation
and violence to increase
employment opportunities and
improve economic outcomes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for WestCare Ohio, Inc., Dayton, OH 1,000,000 Turner
and Human Services Children and Families. for community services
programming, including
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for White Pony Express, Pleasant 105,000 DeSaulnier
and Human Services Children and Families. Hill, CA for services, and the
purchase of food and equipment
to support low income children.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Willow Domestic Violence Center 325,000 Morelle
and Human Services Children and Families. of Greater Rochester, Inc.,
Rochester, NY for services and
training to support survivors of
abuse.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for YMCA of Greater Louisville, 200,000 Yarmuth
and Human Services Children and Families. Louisville, KY, for model
service improvement, information
dissemination, and technical
assistance to address and
prevent child abuse and neglect.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for A Kid Again, Columbus, OH for 510,000 Beatty
and Human Services Community Living. increasing access to therapeutic
events for children, including
the purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for AIDS Foundation of Chicago, 250,000 Quigley
and Human Services Community Living. Chicago, IL for training and
services to better support
seniors living with HIV.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Alpha Phi Alpha Senior Citizens 154,000 Meeks
and Human Services Community Living. Center, Inc., Cambria Heights,
NY for assisted transportation
services, including for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Alzheimer's Foundation of 250,000 Garbarino
and Human Services Community Living. America, Amityville, NY for an
Alzheimer's education, training,
and supportive services center,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for APNA Brooklyn Community Center, 670,902 Jeffries
and Human Services Community Living. Inc., Brooklyn, NY for expanding
senior services, including for
the purchase of food and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Arc of Prince George's County 819,500 Brown (MD)
and Human Services Community Living. Inc., Largo, MD for expanding
services for individuals with
disabilities to prepare them for
employment and independent
living.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for BakerRipley, Houston, TX for 1,000,000 Garcia (TX)
and Human Services Community Living. increasing access to food and
other services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Bancroft, Cherry Hill, NJ for 500,000 Norcross
and Human Services Community Living. increasing independent living,
including for the purchase of
equipment, including technology
and devices.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Central Massachusetts Agency on 1,200,000 McGovern
and Human Services Community Living. Aging, Inc., Worcester, MA for
increasing services and
resources for grandparents
raising grandchildren.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Charter Township of Commerce, 235,050 Stevens
and Human Services Community Living. Commerce Township, MI for
increasing senior reading and
independence including for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Choice in Aging, Pleasant Hill, 500,000 DeSaulnier
and Human Services Community Living. CA for increasing access to and
awareness of community-based
alternatives to nursing homes.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for City of Ontario, CA for expanding 439,094 Torres (CA)
and Human Services Community Living. wellness programs, meal
services, and transportation
services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Clausen House, Oakland, CA for an 1,058,408 Lee (CA)
and Human Services Community Living. adult transition services
program to improve employment,
educational, life skills and
supports for individuals with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Community Action of Greater 100,000 Carson
and Human Services Community Living. Indianapolis, Indianapolis, IN
for services, outreach, events,
transportation expenses, and
supplies to increase the number
of senior volunteers in their
communities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Community Services Inc. of Ocean 270,475 Kim (NJ)
and Human Services Community Living. County, Manahawkin, NJ for
increasing food delivery to
seniors, including the purchase
of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Creative Enterprises, Inc, 612,320 Bourdeaux
and Human Services Community Living. Lawrenceville, GA for expanding
access and increasing
opportunities for employment and
community inclusion, including
the purchase of equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Designated Exceptional Services 85,000 Roybal-Allard
and Human Services Community Living. for Independence (DESI), Los
Angeles, CA for expanding access
to and delivery of food for
seniors, including for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for DOROT, Inc., New York, NY for 551,210 Meng
and Human Services Community Living. expanding intergenerational
programming to increase social
enrichment services for older
adults.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Endeavor Forward, Inc, Marianna, 300,000 Dunn
and Human Services Community Living. FL for a transition program for
adults with autism.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Fairfax County, VA for services 1,000,000 Beyer
and Human Services Community Living. and purchase of equipment,
including technology, to
increase access to technology
and community engagement.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Friendship Circle, West 364,009 Lawrence
and Human Services Community Living. Bloomfield Township, MI for
expanding developmental learning
opportunities to promote
independence of students with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Hawaii Public Health Institute, 1,800,000 Case
and Human Services Community Living. Honolulu, HI for support
navigator services for seniors
and caregivers.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Health Care District of Palm 1,000,000 Frankel, Lois
and Human Services Community Living. Beach County, West Palm Beach,
FL for falls and injury
prevention programs, outreach,
and education.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for India Home, Inc., Jamaica, NY for 500,000 Suozzi
and Human Services Community Living. an outreach program to promote
and incentivize senior health.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Island Harvest, Brentwood, NY for 1,100,000 Garbarino
and Human Services Community Living. a nutrition program, including
the purchase of food, supplies
and equipment, and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Jewish Service for the 760,000 Sherrill
and Human Services Community Living. Developmentally Disabled (JSDD),
Livingston, NJ for equipment and
support to expand access to
technology for individuals with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Lighthouse for the Visually 600,000 Bilirakis
and Human Services Community Living. Impaired and Blind of Pasco,
Hernando and Citrus Counties,
New Port Richey, FL for an
education, training, and support
services program for seniors
with visual impairment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Metropolitan Council on Jewish 1,000,000 Jeffries
and Human Services Community Living. Poverty, New York, NY for food
and services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Metropolitan Council on Jewish 1,000,000 Meeks
and Human Services Community Living. Poverty, New York, NY for food
and services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Metropolitan Council on Jewish 1,000,000 Meng
and Human Services Community Living. Poverty, New York, NY for
increasing senior access to and
delivery of food.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Minute Man Arc for Human 331,110 Trahan
and Human Services Community Living. Services, Concord, MA for
increasing community
integration, access to social
services, and benefits
assistance resources.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Ocean Community Economic Action 55,000 Kim (NJ)
and Human Services Community Living. Now, Inc., Toms River, NJ for
transportation and outreach
activities to expand seniors'
access to community living and
supports.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Pathlights Human Services, Palos 100,000 Newman
and Human Services Community Living. Heights, IL for expanding access
to and delivery of meals for
seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for People Inc., Williamsville, NY 2,035,139 Higgins (NY)
and Human Services Community Living. for improving access to health
services, including for health
staffing, purchase of equipment
and technology expenses.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Regional Aid for Interim Needs, 800,000 Bowman
and Human Services Community Living. Incorporated, Bronx, NY for
wraparound and case management
support services to support
older adults.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Scranton Neighborhood Housing 1,000,000 Cartwright
and Human Services Community Living. Services, Inc., Scranton, PA for
services including home repairs
and modifications to support
aging in place.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Senior Services of Snohomish 250,400 DelBene
and Human Services Community Living. County DBA Homage, Lynnwood, WA
for a rural transportation
project, including the purchase
of equipment, to increase access
to services.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Shepherd Center Inc., Atlanta, GA 800,000 Williams (GA)
and Human Services Community Living. for the purchase of equipment,
including information
technology, and training
expenses to increase the
independence of people with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Tennessee State University, 500,000 Cooper
and Human Services Community Living. Nashville, TN for a new program
to expand opportunities for
students to attend college and
prepare for independent living
and employment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for The City of Dover, DE for 500,000 Blunt
and Human Services Community Living. improving opportunities for Rochester
children, youth and adults who
have physical and intellectual
disabilities, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for The Monmouth Ocean Foundation for 400,000 Smith (NJ)
and Human Services Community Living. Children (MOFFC), Tinton Falls,
NJ for an autism education,
training, and support services
program, including the purchase
of information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for The Rosalynn Carter Institute for 1,020,047 Bishop (GA)
and Human Services Community Living. Caregivers, Americus, GA for
expanding and increasing
awareness of programs for
caregivers.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for The University of Texas at San 492,370 Castro (TX)
and Human Services Community Living. Antonio, San Antonio, TX for an
evaluation and research center
to improve access to care and
quality of life outcomes for
individuals living with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Wesley Community Services, Inc., 1,322,415 Axne
and Human Services Community Living. Johnston, IA for expanding
access to and delivery of senior
services, including the purchase
of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for West Bloomfield Parks and 85,000 Stevens
and Human Services Community Living. Recreation Commission, West
Bloomfield, MI for social
workers and expansion of social
services for seniors.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Westchester Residential 500,000 Jones
and Human Services Community Living. Opportunities, Inc., White
Plains, NY for home repairs and
modifications to support aging
in place and enable healthy
living.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for Yellow House Community Services, 250,000 Welch
and Human Services Community Living. Inc., Middlebury, VT for housing
and services for individuals
with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Administration for YWCA Greater Los Angeles, Los 375,000 Roybal-Allard
and Human Services Community Living. Angeles, CA for expanding senior
empowerment services.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Abide Women's Health Services, 290,261 Johnson (TX)
and Human Services Services Dallas, TX for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and About Sojourners with Healing 167,500 Cherfilus-
and Human Services Services Hearts, West Palm Beach, FL for McCormick
Administration. a cancer screening initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Adapt, Inc., Roseburg, OR for 1,000,000 DeFazio
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Adult & Teen Challenge USA, 750,000 Long
and Human Services Services Ozark, MO for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and AdventHealth Durand, West Durand, 916,000 Kind
and Human Services Services WI for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and AdventHealth for Children, 1,000,000 Murphy (FL)
and Human Services Services Orlando, FL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Adventist Health/Central Valley 1,250,000 Valadao
and Human Services Services Network, Hanford, CA for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Adventist HealthCare Fort 1,000,000 Hoyer
and Human Services Services Washington Medical Center, Inc.,
Administration. Fort Washington, MD for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Adventist Healthcare Inc., 500,000 Raskin
and Human Services Services Gaithersburg, MD for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Advocate Health and Hospitals 2,940,000 Newman
and Human Services Services Corporation, Downers Grove, IL
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Advocates for a Health Community 2,000,000 Long
and Human Services Services DBA Jordan Valley Community
Administration. Health Center, Springfield, MO
for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Advocates Inc., Framingham, MA 500,000 Clark (MA)
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Alivio Medical Center, Chicago, 3,000,000 Garcia (IL)
and Human Services Services IL for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Allegheny Health Network, 1,400,000 Lamb
and Human Services Services Pittsburgh, PA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and AltaMed Health Services, Los 255,000 Gomez
and Human Services Services Angeles, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and AltaMed Health Services, Los 2,346,186 Barragan
and Human Services Services Angeles, CA for equipment and
Administration. operational costs.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and AMAAD Institute, Los Angeles, CA 935,000 Waters
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and American Indian Health & Family 1,500,000 Tlaib
and Human Services Services Services of Southeastern
Administration. Michigan, Inc., Detroit, MI for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Americana Community Center Inc., 2,000,000 Yarmuth
and Human Services Services Louisville, KY for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Anna Maria College, Paxton, MA 1,000,000 McGovern
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and APLA Able Arts, Long Beach, CA 500,000 Lowenthal
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Arts and Services for the 980,000 Lowenthal
and Human Services Services Disabled, Inc. dba Able ARTS
Administration. Work, Long Beach, CA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and ARUP Laboratories, Inc., Salt 3,000,000 Stewart
and Human Services Services Lake City, UT for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Ashtabula County Medical Center, 3,000,000 Joyce (OH)
and Human Services Services Ashtabula, OH for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Asian American Drug Abuse 2,230,000 Bass
and Human Services Services Prevention, Inc., Los Angeles,
Administration. CA for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Asian American Health Coalition- 1,300,000 Garcia (TX)
and Human Services Services HOPE Clinic, Houston, TX for
Administration. equipment and operational costs
for an oral health program.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Aspire Health Partners, Orlando, 310,000 Murphy (FL)
and Human Services Services FL for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Association for Individual 3,000,000 Krishnamoorth
and Human Services Services Development, Aurora, IL for i
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Atlantic Health System, 1,000,000 Sherrill
and Human Services Services Morristown, NJ for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Auburn Community Hospital, 2,000,000 Katko
and Human Services Services Auburn, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Aunt Martha's Health and 450,000 Underwood
and Human Services Services Wellness, Olympia Fields, IL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Aurora Community Mental Health 2,000,000 Crow
and Human Services Services Center, Aurora, CO for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Ballad Health, Johnson City, TN 605,000 Griffith
and Human Services Services for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Ballad Health, Johnson City, TN 500,000 Harshbarger
and Human Services Services for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Banyan Community Health Center, 2,500,000 Salazar
and Human Services Services Miami, FL for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Baptist Health Deaconess 515,000 Comer
and Human Services Services Madisonville, Inc.,
Administration. Madisonville, KY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Barton Hose Company No 1. Inc., 1,875,000 Trone
and Human Services Services Barton, MD for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Bay Area Community Health, 700,000 Swalwell
and Human Services Services Fremont, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Bay Area Community Health, San 1,000,000 Lofgren
and Human Services Services Jose, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Bay County Health Department, Bay 2,000,000 Kildee
and Human Services Services City, MI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Baylor Scott & White Medical 3,000,000 Carter (TX)
and Human Services Services Center--Round Rock, Round Rock,
Administration. TX for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Beloved Community Family Wellness 2,000,000 Rush
and Human Services Services Center, Chicago, IL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Beth Israel Deaconess Hospital-- 2,000,000 Keating
and Human Services Services Plymouth, Inc., Plymouth, MA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Block Island Health Services, New 2,000,000 Langevin
and Human Services Services Shoreham, RI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Bobby Benson Center, Kahuku, HI 1,200,000 Kahele
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Bon Secours Charity Health 1,000,000 Jones
and Human Services Services System, Suffern, NY for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Boone Memorial Hospital, Inc., 3,000,000 Miller (WV)
and Human Services Services Madison, WV for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Bread for the City, Washington, 3,000,000 Norton
and Human Services Services DC for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Brockton Neighborhood Health 1,000,000 Lynch
and Human Services Services Center, Brockton, MA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Bronx Community Health Network, 2,001,503 Bowman
and Human Services Services Bronx, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Brooks County Independent School 1,500,000 Gonzalez,
and Human Services Services District, Falfurrias, TX for Vicente
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Brownsville Community Development 2,200,000 Clarke (NY)
and Human Services Services Corporation, Brooklyn, NY for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cabell Huntington Hospital, Inc., 3,000,000 Miller (WV)
and Human Services Services Huntington, WV for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and California State University, San 2,000,000 Aguilar
and Human Services Services Bernardino, CA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and CalvertHealth Medical Center, 950,000 Hoyer
and Human Services Services Prince Frederick, MD for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cambridge Public Health 1,000,000 Clark (MA)
and Human Services Services Commission (dba Cambridge Health
Administration. Alliance), Cambridge, MA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Campbell City School District, 2,000,000 Ryan
and Human Services Services Campbell, OH for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Caridad Center, Inc., Boynton 1,000,000 Frankel, Lois
and Human Services Services Beach, FL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cedar Riverside People's Center, 1,000,000 Omar
and Human Services Services Minneapolis, MN for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Center for Addiction Treatment, 500,000 Chabot
and Human Services Services Cincinnati, OH for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Centerstone, Bradenton, FL for 1,200,000 Buchanan
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Central Pennsylvania Institute of 2,000,000 Thompson (PA)
and Human Services Services Science and Technology,
Administration. Bellefonte, PA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Central Piedmont Community 575,000 Adams
and Human Services Services College, Charlotte, NC for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Central Vermont Medical Center, 735,560 Welch
and Human Services Services Berlin, VT for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Central Washington University, 1,000,000 Schrier
and Human Services Services Ellensburg, WA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and CentraState Medical Center, Inc. 615,000 Smith (NJ)
and Human Services Services , Freehold, NJ for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Centro del Barrio, Inc., San 1,000,000 Castro (TX)
and Human Services Services Antonio, TX for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Centro Hispano Daniel Torres 635,713 Houlahan
and Human Services Services Inc., Reading, PA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Charles River Community Health 247,000 Clark (MA)
and Human Services Services Center, Waltham, MA for an
Administration. electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Charlotte Community Health 600,000 Adams
and Human Services Services Clinic, Inc., Charlotte, NC for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Chattanooga-Hamilton County 2,000,000 Fleischmann
and Human Services Services Hospital Authority d/b/a
Administration. Erlanger Health System,
Chattanooga, TN for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cherry Creek School District, 1,500,000 Crow
and Human Services Services Greenwood Village, CO for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cherry Hill Free Clinic, Cherry 440,905 Norcross
and Human Services Services Hill, NJ for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Children's Health Clinical 1,000,000 Allred,
and Human Services Services Operations, Dallas, TX for Veasey
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Children's Hospital Los Angeles, 1,500,000 Garcia (CA)
and Human Services Services Los Angeles, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Children's Clinic dba TCC Family 575,000 Lowenthal
and Human Services Services Health, Long Beach, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Children's Health Clinical 1,000,000 Van Duyne
and Human Services Services Operations, Dallas, TX for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Children's Health of Orange 1,000,000 Correa
and Human Services Services County, Orange, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Children's Hospital Medical 2,000,000 Ryan
and Human Services Services Center of Akron, OH for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Chinatown Service Center, 215,000 Chu
and Human Services Services Monterey Park, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Chinese Culture and Community 1,000,000 Trone
and Human Services Services Service Center, Inc.,
Administration. Gaithersburg, MD for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Chiricahua Community Health 983,265 Kirkpatrick
and Human Services Services Centers, Inc., Douglas, AZ for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and ChristianaCare Health System, 900,000 Blunt
and Human Services Services Wilmington, DE for a nutrition Rochester
Administration. program for pregnant women.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and CHRISTUS Ochsner Health 1,000,000 Higgins (LA)
and Human Services Services Southwestern Louisiana -- St.
Administration. Patrick Hospital, Lake Charles,
LA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and CHRISTUS St. Frances Cabrini 775,000 Letlow
and Human Services Services Hospital, Alexandria, LA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cincinnati Children's Hospital 630,000 Chabot
and Human Services Services Medical Center, Cincinnati, OH
Administration. for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and City of Albuquerque, NM for 2,200,000 Stansbury
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and City of Berea, KY for equipment.. 350,000 Barr
and Human Services Services
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and City of Greenville, MS for 2,000,000 Thompson (MS)
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and City of Guin, AL for facilities.. 150,000 Aderholt
and Human Services Services
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and City of Hope National Medical 150,000 Garcia (CA)
and Human Services Services Center, Duarte, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and City of Houston--Houston Health 1,000,000 Jackson Lee
and Human Services Services Department, Houston, TX for a
Administration. vision health program.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and City of West Hollywood, CA for 300,000 Schiff
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Clay County Healthcare Authority, 1,500,000 Rogers (AL)
and Human Services Services Ashland, AL for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cleveland Clinic, Cleveland, OH 905,000 Gonzalez (OH)
and Human Services Services for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cleveland Clinic, Cleveland, OH 615,000 Joyce (OH)
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Clinica Msr. Oscar A. Romero, Los 1,000,000 Gomez
and Human Services Services Angeles, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cold Spring Harbor Laboratory, 1,000,000 Suozzi
and Human Services Services Cold Spring Harbor, NY for
Administration. equipment and operational costs.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and College of Southern Nevada, North 750,000 Horsford
and Human Services Services Las Vegas Campus, North Las
Administration. Vegas, NV for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and CommuniCare Health Centers, West 1,500,000 Matsui
and Human Services Services Sacramento, CA for an electronic
Administration. health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Bridges, Inc., Mesa, AZ 1,000,000 Gallego
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Care Clinic of 575,000 Cawthorn
and Human Services Services Franklin, Inc., Franklin, NC for
Administration. facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Consolidated School 1,000,000 Schneider
and Human Services Services District 21, Wheeling, IL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Foundation of Greater 3,000,000 Miller-Meeks
and Human Services Services Muscatine, Muscatine, IA for
Administration. facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Health Partnership, San 175,000 Lofgren
and Human Services Services Jose, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Medical Centers, 500,000 Harder (CA),
and Human Services Services Stockton, CA for facilities and McNerney
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Medical Centers, 950,000 Harder (CA)
and Human Services Services Stockton, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Community Regional Medical 1,500,000 Costa
and Human Services Services Center, Fresno, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Compass Health, Inc., St. Peters, 1,000,000 Luetkemeyer
and Human Services Services MO for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Comprehensive Community Action, 1,000,000 Langevin
and Human Services Services Inc., Cranston, RI for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Connecticut Hospice, Inc., 1,940,000 DeLauro
and Human Services Services Branford, CT for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Connecticut Institute For 2,000,000 Hayes
and Human Services Services Communities, Inc., Danbury, CT
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cook County Health, Chicago, IL 1,000,000 Krishnamoorth
and Human Services Services for facilities and equipment. i
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cooperman Barnabas Medical 1,000,000 Sherrill
and Human Services Services Center, Livingston, NJ for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cornerstone Family Healthcare, 2,800,000 Maloney, Sean
and Human Services Services Cornwall, NY for facilities and Patrick
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cortland County, NY for 2,995,000 Tenney
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Bernalillo, 422,031 Stansbury
and Human Services Services Albuquerque, NM for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Clark, Las Vegas, NV 1,330,000 Lee (NV)
and Human Services Services for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Clark, Las Vegas, NV 1,600,000 Titus
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Culpeper, VA for 324,494 Spanberger
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Delaware, Media, PA for 1,750,000 Scanlon
and Human Services Services an electronic health records
Administration. initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Fairfax, VA for 1,700,000 Beyer
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Lane, Eugene, OR for 1,500,000 DeFazio
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Montgomery, Rockville, 3,000,000 Raskin
and Human Services Services MD for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Northampton, Easton, PA 1,000,000 Wild
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Oakland, Pontiac, MI 1,200,000 Stevens
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Orange, Santa Ana, CA 3,000,000 Correa
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Riverside--Riverside 1,000,000 Takano
and Human Services Services University Health System, Moreno
Administration. Valley, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Riverside--Riverside 1,000,000 Ruiz
and Human Services Services University Health System,
Administration. Riverside, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of San Mateo, CA for an 1,000,000 Speier
and Human Services Services electronic health records
Administration. initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Taos, NM for facilities 2,200,000 Leger
and Human Services Services and equipment. Fernandez
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and County of Wake, Raleigh, NC for 2,000,000 Ross
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Covenant Community Care, Inc., 500,000 Tlaib
and Human Services Services Detroit, MI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cowlitz Indian Tribe, Longview, 765,000 Herrera
and Human Services Services WA for facilities. Beutler
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cowlitz Indian Tribe, Longview, 1,000,000 Smith (WA)
and Human Services Services WA for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Crouse Health, Syracuse, NY for 1,010,000 Katko
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cullman Regional Medical Center, 1,585,000 Aderholt
and Human Services Services Inc., Cullman, AL for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Cumberland University, Lebanon, 750,000 Rose
and Human Services Services TN for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Denver Health and Hospital 2,200,000 DeGette
and Human Services Services Authority, Denver, CO for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Desert AIDS Project, Palm 2,000,000 Ruiz
and Human Services Services Springs, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Division of Infectious Diseases, 500,000 Deutch
and Human Services Services University of Miami Miller
Administration. School of Medicine, Miami, FL
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Downtown Emergency Service 985,000 Jayapal
and Human Services Services Center, Seattle, WA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Doylestown Health Foundation 1,000,000 Fitzpatrick
and Human Services Services D.B.A. Doylestown Health,
Administration. Doylestown, PA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Duncan Regional Hospital, Inc., 750,000 Cole
and Human Services Services Duncan, OK for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Duquesne University, Pittsburgh, 2,200,000 Doyle,
and Human Services Services PA for facilities and equipment. Michael F.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and East Bay Community Action 513,600 Cicilline
and Human Services Services Program, Newport, RI for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and East Tennessee Children's 2,500,000 Burchett
and Human Services Services Hospital, Knoxville, TN for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Easterseals of Oak Hill, 1,874,000 Courtney
and Human Services Services Hartford, CT for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Edward M. Kennedy Community 1,000,000 Auchincloss
and Human Services Services Health Center, Inc., Worcester,
Administration. MA for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Edward M. Kennedy Health Center, 3,000,000 McGovern
and Human Services Services Inc., Boston, MA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Eisner Health, Los Angeles, CA 610,000 Barragan
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and El Centro de Corazon, Houston, TX 3,000,000 Garcia (TX)
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and El Paso Children's Hospital, El 595,000 Escobar
and Human Services Services Paso, TX for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and El Proyecto del Barrio Inc., 1,000,000 Sherman
and Human Services Services Winnetka, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Ellis County Coalition for Health 3,000,000 Ellzey
and Human Services Services Options, Inc., dba Hope Clinic,
Administration. Waxahachie, TX for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Erie Family Health Centers, 1,173,900 Garcia (IL)
and Human Services Services Chicago, IL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Escambia County Health Care 655,000 Carl
and Human Services Services Authority dba Atmore Community
Administration. Hospital, Atmore, AL for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Fair Haven Community Health 3,000,000 DeLauro
and Human Services Services Clinic, Inc., New Haven, CT for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Family Centers Inc., Stamford, CT 1,000,000 Himes
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Family Christian Health Center, 353,441 Kelly (IL)
and Human Services Services Harvey, IL for equipment and
Administration. operational costs.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Family Health Services 1,550,000 Simpson
and Human Services Services Corporation, Twin Falls, ID for
Administration. facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Ferd & Gladys Alpert Jewish 700,000 Frankel, Lois
and Human Services Services Family & Children's Service of
Administration. Palm Beach County, Inc., West
Palm Beach, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Figgers Foundation, Lauderhill, 2,200,000 Cherfilus-
and Human Services Services FL for a telehealth initiative. McCormick
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Finkelstein Memorial Library, 2,000,000 Jones
and Human Services Services Spring Valley, NY for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and First Nations Community 1,000,000 Stansbury
and Human Services Services HealthSource, Albuquerque, NM
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Flaget Memorial Hospital 635,000 Guthrie
and Human Services Services Foundation, Bardstown, KY for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Florida International University, 3,000,000 Gimenez
and Human Services Services Miami, FL for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Florida State University, 2,490,000 Dunn
and Human Services Services Tallahassee, FL for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Franciscan Missionaries of Our 1,935,000 Graves (LA)
and Human Services Services Lady University, Baton Rouge, LA
Administration. for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Frederick County Government, 698,083 Trone
and Human Services Services Frederick, MD for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Freedom Rain Incorporated dba The 2,000,000 Sewell
and Human Services Services Lovelady Center, Birmingham, AL
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Fresno Center, Fresno, CA for 1,500,000 Costa
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Friends of Youth, Kirkland, WA 1,000,000 DelBene
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Friendship House, Scranton, PA 1,500,000 Cartwright
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Gardner Family Health Network, 500,000 Khanna
and Human Services Services Incorporated, Alviso, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Gardner Family Health Network, 1,000,000 Lofgren
and Human Services Services Incorporated, San Jose, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Garfield Health Center, Monterey 480,000 Chu
and Human Services Services Park, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Garrett Regional Medical Center, 650,000 Trone
and Human Services Services Oakland, MD, for an electronic
Administration. health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Gateway Community Health Center, 1,997,000 Cuellar
and Human Services Services Inc., Laredo, TX for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and George Corley Wallace State 1,143,018 Sewell
and Human Services Services Community College, Demopolis, AL
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and George Mason University, Fairfax, 820,000 Wexton
and Human Services Services VA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and George Washington University, 1,190,000 Norton
and Human Services Services Washington, DC for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Germanna Community College 251,000 Spanberger
and Human Services Services Educational Foundation Inc.,
Administration. Locust Grove, VA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Gillette Children's Specialty 1,500,000 McCollum
and Human Services Services Healthcare, St. Paul, MN for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Grace Health, Battle Creek, MI 525,000 Meijer
and Human Services Services for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Grand View Hospital d/b/a Grand 1,000,000 Fitzpatrick
and Human Services Services View Health, Sellersville, PA
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Grant County Public Hospital 2,500,000 Newhouse
and Human Services Services District No 1, dba Samaritan
Administration. Healthcare, Moses Lake, WA for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Great Basin College, Elko, NV for 940,000 Amodei
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Great Salt Plains Health Center, 2,180,000 Lucas
and Human Services Services Inc., Cherokee, OK for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Greater Baden Medical Services, 3,000,000 Brown (MD)
and Human Services Services Inc., Brandywine, MD for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Greene County Hospital and 521,100 Sewell
and Human Services Services Nursing Home, Eutaw, AL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Grover C. Dils Medical Center, 3,000,000 Horsford
and Human Services Services Caliente, NV for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Gundersen Tri-County Hospital, 1,000,000 Kind
and Human Services Services Whitehall, WI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and H. Lee Moffitt Cancer Center and 3,000,000 Bilirakis
and Human Services Services Research Institute, Inc., Tampa,
Administration. FL for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and H. Lee Moffitt Cancer Center and 1,000,000 Castor (FL)
and Human Services Services Research Institute, Inc., Tampa,
Administration. FL for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Hackensack Meridian Health, 1,000,000 Pascrell
and Human Services Services Edison, NJ for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Hamakua-Kohala Health Center, 2,000,000 Kahele
and Human Services Services Honokaa, HI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Hamilton Community Health 1,000,000 Kildee
and Human Services Services Network, Flint, MI for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Harris County Precinct 2, 3,000,000 Garcia (TX)
and Human Services Services Houston, TX for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Havana Community Development 1,967,328 Lawson (FL)
and Human Services Services Corp., Inc., Havana, FL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Health and Hospital Corporation 1,385,487 Carson
and Human Services Services of Marion County, Indianapolis,
Administration. IN for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Health Care Authority Corporation 1,000,000 Sewell
and Human Services Services of the City of Thomasville, AL
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Health Service Alliance-Montclair 300,000 Torres (CA)
and Human Services Services Community Health Center,
Administration. Montclair, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Health Unit on Davidson Avenue 281,200 Tlaib
and Human Services Services (The HUDA Clinic), Detroit, MI
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and HealthFirst Family Center, 450,000 Kuster
and Human Services Services Franklin, NH for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and HealthPoint, Renton, WA for 2,000,000 DelBene
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and HealthRIGHT 360, San Francisco, 2,500,000 Pelosi
and Human Services Services CA for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Healthy Mothers, Healthy Babies 305,313 Cherfilus-
and Human Services Services Coalition of Palm Beach County, McCormick
Administration. Inc., Greenacres, FL for a doula
training program.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Henderson County Rural Health 517,783 Bustos
and Human Services Services Center, Inc., dba Eagle View
Administration. Community Health System,
Oquawka, IL for health clinic
operational costs.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Hendry County, LaBelle, FL for 700,000 Diaz-Balart
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Henry J. Austin Health Center, 813,600 Watson
and Human Services Services Trenton, NJ for a mobile health Coleman
Administration. unit and staffing.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Henry Mayo Newhall Hospital 1,115,000 Garcia (CA)
and Human Services Services Foundation, Valencia, CA for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Heritage Heights at Lake Chelan, 800,000 Schrier
and Human Services Services WA for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Highlands Hospital dba Penn 1,000,000 Reschenthaler
and Human Services Services Highlands Connellsville (PHCV),
Administration. a subsidiary of Penn Highlands
Healthcare (PHH), Connellsville,
PA for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Hillsdale Community Health 345,000 Walberg
and Human Services Services Center, Hillsdale, MI for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and His Branches, Inc., Rochester, NY 819,312 Morelle
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Howard Brown Health, Chicago, IL 1,110,400 Quigley
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Hyndman Area Health Center, Inc, 425,000 Joyce (PA)
and Human Services Services Bedford, PA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and I. M. Sulzbacher Center for the 2,000,000 Rutherford
and Human Services Services Homeless, Inc., Jacksonville, FL
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Illinois College of Optometry, 445,000 Rush
and Human Services Services Chicago, IL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Illinois Community College 300,000 Bustos
and Human Services Services District #519 (Highland
Administration. Community College), Freeport, IL
for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Illinois State University, 2,000,000 LaHood
and Human Services Services Mennonite College of Nursing,
Administration. Normal, IL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Inner City Health Center, Denver, 183,486 DeGette
and Human Services Services CO for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Interfaith Medical Center Campus, 3,000,000 Jeffries
and Human Services Services Brooklyn, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and J. Paul Jones Hospital, Camden, 595,041 Sewell
and Human Services Services AL for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jackson Parish Hospital, 2,000,000 Letlow
and Human Services Services Jonesboro, LA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jamaica Hospital Medical Center, 1,905,000 Meeks
and Human Services Services Jamaica, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jamaica Hospital Medical Center, 2,400,000 Meeks
and Human Services Services Jamaica, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jawonio Inc., New City, NY for 1,300,000 Jones
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jersey Community Hospital 2,000,000 Davis, Rodney
and Human Services Services District, Jerseyville, IL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jessie Trice Community Health 3,000,000 Wilson (FL)
and Human Services Services System, Inc., Miami, FL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jewish Community Free Clinic, 200,000 Huffman
and Human Services Services Santa Rosa, CA for an electronic
Administration. health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jewish Foundation for Group 750,000 Raskin
and Human Services Services Homes, Rockville, MD for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Joseph P. Addabbo Family Health 325,000 Meeks
and Human Services Services Center, Inc., New York, NY for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Josselyn Center, Northfield, IL 1,000,000 Schneider
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Jurupa Unified, Jurupa Valley, CA 1,623,000 Takano
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Kern County Hospital Authority, 3,000,000 Valadao
and Human Services Services Bakersfield, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Kern County Hospital Authority, 3,000,000 Valadao
and Human Services Services Bakersfield, CA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Keryx Ministries, Inc., Macon, GA 400,000 Bishop (GA)
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Keystone Valley Fire Department, 29,385 Houlahan
and Human Services Services Parkesburg, PA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Kids' Community Clinic of 1,200,000 Schiff
and Human Services Services Burbank, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and KidsPeace, Orefield, PA for 1,000,000 Wild
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and King Lunalilo Trust and Home, 1,740,550 Case
and Human Services Services Honolulu, HI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Kings County Hospital Center, 2,200,000 Clarke (NY)
and Human Services Services Brooklyn, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Klingberg Family Centers, 1,000,000 Hayes
and Human Services Services Incorporated, New Britain, CT
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and La Maestra Family Clinic Inc., 751,681 Jacobs (CA)
and Human Services Services San Diego, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lake County Free Clinic, 100,000 Joyce (OH)
and Human Services Services Painesville, OH for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lakewood Community Services 1,000,000 Smith (NJ)
and Human Services Services Corporation, Lakewood, NJ for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lana'i Community Health Center, 1,538,000 Kahele
and Human Services Services Lana'i City, HI for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lansing Fire Department, Lansing, 1,000,000 Slotkin
and Human Services Services MI for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and LaSalle General Hospital, Jena, 1,065,000 Letlow
and Human Services Services LA for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lawrence General Hospital, 1,000,000 Trahan
and Human Services Services Lawrence, MA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Le Bonheur Children's Hospital, 970,000 Cohen
and Human Services Services Memphis, TN for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Legacy Community Health, Houston, 1,000,000 Green (TX)
and Human Services Services TX for an electronic health
Administration. records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Legacy Community Health, Houston, 300,000 Garcia (TX)
and Human Services Services TX for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Leyden Family Service & Mental 266,059 Krishnamoorth
and Human Services Services Health Center, Hoffman Estates, i
Administration. IL for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and LifeCare Alliance, Columbus, OH 975,000 Beatty
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lighthouse Youth Services, Inc., 1,850,000 Wenstrup
and Human Services Services Cincinnati, OH for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lions Eye Institute for 1,000,000 Castor (FL)
and Human Services Services Transplant and Research
Administration. Foundation, Tampa, FL for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Livingston County Emergency 1,169,950 Slotkin
and Human Services Services Management Services, Howell, MI
Administration. for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Loma Linda University Medical 2,000,000 Calvert
and Human Services Services Center- Murrieta, Murrieta, CA
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Long Island Jewish Forest Hills, 1,000,000 Meng
and Human Services Services NY for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Los Angeles County Fire 201,834 Torres (CA)
and Human Services Services Department, Los Angeles, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Louisiana Children's Medical 2,000,000 Carter (LA)
and Human Services Services Center, New Orleans, LA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Louisiana State University Health 2,350,000 Carter (LA)
and Human Services Services Sciences Center--New Orleans, LA
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Loveland Fire Rescue Authority, 500,000 Neguse
and Human Services Services Loveland, CO for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lower Bucks Hospital, Bristol, PA 1,200,000 Fitzpatrick
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lower Elwha Tribal Community, 1,911,875 Kilmer
and Human Services Services Port Angeles, WA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and LTSC Community Development 1,000,000 Schiff
and Human Services Services Corporation, Los Angeles, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Lynn Community Health Center, 1,000,000 Moulton
and Human Services Services Lynn, MA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Madison County Fiscal Court, 390,000 Barr
and Human Services Services Richmond, KY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Main Line Hospitals, Inc., 1,000,000 Scanlon
and Human Services Services Radnor, PA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Maine Department of Defense, 3,000,000 Golden
and Human Services Services Veterans and Emergency
Administration. Management, Augusta, ME for
facilities and equipment, and
operational costs for a rural
health project.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and MaineHealth dba Western Maine 1,642,000 Golden
and Human Services Services Health/Stephens Memorial
Administration. Hospital, Norway, ME for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Makah Indian Tribe, Neah Bay, WA 3,000,000 Kilmer
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Marian Regional Medical Center, 1,000,000 Carbajal
and Human Services Services Santa Maria, CA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Marshall University Research 3,000,000 Miller (WV)
and Human Services Services Corporation, Huntington, WV for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Mary Free Bed Rehabilitation 3,000,000 Meijer
and Human Services Services Hospital, Grand Rapids, MI for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Matthew Walker Comprehensive 480,000 Cooper
and Human Services Services Health Center Inc., Nashville,
Administration. TN for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and McLaren Central Michigan, Grand 850,000 Moolenaar
and Human Services Services Blanc, MI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and MedStar Curtis National Hand 1,500,000 Ruppersberger
and Human Services Services Center, Baltimore, MD for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and MedStar St. Mary's Hospital, 975,000 Hoyer
and Human Services Services Leonardtown, MD for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Melvin & Claire Levine Jewish 825,000 Mast
and Human Services Services Residential and Family Service,
Administration. West Palm Beach, FL for
facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Metropolitan Government of 2,200,000 Cooper
and Human Services Services Nashville and Davidson County,
Administration. Nashville, TN for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Mid-Coast Health Net Inc. dba 2,105,000 Pingree
and Human Services Services Knox Clinic, Rockland, ME for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Mid-State Health Center, 750,000 Kuster
and Human Services Services Plymouth, NH for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Mid-Valley Healthcare, Inc., 1,000,000 DeFazio
and Human Services Services Lebanon, OR for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Milwaukee Health Services, Inc., 2,983,000 Moore (WI)
and Human Services Services Milwaukee, WI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Molokai Community Health Center, 1,664,000 Kahele
and Human Services Services Kaunakakai, HI for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Morehead State University, 3,000,000 Rogers (KY)
and Human Services Services Morehead, KY for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Morehouse School of Medicine, 950,000 Williams (GA)
and Human Services Services Atlanta, GA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and MossRehab-Albert Einstein 210,000 Dean
and Human Services Services Healthcare Network, Elkins Park,
Administration. PA for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Mount Sinai Hospital, Chicago, IL 2,000,000 Davis, Danny
and Human Services Services for facilities and equipment. K.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Mountain Park Health Center, 3,000,000 Gallego
and Human Services Services Phoenix, AZ for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and MRIGlobal, Kansas City, MO for 1,000,000 Cleaver
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and MyMichigan Medical Center 2,000,000 Moolenaar
and Human Services Services Midland, Midland, MI for
Administration. facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Native American Community Clinic, 1,000,000 Omar
and Human Services Services Minneapolis, MN for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Native American Health Center, 1,000,000 Lee (CA)
and Human Services Services Inc., Oakland, CA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and NATIVE HEALTH, Inc., Phoenix, AZ 650,000 Stanton
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Natrona County, Casper, WY for 1,500,000 Cheney
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Navajo Nation Division of Social 3,000,000 Leger
and Human Services Services Services, Window Rock, AZ for Fernandez
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Navajo Nation Division of Social 2,000,000 O'Halleran
and Human Services Services Services, Window Rock, AZ for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Near North Health Service 2,000,000 Davis, Danny
and Human Services Services Corporation, Chicago, IL for K.
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Nehalem Bay Health District, 1,000,000 Schrader
and Human Services Services Wheeler, OR for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Neighborhood Health Association 1,000,000 Kaptur
and Human Services Services of Toledo, Inc., Toledo, OH for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Neighborhood Healthcare Inc, 575,000 Calvert
and Human Services Services Menifee, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Neighborhood Medical Center, 1,650,000 Lawson (FL)
and Human Services Services Incorporated, Tallahassee, FL
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New Destiny Treatment Center, 1,500,000 Gonzalez (OH)
and Human Services Services Clinton, OH for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New Directions for Youth, Inc., 1,000,000 Cardenas
and Human Services Services North Hollywood, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New England College, Henniker, NH 2,000,000 Kuster
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New Paths, Inc., Flint, MI for 1,000,000 Kildee
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New York City Health and 3,000,000 Torres (NY)
and Human Services Services Hospitals--Lincoln Medical and
Administration. Mental Health Center, Bronx, NY
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New York City Health and 2,000,000 Velazquez
and Human Services Services Hospitals Corporation, New York,
Administration. NY for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New York City Health and 1,000,000 Meng
and Human Services Services Hospitals/Elmhurst, Queens, NY
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New York Community Hospital, 2,200,000 Clarke (NY)
and Human Services Services Brooklyn, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and New York Medical College, 1,900,000 Jones
and Human Services Services Valhalla, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Newark Community Health Centers, 1,000,000 Payne
and Human Services Services Inc. , Newark, NJ for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Newport County Community Mental 1,000,000 Cicilline
and Human Services Services Health Center Inc., Middletown,
Administration. RI for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Next Steps of O'Connor Foundation 645,695 Newman
and Human Services Services dba Next Steps Chicago, Chicago,
Administration. IL for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and NextStep Orlando, Inc., Altamonte 533,499 Murphy (FL)
and Human Services Services Springs, FL for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Nicholas H. Noyes Memorial 1,500,000 Jacobs (NY)
and Human Services Services Hospital, Dansville, NY for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Niscasa, Round Lake, IL for 2,100,000 Schneider
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and North Broward Hospital District 3,000,000 Cherfilus-
and Human Services Services dba Broward Health, Fort McCormick
Administration. Lauderdale, FL for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and North Carolina Central 643,750 Price (NC)
and Human Services Services University, Durham, NC for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and North Central Michigan College, 2,000,000 Bergman
and Human Services Services Petoskey, MI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and North Memorial Health Care, 1,000,000 Phillips
and Human Services Services Robbinsdale, MN for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Northeast Iowa Community College, 375,000 Hinson
and Human Services Services Peosta, IA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Northeast Valley Health 1,655,000 Cardenas
and Human Services Services Corporation, San Fernando, CA
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Northern Marianas College, 1,000,000 Sablan
and Human Services Services Saipan, NP for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Northern Nevada HOPES, Reno, NV 2,000,000 Amodei
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Northwest Indian College, 2,000,000 DelBene
and Human Services Services Bellingham, WA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Northwest Medical Foundation 1,000,000 Schrader
and Human Services Services Tillamook, OR for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Northwest Technical Institute, 2,000,000 Womack
and Human Services Services Springdale, AR for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and NYU Langone Health, New York, NY 2,000,000 Malliotakis
and Human Services Services for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Odyssey House Louisiana Inc., New 1,000,000 Carter (LA)
and Human Services Services Orleans, LA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Oklahoma Blood Institute, 1,250,000 Bice (OK)
and Human Services Services Oklahoma City, OK for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Oklahoma Medical Research 1,755,000 Bice (OK)
and Human Services Services Foundation, Oklahoma City, OK
Administration. for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Oklahoma Medical Research 2,000,000 Cole
and Human Services Services Foundation, Oklahoma City, OK
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Olathe Fire Department 660,000 Davids (KS)
and Human Services Services Administration, Olathe, KS for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and OLE Health, Napa, CA for 1,796,139 Thompson (CA)
and Human Services Services equipment, for an electronic
Administration. health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Oneida Health Systems Inc., 1,000,000 Tenney
and Human Services Services Oneida, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Orange County Board of County 239,059 Murphy (FL)
and Human Services Services Commissioners, Orlando, FL for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Orange County Health Authority 2,000,000 Kim (CA)
and Human Services Services (dba CalOptima), Orange, CA for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Orange County Health Authority, 1,000,000 Correa
and Human Services Services Orange, CA for a health
Administration. information technology
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Oregon Association of Relief 5,055,844 Bonamici,
and Human Services Services Nurseries, Newberg, OR for Schrader
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Oregon Health & Science 800,000 Blumenauer
and Human Services Services University, Portland, OR for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Ozark Tri-County Healthcare 1,500,000 Long
and Human Services Services Consortium, DBA ACCESS Family
Administration. Care, Neosho, MO for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Park West Health System, 1,000,000 Mfume
and Human Services Services Baltimore, MD for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Parkland College, Champaign, IL 320,000 Davis, Rodney
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and People Coordinated Services of 1,162,000 Bass
and Human Services Services Southern California, Los
Administration. Angeles, CA for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and People's Community Clinic, 850,000 Doggett
and Human Services Services Austin, TX for an electronic
Administration. health records initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Personal Enrichment through 2,000,000 Bilirakis
and Human Services Services Mental Health Services, Inc.,
Administration. Pinellas Park, FL for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Perspectives Inc., St. Louis 3,000,000 Omar
and Human Services Services Park, MN for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Pikeville Medical Center, Inc., 3,000,000 Rogers (KY)
and Human Services Services Pikeville, KY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Plymouth Housing, Seattle, WA for 1,000,000 Smith (WA)
and Human Services Services equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Portsmouth Community Health 807,137 Scott (VA)
and Human Services Services Center, Inc., dba Hampton Roads
Administration. Community Health Center,
Portsmouth, VA for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Potomac Valley Hospital, Keyser, 1,100,000 McKinley
and Human Services Services WV for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Power4STL, St. Louis, MO for 3,000,000 Bush
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Presbyterian Hospital DBA Novant 216,200 Adams
and Human Services Services Health Presbyterian Medical
Administration. Center, Charlotte, NC for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Presbyterian Villages of 140,000 Bergman
and Human Services Services Michigan, Southfield, MI for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Presbyterian Villages of 115,000 Moolenaar
and Human Services Services Michigan, Southfield, MI for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Primary Care Health Services, 2,200,000 Doyle,
and Human Services Services Inc., Pittsburgh, PA for Michael F.
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Prince William County Government, 2,000,000 Connolly
and Human Services Services Prince William, VA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Project Angel Food, Los Angeles, 913,500 Schiff
and Human Services Services CA for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Promise Fund of Florida, Inc., 900,100 Wasserman
and Human Services Services Palm Beach, FL for equipment. Schultz
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Promise Fund of Florida, Inc., 894,100 Cherfilus-
and Human Services Services Palm Beach, FL for facilities McCormick
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Promise Fund of Florida, Inc., 951,500 Frankel, Lois
and Human Services Services Palm Beach, FL for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Providence Holy Cross Medical 750,000 Cardenas
and Human Services Services Center, Mission Hills, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Rappahannock Area Health 400,000 Spanberger
and Human Services Services District, Fredericksburg, VA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Rappahannock-Rapidan Community 1,000,000 Spanberger
and Human Services Services Services, Culpeper, VA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Red Oak Behavioral Health, Akron, 2,000,000 Ryan
and Human Services Services OH for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Redwoods Rural Health Center, 775,000 Huffman
and Human Services Services Redway, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Regional One Health, Memphis, TN 2,000,000 Cohen
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Research Institute at Nationwide 1,000,000 Balderson
and Human Services Services Children's Hospital, Columbus,
Administration. OH for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Resources for Human Development, 1,000,000 Scanlon
and Human Services Services Philadelphia, PA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Riverside Community Health 2,000,000 Takano
and Human Services Services Foundation, Riverside, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Riverside Medical Center, 1,000,000 Kelly (IL)
and Human Services Services Kankakee, IL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Roanoke Chowan Community Health 1,300,000 Butterfield
and Human Services Services Center, Ahoskie, NC for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Roanoke College, Salem, VA for 505,000 Griffith
and Human Services Services equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Rockland Community College, 3,000,000 Jones
and Human Services Services Suffern, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Roxbury Volunteer Emergency 257,000 Meeks
and Human Services Services Services, Inc., New York, NY for
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Rutgers Biomedical and Health 950,650 Payne
and Human Services Services Sciences, Newark, NJ for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Sacramento Native American Health 1,000,000 Matsui
and Human Services Services Center, Sacramento, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Saint Anselm College, Manchester, 2,200,000 Pappas
and Human Services Services NH for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Saint Anthony Hospital, Chicago, 1,000,000 Garcia (IL)
and Human Services Services IL for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Saint Francis University, 500,000 Joyce (PA)
and Human Services Services Loretto, PA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Saint Xavier University, Chicago, 106,885 Newman
and Human Services Services IL for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and San Francisco Community Clinic 2,200,000 Pelosi
and Human Services Services Consortium, San Francisco, CA
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and San Gorgonio Memorial Hospital, 452,000 Ruiz
and Human Services Services Banning, CA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and San Joaquin Health Centers, 1,810,929 McNerney
and Human Services Services Stockton, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and San Juan County, Monticello, UT 515,000 Curtis
and Human Services Services for cancer screening.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Sea Mar Community Health Centers, 2,200,000 Smith (WA)
and Human Services Services Seattle, WA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Seattle Indian Health Board, 3,000,000 Jayapal
and Human Services Services Seattle, WA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Self Help Movement, Inc., 1,500,000 Boyle,
and Human Services Services Philadelphia, PA for facilities Brendan F.
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Seton Hall University, South 1,140,000 Pascrell
and Human Services Services Orange, NJ for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Shands Jacksonville Medical 2,000,000 Rutherford
and Human Services Services Center, Inc., Jacksonville, FL
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Shepherd's Hope, Winter Park, FL 395,500 Demings
and Human Services Services for facilities and equipment,
Administration. including equipment related to
telehealth.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Siena College, Loudonville, NY 496,541 Tonko
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Sight For All United, Struthers, 550,000 Ryan
and Human Services Services OH for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Sinclair Community College, 2,000,000 Turner
and Human Services Services Dayton, OH for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Singing River Health System, 2,800,000 Palazzo
and Human Services Services Ocean Springs, MS for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Siskin Hospital for Physical 2,500,000 Fleischmann
and Human Services Services Rehabilitation, Inc.,
Administration. Chattanooga, TN for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Sisters of Charity Hospital of 2,377,172 Higgins (NY)
and Human Services Services Buffalo, New York, Cheektowaga,
Administration. NY for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Solano County Public Health 1,000,000 Garamendi
and Human Services Services Department's Family Health
Administration. Services, Fairfield, CA for an
electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and South Boston Community Health 2,000,000 Lynch
and Human Services Services Center, Inc., South Boston, MA
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and South Central Family Health 707,414 Roybal-Allard
and Human Services Services Center, Cudahy, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and South Shore Hospital Corporation, 2,000,000 Kelly (IL)
and Human Services Services Chicago, IL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and South Ward Alliance dba South 2,000,000 Payne
and Human Services Services Ward Promise Neighborhood,
Administration. Newark, NJ for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Southeast Council on Alcoholism 915,000 Courtney
and Human Services Services and Drug Dependence, Inc.,
Administration. Lebanon, CT for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Southwest Community Health 2,000,000 Himes
and Human Services Services Center, Inc., Bridgeport, CT for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Southwestern Vermont Medical 250,000 Welch
and Human Services Services Center, Bennington, VT for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and SSM Health--St. Mary's Hospital-- 1,000,000 Bush
and Human Services Services St. Louis, MO for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and St. Catherine Hospital, Inc., 1,500,000 Mrvan
and Human Services Services East Chicago, IN for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and St. Francis Medical Center, 2,000,000 Letlow
and Human Services Services Monroe, LA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and St. John's Episcopal Hospital, 3,000,000 Meeks
and Human Services Services Episcopal Health Services Inc.,
Administration. Far Rockaway, NY for facilities
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and St. John's Riverside Hospital, 1,000,000 Bowman
and Human Services Services Yonkers, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and St. Joseph Regional Health 1,000,000 Meuser
and Human Services Services Network, Reading, PA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and St. Joseph's Medical Center, 4,000,000 Harder (CA),
and Human Services Services Stockton, CA for facilities and McNerney
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and State University of New York 900,000 Katko
and Human Services Services Upstate Medical University,
Administration. Syracuse, NY for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Stockbridge Community Schools, 2,500,000 Slotkin
and Human Services Services Stockbridge, MI for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Sun River Health, Inc. dba Hudson 2,000,000 Maloney, Sean
and Human Services Services River HealthCare, Peekskill, NY Patrick
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Sun River Health, Peekskill, NY 1,800,000 Jeffries
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Susannah's House, Inc., 500,000 Burchett
and Human Services Services Knoxville, TN for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and TCC Family Health, Long Beach, CA 375,000 Barragan
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Tennyson Center for Children, 1,000,000 DeGette
and Human Services Services Denver, CO for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Texas A&M University College of 940,000 Johnson (TX)
and Human Services Services Dentistry, Dallas, TX for an
Administration. oral health care initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Texas A&M University- San 1,945,000 Gonzales,
and Human Services Services Antonio, San Antonio, TX for Tony
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Texas Children's Hospital, 2,000,000 Green (TX)
and Human Services Services Houston, TX for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Texas Tech University Health 2,600,000 Pfluger
and Human Services Services Science Center (TTUHSC) Odessa,
Administration. Odessa, TX for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Texas Tech University Health 3,000,000 Escobar
and Human Services Services Sciences Center El Paso, TX for
Administration. an initiative related to health
information technology and
telehealth.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Texas Tech University Health 2,000,000 Johnson (TX)
and Human Services Services Sciences Center, Dallas, TX for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and The Floating Hospital, Inc., Long 1,040,489 Maloney,
and Human Services Services Island City, NY for facilities Carolyn B.
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and The Foodbank, Inc., Dayton, OH 2,000,000 Turner
and Human Services Services for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and The Good Samaritan Hospital of 590,000 Chabot
and Human Services Services Cincinnati, OH for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and TidalHealth Nanticoke, Seaford, 1,000,000 Blunt
and Human Services Services DE for facilities and equipment. Rochester
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Town of Geraldine, AL for 375,000 Aderholt
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Township of Brick, NJ for 250,000 Kim (NJ)
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Township of Edison, NJ for 3,000,000 Pallone
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Township of Mount Olive, Budd 1,982,500 Malinowski
and Human Services Services Lake, NJ for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Tri-Area Community Health, Laurel 600,000 Griffith
and Human Services Services Fork, VA for facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Trinity Health System, 2,000,000 Johnson (OH)
and Human Services Services Steubenville, OH for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Tri-State Memorial Hospital, 2,500,000 Rodgers (WA)
and Human Services Services Clarkston, WA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Tucson Indian Center, Tucson, AZ 588,059 Grijalva
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and UMass Memorial Health-- 450,000 Trahan
and Human Services Services HealthAlliance--Clinton
Administration. Hospital, Leominster, MA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and UMass Memorial Medical Center, 1,000,000 McGovern
and Human Services Services Worcester, MA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Union Community Health Center, 675,000 Torres (NY)
and Human Services Services Inc., Bronx, NY for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and United Neighborhood Health 750,000 Cooper
and Human Services Services Services dba Neighborhood
Administration. Health, Nashville, TN for
facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University at Buffalo, NY for 933,800 Higgins (NY)
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Community Health 2,000,000 Cooper
and Human Services Services Services, Inc., Nashville, TN
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Health System (UHS) d/ 1,250,000 Fleischmann
and Human Services Services b/a University of Tennessee
Administration. Medical Center, Knoxville, TN
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Health System (UHS) d/ 750,000 Fleischmann
and Human Services Services b/a University of Tennessee
Administration. Medical Center, Knoxville, TN
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Health System (UHS), d/ 1,000,000 Burchett
and Human Services Services b/a/ University of Tennessee
Administration. Medical Center, Knoxville, TN
for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Hospital, Newark, NJ 3,000,000 Payne
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Hospitals Cleveland 855,000 Gonzalez (OH)
and Human Services Services Medical Center, Cleveland, OH
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Hospitals, Cleveland, 1,145,520 Brown (OH)
and Human Services Services OH for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Hospitals, Cleveland, 1,500,000 Joyce (OH)
and Human Services Services OH for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University Muslim Medical 158,000 Roybal-Allard
and Human Services Services Association Inc. (UMMA Community
Administration. Clinic), Huntington Park, CA for
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of California, San 1,095,000 Jacobs (CA),
and Human Services Services Diego, La Jolla, CA for Vargas
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Hawaii--Office of 1,000,000 Case
and Human Services Services Strategic Health Initiatives,
Administration. Honolulu, HI for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Kansas Medical 2,594,226 Davids (KS)
and Human Services Services Center, Kansas City, KS for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Kansas Medical 2,956,507 Davids (KS)
and Human Services Services Center, Kansas City, KS for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Kansas Medical 1,000,000 Davids (KS)
and Human Services Services Center, Kansas City, KS for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Louisville, KY for 2,000,000 Yarmuth
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Massachusetts 3,000,000 Lynch
and Human Services Services Boston, MA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Miami Leonard M. 500,000 Wasserman
and Human Services Services Miller School of Medicine, Schultz
Administration. Miami, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Miami, Miami, FL 800,000 Gimenez
and Human Services Services for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Mississippi Medical 2,000,000 Guest
and Human Services Services Center, Jackson, MS for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Nevada Las Vegas, 1,000,000 Lee (NV)
and Human Services Services NV for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Rochester, NY for 1,000,000 Morelle
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of South Alabama, 1,500,000 Carl
and Human Services Services Mobile, AL for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of South Florida, 2,000,000 Buchanan
and Human Services Services Sarasota, FL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of South Florida, 1,000,000 Castor (FL)
and Human Services Services Tampa, FL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Texas at Dallas, 1,500,000 Allred
and Human Services Services Richardson, TX for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Texas Health 1,000,000 Jackson Lee
and Human Services Services Science Center at Houston, TX
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Texas Health 1,000,000 Castro (TX)
and Human Services Services Science Center at San Antonio,
Administration. TX for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Texas Rio Grande 1,000,000 Gonzalez,
and Human Services Services Valley, Edinburg, TX for Vicente
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Texas School of 1,000,000 Castro (TX)
and Human Services Services Public Health San Antonio, TX
Administration. for facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Texas Southwestern 1,500,000 Allred
and Human Services Services Medical Center, Dallas, TX for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Toledo, OH for 1,000,000 Kaptur
and Human Services Services equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Utah, Salt Lake 3,000,000 Stewart
and Human Services Services City, UT for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and University of Wisconsin-Madison, 1,000,000 Pocan
and Human Services Services WI for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and UPMC Altoona, Altoona, PA for 250,000 Joyce (PA)
and Human Services Services facilities.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Urban Health Plan, Inc., Bronx, 2,106,950 Torres (NY)
and Human Services Services NY for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Urban Health Plan, Inc., Corona, 3,000,000 Ocasio-Cortez
and Human Services Services NY for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Valley Health Services, Inc., 2,000,000 Tenney
and Human Services Services Herkimer, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Valley Health System, Winchester, 1,500,000 Wexton
and Human Services Services VA for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Valley Hospital, Ridgewood, NJ 608,860 Gottheimer
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Valparaiso University, 1,000,000 Mrvan
and Human Services Services Valparaiso, IN for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Van Buren County Hospital, 1,845,000 Miller-Meeks
and Human Services Services Keosauqua, IA for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Variety Care, Inc., Oklahoma 3,000,000 Cole
and Human Services Services City, OK for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Variety Children's Hospital DBA 450,000 Salazar
and Human Services Services Nicklaus Children's Hospital,
Administration. Miami, FL for equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Variety Children's Hospital DBA 1,000,000 Salazar
and Human Services Services Nicklaus Children's Hospital,
Administration. Miami, FL for facilities and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Venice Family Clinic, Venice, CA 500,000 Lieu
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Vera French Community Mental 1,885,000 Miller-Meeks
and Human Services Services Health Center, Davenport, IA for
Administration. facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Via Care Community Health Center, 389,000 Roybal-Allard
and Human Services Services East Los Angeles, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and View Point Health, Lawrenceville, 900,000 Bourdeaux
and Human Services Services GA for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Virgin Islands Diabetes Center of 995,000 Plaskett
and Human Services Services Excellence, St. Croix, VI for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Virgin Islands Fire Services, St. 1,897,000 Plaskett
and Human Services Services Thomas, VI for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Virtua Health, Camden, NJ for 2,000,000 Norcross
and Human Services Services facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Virtua Health, Inc., Marlton, NJ 1,000,000 Kim (NJ)
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Vision Urbana, Inc., New York, NY 1,000,000 Nadler
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and VNA Health Care, Aurora, IL for 500,000 Foster,
and Human Services Services facilities and equipment. Underwood
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and W.A. Foote Memorial Hospital, 310,000 Walberg
and Human Services Services Inc., Jackson, MI for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Waimanalo Health Center, 2,000,000 Kahele
and Human Services Services Waimanalo, HI for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and WakeMed Health & Hospitals, 6,000,000 Price (NC),
and Human Services Services Raleigh, NC for facilities and Ross
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Washington County Healthcare 1,845,000 Carl
and Human Services Services Authority, INC dba Washington
Administration. County Hospital and Nursing
Home, Chatom, AL for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Watts Healthcare Corporation, Los 2,000,000 Waters
and Human Services Services Angeles, CA for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Wayside House, Inc., Delray 1,000,000 Frankel, Lois
and Human Services Services Beach, FL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Weber State University, Ogden, UT 1,500,000 Moore (UT)
and Human Services Services for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and West County Health Centers, Inc., 901,575 Huffman
and Human Services Services Guerneville, CA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and West Virginia School of 325,000 Miller (WV)
and Human Services Services Osteopathic Medicine, Lewisburg,
Administration. WV for facilities.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Westchester Sickle Cell Outreach, 500,000 Jones
and Human Services Services Inc., White Plains, NY for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Western Nevada College, Carson 2,000,000 Amodei
and Human Services Services City, NV for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and White Memorial Community Health 1,000,000 Gomez
and Human Services Services Center, Los Angeles, CA for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Whitman County Public Hospital 3,000,000 Rodgers (WA)
and Human Services Services District Number 1-A, Pullman, WA
Administration. for an electronic health records
initiative.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Whitman-Walker Health, 250,000 Norton
and Human Services Services Washington, DC for equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Wilmington Community Clinic, 200,000 Barragan
and Human Services Services Wilmington, CA for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Wilson Community College, Wilson, 3,000,000 Butterfield
and Human Services Services NC for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and WINGS Program, Inc., Rolling 200,000 Casten
and Human Services Services Meadows, IL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Winston-Salem State University, 1,342,840 Manning
and Human Services Services Winston-Salem, NC for facilities
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Wintersville Volunteer Fire 110,000 Johnson (OH)
and Human Services Services Department, Wintersville, OH for
Administration. facilities and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Worry Free Community, Glendale 144,800 Casten
and Human Services Services Heights, IL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Worry Free Community, Glendale 1,000,000 Newman
and Human Services Services Heights, IL for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and Wyckoff Heights Medical Center, 2,000,000 Velazquez
and Human Services Services Brooklyn, NY for facilities and
Administration. equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Health Resources and YMCA of Central Florida, Orlando, 1,000,000 Demings
and Human Services Services FL for facilities and equipment.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And A Safe Haven Foundation, Chicago, 2,000,000 Davis, Danny
and Human Services Mental Health Services IL for behavioral health, K.
Administration. substance use disorder, and peer
support services, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And AABR, Inc., College Point, NY for 382,174 Ocasio-Cortez
and Human Services Mental Health Services behavioral health services and
Administration. training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And AboutFace-USA, Inc., Cumming, GA 1,280,000 Bourdeaux
and Human Services Mental Health Services for mental health treatment and
Administration. services for veterans, including
equipment and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Alliance for Healthy Communities, 800,000 Bilirakis
and Human Services Mental Health Services Inc., New Port Richey, FL for a
Administration. substance use prevention,
treatment, and recovery
services, and resources center,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Amistad, Inc., Portland, ME for 535,000 Pingree
and Human Services Mental Health Services behavioral health services and
Administration. recovery housing.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Anaheim Community Foundation, 1,000,000 Correa
and Human Services Mental Health Services Anaheim, CA for mental health
Administration. and related support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Apna Ghar, Chicago, IL for a 300,000 Schakowsky
and Human Services Mental Health Services mobile mental health advocacy
Administration. unit, including training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Arab-American Family Support 1,800,453 Velazquez
and Human Services Mental Health Services Center, Brooklyn, NY for mental
Administration. health services, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Ashley Addiction Treatment 420,000 Ruppersberger
and Human Services Mental Health Services Center, Havre de Grace, MD for
Administration. behavioral health services and
youth education programs.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Asian Health Services, Oakland, 1,000,000 Lee (CA)
and Human Services Mental Health Services CA for mental health and
Administration. wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Bay Area Community Health, San 1,000,000 Lofgren
and Human Services Mental Health Services Jose, CA for behavioral health
Administration. services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Baylor College of Medicine, 1,000,000 Jackson Lee
and Human Services Mental Health Services Houston, TX for substance use
Administration. disorder services and treatment
for people experiencing
homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Baylor College of Medicine, 1,200,000 Garcia (TX)
and Human Services Mental Health Services Houston, TX to provide substance
Administration. use disorder services and
treatment, including minor
facility repairs, improvements,
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Beit T'Shuvah, Los Angeles, CA 301,649 Sherman
and Human Services Mental Health Services for behavioral health, recovery,
Administration. and other supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Boys & Girls Clubs of Delaware, 250,000 Blunt
and Human Services Mental Health Services Wilmington, DE for mental health Rochester
Administration. and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Boys & Girls Clubs of the Valley, 1,000,000 Gallego
and Human Services Mental Health Services Phoenix, AZ for the Whole Child
Administration. Approach Program to provide
mental health and other
supportive services for children.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And BPSOS Center for Community 300,000 Lowenthal
and Human Services Mental Health Services Advancement, Westminster, CA for
Administration. behavioral health services and
training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Cenikor Foundation, Waco, TX for 640,000 Sessions
and Human Services Mental Health Services a substance use treatment and
Administration. recovery program, including
behavioral health services and
support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Champions In Service, Pacoima, CA 722,223 Cardenas
and Human Services Mental Health Services for mental health and supportive
Administration. services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Child and Family Agency of 693,437 Courtney
and Human Services Mental Health Services Southeastern CT, Inc., New
Administration. London, CT for mental health and
related services for youth,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Children's Health Clinical 915,000 Allred,
and Human Services Mental Health Services Operations, Dallas, TX for Johnson
Administration. training, education, and (TX), Van
pediatric mental health services. Duyne
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Children's Health Clinical 500,000 Allred, Van
and Human Services Mental Health Services Operations, Dallas, TX for youth Duyne
Administration. behavioral health services and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Children's Hospital Colorado, 668,313 Crow
and Human Services Mental Health Services Aurora, CO to enhance access to
Administration. mental health care services,
including training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Children's Hospital of The King's 1,000,000 Scott (VA)
and Human Services Mental Health Services Daughters, Norfolk, VA for
Administration. mental health services and
treatment, including outreach
and programming.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Chinese-American Planning 500,000 Nadler
and Human Services Mental Health Services Council, Inc., New York, NY for
Administration. mental health services and
treatment, outreach, education,
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Austin, TX for substance 2,000,420 Doggett
and Human Services Mental Health Services use prevention, awareness, and
Administration. education activities.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Hermosa Beach, CA for 1,000,000 Lieu
and Human Services Mental Health Services mobile mental health crisis
Administration. response teams.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Monroe, WA for mental 480,804 DelBene
and Human Services Mental Health Services health crisis support services,
Administration. including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Moreno Valley, CA for the 1,000,000 Takano
and Human Services Mental Health Services Homeless to Work program to
Administration. provide behavioral health
services, including equipment
and outreach.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Norco, CA for a 800,000 Calvert
and Human Services Mental Health Services homelessness services program.
Administration.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of North Las Vegas, NV for a 875,000 Horsford
and Human Services Mental Health Services mental health crisis response
Administration. unit.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Pasadena, CA for the 900,000 Chu
and Human Services Mental Health Services Pasadena Outreach Response Team
Administration. to provide behavioral health and
related services to people
experiencing homelessness.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Pittsburg, PA for the 1,000,000 Doyle,
and Human Services Mental Health Services Reaching Out On The Streets Michael F.
Administration. (ROOTS) Overdose and Support
Teams to provide behavioral
health services, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of San Fernando, CA for 800,000 Cardenas
and Human Services Mental Health Services mental health crisis response
Administration. services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And City of Santa Monica, CA for 1,500,000 Lieu
and Human Services Mental Health Services behavioral health and other
Administration. supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Clark County, Nevada, Las Vegas, 1,709,594 Lee (NV)
and Human Services Mental Health Services NV for behavioral health and
Administration. other support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Community Health Connections, 2,500,000 Trahan
and Human Services Mental Health Services Inc., Fitchburg, MA for youth
Administration. mental health services and
treatment, including training
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Community Hero Action Group, King 450,000 Dean
and Human Services Mental Health Services of Prussia, PA for the Black
Administration. Health Matters initiative to
provide mental health services,
and other supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Community Medical Wellness 2,000,000 Lowenthal
and Human Services Mental Health Services Centers, USA, Long Beach, CA for
Administration. behavioral health and substance
use disorder services, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Compass LGBTQ Youth and Family 523,345 Cherfilus-
and Human Services Mental Health Services Services, Lake Worth Beach, FL McCormick
Administration. for behavioral health and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Contact Community Services, Inc., 135,000 Katko
and Human Services Mental Health Services Syracuse, NY for a crisis call
Administration. center upgrade, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And County of San Diego, CA for 4,480,000 Levin (CA),
and Human Services Mental Health Services mobile behavioral health crisis Peters
Administration. response teams.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Court Appointed Special Advocates 600,000 DeSaulnier
and Human Services Mental Health Services Program, Inc. of Contra Costa,
Administration. Concord, CA for mental health
services for youth and education
programming.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Douglas County, Castle Rock, CO 629,970 Crow
and Human Services Mental Health Services for mental and behavioral health
Administration. services and treatment,
including technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And DuPage County Health Department, 1,000,000 Casten
and Human Services Mental Health Services Wheaton, IL for mental health
Administration. and substance use disorder
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And East Bay Agency for Children, 477,000 Swalwell
and Human Services Mental Health Services Oakland, CA for student and
Administration. teacher mental health services
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And El Futuro, Inc., Durham, NC for 192,371 Price (NC)
and Human Services Mental Health Services mental health training and
Administration. curriculum development.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And EmblemHealth, Inc., New York, NY 450,000 Clarke (NY)
and Human Services Mental Health Services for mental health services,
Administration. education, and other related
activities.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Emory University, Atlanta, GA for 500,000 Williams (GA)
and Human Services Mental Health Services a hospital-based violence
Administration. intervention program to provide
behavioral health services and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Family and Children's 790,817 Rice (NY)
and Human Services Mental Health Services Association, Garden City, NY for
Administration. the Senior Safety Net Program to
provide behavioral health and
wraparound services, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Family and Children's Center 450,000 Kind
and Human Services Mental Health Services Wisconsin, La Crosse, WI to
Administration. expand behavioral health
services, including outreach,
education, equipment, and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And FosterHope Sacramento, 600,000 Bera
and Human Services Mental Health Services Sacramento, CA for mental health
Administration. and associated support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Friends of the Children- Detroit, 150,000 Lawrence
and Human Services Mental Health Services Detroit, MI for mental health
Administration. and other supportive services,
including training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And GAAMHA Inc., Gardner, MA for 200,000 Trahan
and Human Services Mental Health Services behavioral health and supportive
Administration. services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And George Mason University, Fairfax, 1,037,519 Wexton
and Human Services Mental Health Services VA for substance use services,
Administration. treatment, and associated
support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And George Mason University, Fairfax, 943,983 Connolly
and Human Services Mental Health Services VA for youth mental health
Administration. services, including training and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Grafton City Hospital, Grafton, 995,000 McKinley
and Human Services Mental Health Services WV for a substance use treatment
Administration. and recovery program, including
the purchase of supplies,
equipment, and information
technology, and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Harris County Public Health, 1,000,000 Fletcher
and Human Services Mental Health Services Houston, TX for ACCESS Harris to
Administration. provide behavioral health and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Harris County Public Health, 1,431,174 Fletcher
and Human Services Mental Health Services Houston, TX for behavioral
Administration. health and supportive services
for parents and infants.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Healthier Kids Foundation, San 644,000 Eshoo
and Human Services Mental Health Services Jose, CA for mental and
Administration. behavioral health services for
youth.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Hope for Heroes Horsemanship 70,000 Strickland
and Human Services Mental Health Services Center, Yelm, WA for suicide
Administration. prevention and mental health
awareness training and treatment
programming, including
postvention services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Hope of the Valley Rescue 2,000,000 Sherman
and Human Services Mental Health Services Mission, North Hills, CA for
Administration. mental health and substance use
disorder services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Ibn Sina Foundation, Inc., 1,600,000 Green (TX)
and Human Services Mental Health Services Houston, TX for mental health
Administration. and substance use disorder
services and treatment,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Identity, Inc., Rockville, MD for 121,000 Raskin
and Human Services Mental Health Services the Encuentros program to
Administration. provide mental health and
supportive services, including
curriculum and training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Indian Health Center of Santa 914,000 Lofgren
and Human Services Mental Health Services Clara Valley, San Jose, CA for
Administration. behavioral health and wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Jewish Adoption and Family Care 250,000 Deutch
and Human Services Mental Health Services Options, Sunrise, FL for mental
Administration. health and trauma prevention
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Julia Dyckman Andrus Memorial, 802,583 Bowman
and Human Services Mental Health Services Incorporated, Yonkers, NY to
Administration. expand mental health services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And LCH Health and Community 605,000 Houlahan
and Human Services Mental Health Services Services, Oxford, PA for
Administration. behavioral health services and
treatment, including minor
facility repairs and
improvements.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And LIFE Camp, Inc., Jamaica, NY for 800,000 Meng
and Human Services Mental Health Services mental health, grief counseling,
Administration. and other supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Loma Linda University Medical 542,597 Aguilar
and Human Services Mental Health Services Center, Loma Linda, CA for a
Administration. mental health outreach
demonstration program.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Long Island Council on Alcoholism 150,000 Rice (NY)
and Human Services Mental Health Services and Drug Dependence, Inc.,
Administration. Westbury, NY for the Student
Assistance Program 2.0 to
provide mental health and
substance use disorder services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Long Island Gay and Lesbian 500,000 Suozzi
and Human Services Mental Health Services Youth, Inc., Hauppauge, NY for
Administration. substance use prevention and
mental health services for youth.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Maimonides Medical Center, 1,650,000 Malliotakis,
and Human Services Mental Health Services Brooklyn, NY for behavioral Nadler
Administration. health services, workforce
training, and care coordination.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Massachusetts General Hospital 1,150,000 Pressley
and Human Services Mental Health Services Center for Immigrant Health,
Administration. Boston, MA for mental health and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Massachusetts General Hospital, 1,000,000 Lynch
and Human Services Mental Health Services Boston, MA for behavioral health
Administration. and supportive services for
adults and youth.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Mental Health Association, Inc., 513,000 Neal
and Human Services Mental Health Services Springfield, MA for mental
Administration. health services, including
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Minnesota Psychiatric Information 500,000 Phillips
and Human Services Mental Health Services and Outreach, St. Paul, MN for
Administration. behavioral health educational
materials, training, and peer
support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Mosaic Georgia, Inc., Duluth, GA 1,027,200 Bourdeaux
and Human Services Mental Health Services for behavioral health workforce
Administration. and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Muslim Community and Health 290,000 Moore (WI)
and Human Services Mental Health Services Center, Milwaukee, WI to expand
Administration. mental health services,
including outreach and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And National Runaway Switchboard, 375,000 Quigley
and Human Services Mental Health Services Chicago, IL for the Teen Suicide
Administration. Prevention Line to provide
mental health services,
including technology, public
awareness, training, and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Nevada State College, Henderson, 1,337,000 Lee (NV)
and Human Services Mental Health Services NV for behavioral health and
Administration. support services, including
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And New Age Services Corporation, 600,000 Davis, Danny
and Human Services Mental Health Services Chicago, IL to expand substance K.
Administration. use disorder and mental health
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And New Mexico Human Services 2,800,000 Stansbury
and Human Services Mental Health Services Department, Behavioral Health
Administration. Services Division, Santa Fe, NM
for mobile mental health crisis
response teams.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Northville Township Police 135,359 Stevens
and Human Services Mental Health Services Department, Northville, MI to
Administration. expand mobile crisis response
and related services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And NYC Health + Hospitals/ Jacobi, 845,026 Ocasio-Cortez
and Human Services Mental Health Services Bronx, NY for the Stand Up to
Administration. Violence program to provide
youth mental health and
substance use treatment
services, and other support
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Ohio Fire and Emergency Services 200,000 Joyce (OH)
and Human Services Mental Health Services Foundation, Worthington, OH for
Administration. a mental health training program.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Oklahoma Children's Hospital, 2,115,000 Cole
and Human Services Mental Health Services Oklahoma City, OK for a
Administration. behavioral health program,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Operation New Hope, Jacksonville, 100,000 Lawson (FL)
and Human Services Mental Health Services FL for mental health services
Administration. and trainings.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Orange County Asian and Pacific 805,000 Lowenthal
and Human Services Mental Health Services Islander Community Alliance,
Administration. Inc., Garden Grove, CA for
mental health and supportive
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Overdose Lifeline, Inc., 87,000 Carson
and Human Services Mental Health Services Indianapolis, IN for Camp
Administration. Mariposa-Aaron's Place Youth
Prevention Program to provide
behavioral health and related
services to youth.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Partnership to End Addiction, New 293,000 Maloney,
and Human Services Mental Health Services York, NY for telehealth and Carolyn B.
Administration. mobile behavioral health
services, outreach, and
awareness activities.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Philadelphia Mural Arts 500,000 Boyle,
and Human Services Mental Health Services Advocates, Philadelphia, PA for Brendan F.
Administration. behavioral health and other
support services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Pinebrook Family Answers, 197,477 Wild
and Human Services Mental Health Services Allentown, PA for suicide
Administration. prevention and mental health
services, including training,
technology, and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Polk County, FL for behavioral 1,000,000 Soto
and Human Services Mental Health Services health and mobile crisis
Administration. services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Primo Center for Women and 800,000 Davis, Danny
and Human Services Mental Health Services Children, Chicago, IL for trauma- K.
Administration. informed behavioral health and
other supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Public Defender Association, 1,500,000 Smith (WA)
and Human Services Mental Health Services Seattle, WA for behavioral
Administration. health and wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And RefugeeOne, Chicago, IL for 546,859 Schakowsky
and Human Services Mental Health Services mental health and recovery
Administration. support services for refugee
communities, including training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Reimagining Justice Inc., 1,000,000 Pascrell
and Human Services Mental Health Services Paterson, NJ for mental health
Administration. and wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And San Francisco General Hospital 1,000,000 Pelosi
and Human Services Mental Health Services Foundation, San Francisco, CA
Administration. for behavioral health programs
and services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And San Gabriel Valley Council of 1,500,000 Chu
and Human Services Mental Health Services Governments, Alhambra, CA for
Administration. mental health crisis response
services and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Santa Cruz County Office of 1,000,000 Panetta
and Human Services Mental Health Services Education, Santa Cruz, CA for
Administration. behavioral health services and
treatment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Sheppard Pratt Health System, 1,500,000 Brown (MD)
and Human Services Mental Health Services Inc., Baltimore, MD for mental
Administration. health services and treatment,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Sheppard Pratt Health System, 1,000,000 Raskin
and Human Services Mental Health Services Inc., Baltimore, MD for the Zero
Administration. Suicide Initiative to provide
mental health services and
treatment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Sheppard Pratt Health System, 1,000,000 Trone
and Human Services Mental Health Services Inc., Hagerstown, MD to expand
Administration. mental health services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Stanislaus County Behavioral 711,690 Harder (CA)
and Human Services Mental Health Services Health and Recovery Services,
Administration. Modesto, CA to expand mobile
behavioral health crisis
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Temple University--Of The 750,000 Evans
and Human Services Mental Health Services Commonwealth System of Higher
Administration. Education, Philadelphia, PA for
mental and behavioral health
services to communities in
crisis, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Texas A&M Engineering Extension 500,000 Nehls
and Human Services Mental Health Services Service, College Station, TX for
Administration. a mental health program for
first responders.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Texas State University, San 1,000,000 Doggett
and Human Services Mental Health Services Marcos, TX for mental health
Administration. training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And The Beebe Medical Foundation, 381,406 Blunt
and Human Services Mental Health Services Lewes, DE for a community harm Rochester
Administration. reduction program to provide
mental health and substance use
disorder services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And The Center for Great 500,000 Watson
and Human Services Mental Health Services Expectations, Somerset, NJ for Coleman
Administration. mental health services and
treatment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And The Centre for Women, Inc., 1,205,394 Castor (FL)
and Human Services Mental Health Services Tampa, FL for mental health and
Administration. related services, including
minor facility repairs and
improvements.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And The Institute for Family Health 411,381 Maloney,
and Human Services Mental Health Services at 17th Street, New York, NY for Carolyn B.
Administration. substance use disorder services
and treatment, including a
mobile harm reduction unit.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And The Marion and Aaron Gural JCC, 300,000 Rice (NY)
and Human Services Mental Health Services Cedarhurst, NY for the Resilient
Administration. Impactful Sustaining Empowerment
Project to provide mental health
and supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And The Nemours Foundation, 1,500,000 Blunt
and Human Services Mental Health Services Jacksonville, FL for pediatric Rochester
Administration. mental health therapists,
trainings, and other support
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And The Welcome Project PA, Hatboro, 226,500 Dean
and Human Services Mental Health Services PA for mental health services,
Administration. case management, training, and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Turning Point Behavioral Health 650,000 Schakowsky
and Human Services Mental Health Services Care Center, Skokie, IL for the
Administration. Living Room program to provide
behavioral health crisis and
supportive services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And UCAN, Chicago, IL for behavioral 95,000 Newman
and Human Services Mental Health Services health and supportive services
Administration. for youth, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And United Way of Greater LaPorte 100,000 Mrvan
and Human Services Mental Health Services County, Michigan City, IN for
Administration. mental health and substance use
disorder services, including
community outreach and education.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And United Way of Will County, 883,395 Foster
and Human Services Mental Health Services Joliet, IL for the Resilient
Administration. Youth program to provide
behavioral health services,
including training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And University of California, Davis, 1,509,543 Matsui
and Human Services Mental Health Services Sacramento, CA for behavioral
Administration. health services and treatment,
including technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And University of North Carolina 230,000 Adams
and Human Services Mental Health Services System, Chapel Hill, NC for
Administration. mental health training and
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Unlawful Narcotics 1,400,000 Rogers (KY)
and Human Services Mental Health Services Investigations, Treatment, and
Administration. Education, Inc., London, KY for
a substance use prevention,
treatment, and recovery program,
including the purchase of
equipment and housing
assistance, and education
programming.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And UTOPIA Washington, Kent, WA for 500,000 Smith (WA)
and Human Services Mental Health Services mental health and substance use
Administration. disorder services, including
training and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Valley Health System, Winchester, 500,000 Wexton
and Human Services Mental Health Services VA for behavioral health
Administration. training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Variety Boys and Girls Club of 502,250 Ocasio-Cortez
and Human Services Mental Health Services Queens, Inc., Astoria, NY for
Administration. mental health and supportive
services, including outreach.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Washington State University, 500,000 Rodgers (WA)
and Human Services Mental Health Services Spokane, WA for a mental and
Administration. behavioral health services
program for rural and
underserved communities,
including student stipends.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Wendt Center for Loss and 94,444 Norton
and Human Services Mental Health Services Healing, Washington, DC for
Administration. behavioral health crisis
response services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Western Michigan University, 1,820,000 Upton
and Human Services Mental Health Services Kalamazoo, MI for a mental and
Administration. behavioral health initiative,
including teacher and student
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Wyandotte County Public Health 750,000 Davids (KS)
and Human Services Mental Health Services Department, Kansas City, KS for
Administration. mental and behavioral health
services, including wraparound
services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And YMCA of Honolulu, HI for the 270,000 Case
and Human Services Mental Health Services Youth Wellness Program for
Administration. Mental Health to provide mental
health services, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Youth Shelter Program of 1,600,000 Bowman
and Human Services Mental Health Services Westchester, Mount Vernon, NY
Administration. for the YouthHEAL Integrated
Network project to provide
behavioral health services,
including equipment and training.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And Youth Visionaries Youth 733,533 Aguilar
and Human Services Mental Health Services Leadership Academy, San
Administration. Bernardino, CA for the
Empowering Youth Resilience and
Promoting Social Emotional
Healing project to provide
mental health and other
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Health Substance Use And YWCA Pierce County, Tacoma, WA 151,000 Kilmer
and Human Services Mental Health Services for behavioral health and
Administration. supportive services, including
training.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Abyssinian Development 1,000,000 Espaillat
Secondary Education. Corporation, New York, NY for
SEL programming and professional
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Admiral Peary Area Vocational 1,005,000 Thompson (PA)
Secondary Education. Technical School, Ebensburg, PA
for an instructional program,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Adrienne Arsht Center Trust, 500,000 Wilson (FL)
Secondary Education. Miami, FL for arts education
through theater production and
performance.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and American Association of 491,000 Frankel, Lois
Secondary Education. Caregiving Youth, Boca Raton, FL
for supportive services for
caregiving youth.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and An Achievable Dream, Newport 1,594,355 Scott (VA)
Secondary Education. News, VA for student enrichment
and academic support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Anaheim Union High School 2,000,000 Correa
Secondary Education. District, Anaheim, CA for a
theater and performing arts
program, including equipment and
technology installation.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Austin Independent School 2,015,750 Doggett
Secondary Education. District, Austin, TX for outdoor
learning experiences, including
equipment and furniture for
outdoor classrooms and exhibits.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Baldwin Union Free School 3,000,000 Rice (NY)
Secondary Education. District, Baldwin, NY for SEL
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Beasley-Brown Community 2,280,000 Cuellar
Secondary Education. Development Corporation, San
Antonio, TX for community-based
learning centers.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Best Buddies International, 100,000 Hoyer
Secondary Education. Baltimore, MD for school-based
programs that promote inclusion.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Best Buddies International, 100,000 Sarbanes
Secondary Education. Baltimore, MD for school-based
programs that promote inclusion.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Best Buddies International, 100,000 Jackson Lee
Secondary Education. Houston, TX for inclusion
support for students with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Big Brothers Big Sisters Lone 250,000 Nehls
Secondary Education. Star, Irving, TX for a youth
mentoring program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Big Brothers Big Sisters of 1,000,000 Watson
Secondary Education. Essex, Hudson & Union Counties, Coleman
Newark, NJ for mentoring and
student support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Big Sister Association of Greater 250,000 Pressley
Secondary Education. Boston, MA for student mentoring
and enrichment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Big Thought, Dallas, TX for out- 1,000,000 Allred
Secondary Education. of-school learning, digital
credentialing, and learning
systems.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Birch Family Services, New York, 201,096 Ocasio-Cortez
Secondary Education. NY for communication systems for
nonverbal children and families.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Black Hawk College, Kewanee, IL 1,000,000 Bustos
Secondary Education. for a manufacturing training
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Black Spectrum Theatre Co., 1,275,750 Meeks
Secondary Education. Jamaica, NY for an African
American history program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys & Girls Club of Monmouth 500,000 Pallone
Secondary Education. County, Asbury Park, NJ for
trauma-informed interventions to
address adverse childhood
experiences.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys & Girls Clubs of Southern 750,000 Horsford
Secondary Education. Nevada, Las Vegas, NV for STEM
and SEL programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys & Girls Clubs of the Los 1,000,000 Lieu
Secondary Education. Angeles Harbor, San Pedro, CA
for developing a digital program
for student support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys and Girls Club of Metro 400,861 Bourdeaux
Secondary Education. Atlanta, Chamblee, GA for
academic enrichment and tutoring.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys and Girls Club of Metro 549,374 Perlmutter
Secondary Education. Denver, CO for afterschool and
summer programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys and Girls Club of Metro 1,212,062 Crow
Secondary Education. Denver, CO for afterschool
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys and Girls Club of Pharr, TX 1,753,812 Gonzalez,
Secondary Education. for equipment and supplies for Vicente
youth development services.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Boys and Girls Clubs of Benton 1,500,000 Upton
Secondary Education. Harbor, Benton Harbor, MI for
educational, mentoring, and
tutoring program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Breakthrough of Greater 500,000 Evans
Secondary Education. Philadelphia, PA for a teaching
fellows program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Bridgewater State University, 1,358,000 Keating
Secondary Education. Bridgewater, MA for an aviation
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Bristol Community College, Fall 1,000,000 Keating
Secondary Education. River, MA for workforce
education access and credit
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Brooklyn Bridge Park Conservancy, 1,025,000 Velazquez
Secondary Education. Brooklyn, NY for academic
enrichment programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Broward County Public Schools, 525,000 Wasserman
Secondary Education. Fort Lauderdale, FL for visual Schultz
arts and computer science
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Cambodia Town, Long Beach, CA for 56,950 Lowenthal
Secondary Education. language access programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Cameron Community Ministries, 200,000 Morelle
Secondary Education. Rochester, NY for afterschool
and summer enrichment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Cape Cod Community College, 1,000,000 Keating
Secondary Education. Barnstable, MA for a dental
hygiene program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Capitol Hill Arts Workshop, 250,000 Norton
Secondary Education. Washington, DC for youth
engagement through arts
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Career Technical Education 200,000 Huffman
Secondary Education. Foundation Sonoma County, Santa
Rosa, CA for whole-school
transformation efforts.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Catholic Big Brothers and Big 500,000 Schiff
Secondary Education. Sisters of Los Angeles, CA for a
postsecondary student support
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Centro Cultural Aztlan, San 95,000 Castro (TX)
Secondary Education. Antonio, TX for arts education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Chapman University, Orange, CA 2,200,000 Correa
Secondary Education. for computational clusters, lab
infrastructure, and
postsecondary research
activities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Chicago Public Schools, Chicago, 500,000 Newman
Secondary Education. IL for arts education, including
equipment and supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Chicago Public Schools, Chicago, 500,000 Quigley
Secondary Education. IL for arts education, including
equipment and supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Chicago Public Schools, Chicago, 500,000 Rush
Secondary Education. IL for arts education, including
equipment and supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Chinese American Social Services 105,000 Nadler
Secondary Education. Center, Brooklyn, NY for
academic and arts programs,
including support for English
learners.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and City of Greenacres, FL for youth 1,000,000 Frankel, Lois
Secondary Education. programs, services, and
curricula, including technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and City of Indianapolis Department 1,000,000 Carson
Secondary Education. of Parks and Recreation,
Indianapolis, IN for an
afterschool physical education
enrichment program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and City of Indianapolis Department 1,000,000 Carson
Secondary Education. of Parks and Recreation,
Indianapolis, IN for arts and
environmental education access
in afterschool and summer
learning settings.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and City School District of New 2,000,000 Bowman
Secondary Education. Rochelle, NY for afterschool
programs and summer learning.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Clayton State University, Morrow, 750,000 Scott, David
Secondary Education. GA for environmental studies
research, including equipment
and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Clearwater Marine Aquarium, 976,000 Crist
Secondary Education. Clearwater, FL for science
education and a mobile
classroom, including a vehicle.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Commonwealth of the Northern 311,939 Sablan
Secondary Education. Mariana Islands Public School
System, Saipan, MP for language
immersion curriculum and
programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Connecticut Historical Society 1,000,000 Larson (CT)
Secondary Education. Museum and Library, Hartford, CT
for civics education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and CUNY Dominican Studies Institute, 809,092 Espaillat
Secondary Education. New York, NY for historical
curricula and enrichment
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Dance Institute of Washington, DC 1,000,000 Norton
Secondary Education. for arts education and dance
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Dearborn Heights Libraries, 206,000 Tlaib
Secondary Education. Dearborn Heights, MI for student
mobile library services,
including a vehicle.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Dr. Carter G. Woodson African 3,000,000 Crist
Secondary Education. American History Museum, St.
Petersburg, FL for an African
American history program,
including technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Drew Child Development 143,000 Barragan
Secondary Education. Corporation, Lynwood, CA for an
early childhood education
program, including installation
of an outdoor science lab and
learning space.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and El Paso Independent School 2,000,000 Escobar
Secondary Education. District, El Paso, TX for
afterschool enrichment and STEAM
education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Empowering Success Now, Fontana, 532,500 Torres (CA)
Secondary Education. CA for afterschool and tutoring
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Encompass: Resources for 700,000 Morelle
Secondary Education. Learning, Rochester, NY for
student academic and wraparound
services, including
transportation.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and End Hunger Calvert County, 300,000 Hoyer
Secondary Education. Huntingtown, MD for a pre-
apprentice skills program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Fairfax County, VA for early 1,500,000 Connolly,
Secondary Education. childhood development and Wexton
learning.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Fine Arts Work Center in 400,000 Keating
Secondary Education. Provincetown, MA for arts
education and cultural
programming for community
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Flint Institute of Science and 1,905,421 Kildee
Secondary Education. History, Flint, MI for
afterschool programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Food Literacy Center, Sacramento, 1,050,000 Matsui
Secondary Education. CA for science and nutrition
education, including the
development of a student garden.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Foundation Communities, Austin, 1,107,925 Doggett
Secondary Education. TX for learning center programs,
including enrichment and
literacy support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Foundation for the Advancement of 750,000 Brown (MD)
Secondary Education. Music & Education, Bowie, MD for
music education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Freeport Union Free School 173,923 Rice (NY)
Secondary Education. District, Freeport, NY for a
college and career center,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Friendship Foundation, Redondo 1,000,000 Lieu
Secondary Education. Beach, CA for inclusive programs
for students with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Georgia Institute of Technology, 215,000 Carter (GA)
Secondary Education. Atlanta, GA for educational
services for children of
military families, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Girl Scouts of Eastern Missouri, 70,000 Bush
Secondary Education. St. Louis, MO for student mental
health and anti-violence
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Girl Scouts of Northeast Texas, 920,000 Johnson (TX)
Secondary Education. Dallas, TX for programming to
develop skills and competencies
in STEM, leadership development,
and financial empowerment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Glen Ellyn School District 41, 250,000 Casten
Secondary Education. Glen Ellyn, IL for school-based
mental health services for
students and families.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Grand Valley State University, 1,000,000 Meijer
Secondary Education. Allendale, MI for a student
development program, including
the purchase of supplies and
student stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Greater New York Councils, Boy 50,000 Malliotakis
Secondary Education. Scouts of America, New York, NY
for a youth scouting program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Guadalupe Cultural Arts Center, 102,250 Castro (TX)
Secondary Education. San Antonio, TX for student
literacy programs and access to
culturally relevant texts.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Guilford County Schools, 2,200,000 Manning
Secondary Education. Greensboro, NC for wraparound
services, academic supports, and
learning hubs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Haitian Americans United for 364,558 Meeks
Secondary Education. Progress, Hollis, NY for youth
leadership and youth workforce
programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Harris County Public Library, 139,212 Fletcher
Secondary Education. Houston, TX for student access
to texts, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Hawaii Agriculture Foundation, 372,000 Kahele
Secondary Education. Honolulu, HI for STEM programs
that incorporate innovative
agriculture technologies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Henry County Board of Education, 40,000 Scott, David
Secondary Education. McDonough, GA for afterschool
enrichment and STEM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Hillsborough County Public 1,986,353 Castor (FL)
Secondary Education. Schools, Tampa, FL for arts
education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Hillsborough County Public 1,000,000 Castor (FL)
Secondary Education. Schools, Tampa, FL for career
and technical education in
construction and medical
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Hispanic Counseling Center, 128,468 Rice (NY)
Secondary Education. Hempstead, NY for afterschool
programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Holocaust Memorial Center, 605,000 Levin (MI)
Secondary Education. Farmington Hills, MI for a
Holocaust education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Holocaust Memorial Center, 550,000 Stevens
Secondary Education. Farmington Hills, MI for a
Holocaust education program,
including support for English
learners and students with
disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Houston Independent School 1,975,000 Green (TX)
Secondary Education. District, Houston, TX for family
and community engagement
programs for students.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Houston Public Library, Houston, 2,000,347 Fletcher
Secondary Education. TX for digital literacy
resources.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Iowa Jobs for America's 250,000 Krishnamoorth
Secondary Education. Graduates, Des Moines, IA for i
career pathways and counseling
supports.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Ivy Tech Community College, 500,000 Carson
Secondary Education. Indianapolis, IN for early
childhood education programs,
including furniture, minor
repairs, and classroom upgrades.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Jobs for Arizona's Graduates, 167,700 Grijalva
Secondary Education. Phoenix, AZ for targeted student
support programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Kennedy King Memorial Initiative, 100,000 Carson
Secondary Education. Indianapolis, IN for human
rights education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Kennedy Krieger Institute, 2,000,000 Hoyer
Secondary Education. Baltimore, MD for services to
students with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Kula No Na Poe Hawaii, Honolulu, 1,800,000 Case
Secondary Education. HI for academic supports and
wraparound services.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Lenape Regional High School 593,663 Kim (NJ)
Secondary Education. District, Shamong, NJ for post-
graduation student success
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Leo High School, Chicago, IL for 250,000 Rush
Secondary Education. a parent engagement center,
including equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and LGBT Center of Greater Reading, 113,520 Houlahan
Secondary Education. PA for wraparound services and
support for at-risk youth.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and LIFT, Detroit, MI for a 1,250,000 Lawrence
Secondary Education. manufacturing technician
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Long Beach Day Nursery, Long 250,000 Lowenthal
Secondary Education. Beach, CA for early childhood
learning.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Long Beach Latino Civic 50,000 Rice (NY)
Secondary Education. Association, Long Beach, NY for
student support, mentoring, and
enrichment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Massachusetts Women of Color 416,275 McGovern
Secondary Education. Coalition, Worcester, MA for a
summer learning program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Michigan's Own, Inc. dba-- 215,000 Moolenaar
Secondary Education. Michigan Heroes Museum,
Frankenmuth, MI for curriculum,
exhibit, website development,
and educational programming,
including information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Milwaukee Public Library, 241,250 Moore (WI)
Secondary Education. Milwaukee, WI for child literacy
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Monmouth College, Monmouth, IL 750,000 Bustos
Secondary Education. for rural teacher preparation
and development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Museum of Science and Industry, 1,022,000 Quigley
Secondary Education. Chicago, IL for STEM education,
including teacher stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Museums at Mitchel Doing Business 75,000 Rice (NY)
Secondary Education. As Cradle of Aviation Museum,
Garden City, NY for STEM
education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and NAACP--Hayward/South Alameda 285,000 Swalwell
Secondary Education. County, Hayward, CA for a parent
engagement and student success
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and National Aquarium, Baltimore, MD 401,615 Ruppersberger
Secondary Education. for STEM education and
professional development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and National Center for Families 500,000 Yarmuth
Secondary Education. Learning, Louisville, KY for a
family engagement and immersive
technology program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and National Children's Museum, 1,000,000 Norton
Secondary Education. Washington, DC for student
educational exhibits and
programming.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and National World War II Museum, New 2,000,000 Carter (LA)
Secondary Education. Orleans, LA, for a historical
education project, including
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and New York Hall of Science, Corona, 750,000 Ocasio-Cortez
Secondary Education. NY for science programming for
preschool students, including
exhibits.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and New York Sun Works, New York, NY 800,000 Torres (NY)
Secondary Education. for a hydroponic farm STEM
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and New York Sun Works, New York, NY 800,000 Clarke (NY)
Secondary Education. for hydroponic STEM classrooms,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and New York Sun Works, New York, NY 500,000 Jeffries
Secondary Education. for hydroponic STEM education,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and NH Jobs for America's Graduates, 300,000 Pappas
Secondary Education. Manchester, NH for programs to
develop student academic skills,
including supplies and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Norwalk La-Mirada Unified School 2,200,000 Sanchez
Secondary Education. District, Norwalk, CA for career
and technical education
pathways, dual enrollment
programs, and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Norwalk Public Schools, Norwalk, 1,323,660 Himes
Secondary Education. CT for marine science pathways.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Ontario-Montclair School 272,077 Torres (CA)
Secondary Education. District, Ontario, CA for STEAM
programs, including equipment
and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Open Door Preschools, Austin, TX 824,900 Doggett
Secondary Education. for preschool programs,
including outdoor learning
spaces, and wraparound supports
for at-risk families.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Optimist Boys' Home & Ranch, Inc. 270,000 Garcia (CA)
Secondary Education. dba Optimist Youth Homes &
Family Services, Los Angeles, CA
for a tutoring program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Oregon Institute of Technology, 700,000 Schrader
Secondary Education. Wilsonville, OR for a healthcare
career pathways program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Orlando Community & Youth Trust, 100,000 Demings
Secondary Education. Orlando, FL for student
enrichment through dragon
boating.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Pace Center for Girls, Inc., 500,000 Bilirakis
Secondary Education. Jacksonville, FL for an
educational services,
counseling, and training
program, including the purchase
of equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Pace Center for Girls, Inc., 500,000 Rutherford
Secondary Education. Jacksonville, FL for curriculum,
technology, and training
program, including the purchase
of information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Pace Center for Girls, 500,000 Crist
Secondary Education. Jacksonville, FL for curriculum
development and support services.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Pace Center for Girls, 500,000 Lawson (FL)
Secondary Education. Jacksonville, FL for student
support programs, including SEL
resources and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Pascua Yaqui Tribe, Tucson, AZ 862,813 Grijalva
Secondary Education. for academic programs,
curricula, and teacher
development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Penumbra Theatre, Saint Paul, MN 1,000,000 McCollum
Secondary Education. for the development, testing,
and implementation of curriculum.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Pima County School 252,000 Grijalva
Secondary Education. Superintendent's Office, Tucson,
AZ for curricula, resources, and
professional development.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Pinellas County Education 1,225,000 Bilirakis
Secondary Education. Foundation, Inc., Largo, FL for
an early learning initiative,
including teacher stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Providence After School Alliance, 350,000 Cicilline
Secondary Education. Providence, RI for a summer
learning STEAM program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Research Foundation of the City 191,160 Clarke (NY)
Secondary Education. University of New York,
Brooklyn, NY for a literacy
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Riverside County Office of 1,000,000 Ruiz
Secondary Education. Education, Riverside, CA for
early childhood education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Rock and Roll Hall of Fame and 1,000,000 Brown (OH)
Secondary Education. Museum, Cleveland, OH for arts
education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Roosevelt Union Free School 525,000 Rice (NY)
Secondary Education. District, Roosevelt, NY for
homework and tutoring support.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and San Diego State University, San 524,972 Jacobs (CA)
Secondary Education. Diego, CA for school-based
behavioral health training and
supports.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Santa Ana College, Santa Ana, CA 2,000,000 Correa
Secondary Education. for CTE pathways to certificate
and degree programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Santa Clara County Office of 1,000,000 Eshoo
Secondary Education. Education, San Jose, CA for
student broadband access,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and School District of Borough of 850,000 Fitzpatrick
Secondary Education. Morrisville, PA for a
curriculum, instruction, and
technology program, including
the purchase of information
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and School District of Osceola 953,000 Soto
Secondary Education. County, FL for a youth
entrepreneurship program,
including support for student
internships, a vehicle, and
capital for student businesses.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Seed St. Louis, MO for STEM 380,000 Bush
Secondary Education. education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Seminole County Public Schools, 526,692 Murphy (FL)
Secondary Education. Sanford, FL for high school
health careers programs,
including medical equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Shedd Aquarium, Chicago, IL for 595,025 Quigley
Secondary Education. STEAM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Soulsville Foundation, Memphis, 1,150,000 Cohen
Secondary Education. TN for an afterschool music
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Soundscapes, Newport News, VA for 677,000 Scott (VA)
Secondary Education. expanding access to arts
education, including a
feasibility study for growth.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and South City Foundation, 2,000,000 Lawson (FL)
Secondary Education. Tallahassee, FL for an early
childhood education program,
including technology upgrades.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Southland Career and Technical 1,740,000 Kelly (IL)
Secondary Education. Education Center, Matteson, IL
for classroom design and
curricula for career and
technical education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Springfield Public Schools, 385,000 DeFazio
Secondary Education. Springfield, OR for a career and
technical cosmetology program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and St. Louis Public Schools, St. 252,713 Bush
Secondary Education. Louis, MO for CTE programs in
construction trades, including
scholarships for technical
college programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Stars of New York Dance, 500,000 Jeffries
Secondary Education. Brooklyn, NY for arts education
enrichment programs, including
student scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Start Lighthouse, New York, NY 205,500 Ocasio-Cortez
Secondary Education. for literacy and learning spaces
in schools.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Strategic Human Services, 832,140 Davis, Danny
Secondary Education. Chicago, IL for communication K.
and journalism education,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Tacoma Public School District, 555,000 Strickland
Secondary Education. Tacoma, WA for career
preparation and internship
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and TECH CORPS, Columbus, OH for 300,000 Ryan
Secondary Education. computer science education,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Tennessee Technological 400,000 Rose
Secondary Education. University, Cookeville, TN for
lending library programs,
including purchase of supplies,
information technology, and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Texas A&M University San Antonio, 300,000 Castro (TX)
Secondary Education. TX for a mobile unit offering
school-based autism services and
educational supports.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Texas State University -- Round 1,000,000 Carter (TX)
Secondary Education. Rock, Round Rock, TX for a STEM
educational and professional
development program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and The Bridge Teen Center, Orland 500,000 Newman
Secondary Education. Park, IL for afterschool
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and The Brotherhood Sister Sol, New 1,000,000 Espaillat
Secondary Education. York, NY for afterschool
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and The Center for the Innovative 2,000,000 Carter (LA)
Secondary Education. Training of Youth STEM NOLA, New
Orleans, LA for STEM learning
and career readiness programs,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and The Garage Community and Youth 100,000 Houlahan
Secondary Education. Center, Avondale, PA for
afterschool youth development
programs, including a vehicle.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and The Noel Pointer Foundation, 414,500 Jeffries
Secondary Education. Brooklyn, NY for music
instruction programs, including
student scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and The Regents of the University of 1,125,360 Vargas
Secondary Education. California; University of
California San Diego, La Jolla,
CA for summer math academies.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and The West Virginia Chamber 200,000 Miller (WV)
Secondary Education. Foundation Corporation,
Charleston, WV for a drop-out
prevention and school-to-work
transition program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Toledo Tomorrow, Toledo, OH for 1,050,000 Kaptur
Secondary Education. an early childhood reading
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Town of Randolph, MA for mobile 524,000 Pressley
Secondary Education. library and STEM programming,
including vehicle and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Trumbull County Educational 650,000 Ryan
Secondary Education. Service Center, Niles, OH for
STEM education, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and United Way of Wyoming Valley, 2,200,000 Cartwright
Secondary Education. Wilkes-Barre, PA for wraparound
services and academic supports,
including pre-K tuition stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and University of California 1,000,000 Lee (CA)
Secondary Education. Berkeley, CA for a social
science research and
postdoctoral pipeline program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and University of Connecticut Health 1,000,000 Hayes
Secondary Education. Center, Farmington, CT for K-12
STEM education programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and University of Mississippi, 1,000,000 Kelly (MS)
Secondary Education. University, MS for a
professional development program
and writing initiative.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and University of Nebraska System, 2,000,000 Bacon
Secondary Education. Lincoln, NE for a science,
technology, engineering, and
mathematics program.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and University of Washington Bothell, 811,061 DelBene
Secondary Education. WA for pathways toward
environment and sustainability
degree programs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Upper Darby Arts & Education 115,000 Scanlon
Secondary Education. Foundation, Drexel Hill, PA for
creative arts programs for
students with disabilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Virgin Islands Department of 2,200,000 Plaskett
Secondary Education. Education, St. Thomas, VI for
electric vehicle classes, career
and technical college programs,
and STEM education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Washtenaw Community College, Ann 1,000,000 Dingell
Secondary Education. Arbor, MI for an electric
battery and charging station
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Waterbury Public Schools, 2,265,000 Hayes
Secondary Education. Waterbury, CT for education
technology equipment, including
computers.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Watts Labor Community Action 922,000 Barragan
Secondary Education. Committee, Los Angeles, CA for
afterschool programming and arts
education.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Waukegan to College, Waukegan, IL 315,000 Schneider
Secondary Education. for mentoring, tutoring, and
academic advising programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and West Chester University, West 715,770 Houlahan
Secondary Education. Chester, PA for STEM education
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and Winston-Salem/Forsyth County 301,548 Manning
Secondary Education. Schools, Winston-Salem, NC for
teacher academy programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and YMCA of Greater New York, NY for 1,000,000 Meeks
Secondary Education. youth support and enrichment
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and YMCA of Memphis and the Mid- 1,000,000 Cohen
Secondary Education. South, Cordova, TN for
educational programs before and
after school.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and YMCA of Metropolitan Chicago, IL 666,366 Underwood
Secondary Education. for afterschool programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and YMCA of Metropolitan Los Angeles, 1,500,000 Gomez
Secondary Education. CA for empowerment learning pods.
----------------------------------------------------------------------------------------------------------------
Department of Education Elementary and YMCA of Metropolitan Los Angeles, 2,000,000 Cardenas
Secondary Education. Van Nuys, CA for STEAM and
civics education.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Adoption Rhode Island, 201,639 Langevin
Providence, RI for an adoption
and foster care certificate
program, including scholarships
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Agnes Scott College, Decatur, GA 1,024,940 Williams (GA)
for digital skill building
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Albany Technical College, Albany, 1,000,000 Bishop (GA)
GA for allied health programs,
including equipment, a vehicle,
and scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Aliento Education Fund, Phoenix, 300,000 Kirkpatrick
AZ for first-generation college
student access and success
programs, including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... AltaSea at the Port of Los 1,000,000 Barragan
Angeles, San Pedro, CA for
postsecondary ocean-based
research, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Alvernia University Reading 2,000,000 Houlahan
Collegetowne, Reading, PA for a
health science program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Alvernia University, Reading, PA 1,000,000 Meuser
for the purchase of information
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Angelo State University, San 2,000,000 Pfluger
Angelo, TX for equipment,
scholarships, and stipends for
an aviation degree program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Aquinas College, Grand Rapids, MI 185,000 Meijer
for a professional development
and curriculum development for a
teaching center.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Arkansas Tech University, 730,000 Womack
Russellville, AR for purchase of
lab equipment and technology for
agricultural education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... AUC Consortium, Atlanta, GA for 2,000,000 Williams (GA)
programs promoting career
pathways into government
service, including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Augusta University, Augusta, GA 1,000,000 Carter (GA)
for a telemedicine education
initiative, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Aurora University, Aurora, IL for 955,000 Foster
an emerging technologies
learning lab, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Austin Community College 2,830,000 McCaul
District, Austin, TX for the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Austin Community College, Austin, 1,467,542 Doggett
TX for cybersecurity training,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Austin Independent School 1,862,600 Doggett
District for college and career
preparation, including
transportation.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Bay Path University, Longmeadow, 1,000,000 Neal
MA for wraparound academic and
student support services.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Baylor University, Waco, TX for a 1,500,000 Sessions
cybersecurity program, including
the purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Birmingham-Southern College, 500,000 Sewell
Birmingham, AL for experimental
learning and civic engagement.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Bluegrass Community and Technical 1,570,000 Barr
College, Lexington, KY for a
health professions program,
including the purchase of
equipment and supplies.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Boys & Girls Club of the West 450,000 Sherman
Valley, Canoga Park, CA for
afterschool programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Cabrillo College, Aptos, CA for 163,539 Panetta
science learning, including
learning lab furniture and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... California State University-- 1,681,720 Harder (CA)
Stanislaus, Turlock, CA for a
mental health workforce program,
including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... California State University 550,800 Brownley
Channel Islands, Camarillo, CA
for a cybersecurity degree
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... California State University, 1,000,000 Sherman
Northridge, CA for arts, media,
and communications programs,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Campbellsville University, 950,000 Comer
Campbellsville, KY for
information technology and
equipment upgrades.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Chabot--Las Positas Community 1,000,000 Swalwell
College District, Dublin, CA for
student support programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Chicago State University, 1,600,000 Rush
Chicago, IL for communication
and media career development
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... City College of New York, NY for 2,200,000 Espaillat
an infrastructure workforce
training program and center.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... City Colleges of Chicago Malcom X 1,000,000 Davis, Danny
College, Chicago, IL for an K.
emergency medical technician
student success program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Coahoma Community College, 1,664,100 Thompson (MS)
Clarksdale, MS for campus
safety, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Collaborative for Higher 2,000,000 Leger
Education Shared Services, Santa Fernandez
Fe, NM for a cybersecurity
shared services program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Connecticut Historical Society 1,000,000 Larson (CT)
Museum and Library, Hartford, CT
for the use of community history
in postsecondary education,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Contra Costa Community College 1,000,000 DeSaulnier
District, Martinez, CA for an
open educational resources
project.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... CUNY Mexican Studies Institute, 1,246,080 Espaillat
Bronx, NY for a literacy and
language skills program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... CUNY York College, Queens, NY for 1,267,500 Meeks
geology and environmental
science programs, including
student stipends and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... CUNY York College, Queens, NY for 850,000 Meeks
pharmaceutical science workforce
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Cyber Security Range at Union 3,000,000 Neal
Station, Springfield, MA for a
cybersecurity program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Cypress College, Cypress, CA for 500,000 Lowenthal
veteran and military-connected
student pathways, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Dallas College, Dallas, TX for a 500,000 Allred,
teaching residency Johnson (TX)
apprenticeship program,
including stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Davenport University, Grand 1,325,000 Meijer
Rapids, MI for a dual language
education program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Davenport University, Grand 760,000 Meijer
Rapids, MI for a teacher
training program, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Desert Research Institute, Las 1,000,000 Lee (NV)
Vegas, NV for partnerships
between STEM and education
majors, including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Dominican Women's Development 1,000,000 Espaillat
Center, New York, NY for
afterschool, STEM education, and
postsecondary access programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... East Central College, Union, MO 1,000,000 Luetkemeyer
for the purchase of distance
learning equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Eastern Gateway Community 914,000 Ryan
College, Steubenville, OH for
electric vehicle technology
training, including installation
of equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Eckerd College, St. Petersburg, 1,000,000 Crist
FL for a marine science
laboratory space, including the
installation of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Edmonds College, Lynnwood, WA for 1,300,000 Larsen (WA)
marine and AI robotics pathways
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Elgin Community College, Elgin, 936,000 Krishnamoorth
IL for a mechatronics i
certificate program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Elms College, Chicopee, MA for 1,000,000 Neal
social sciences and education
curriculum and programming,
including scholarships and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Emory University, Atlanta, GA for 500,000 McBath
a nursing apprenticeship
program, including stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Folsom Lake College, Folsom, CA 950,000 Bera
for a prison and reentry program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... FoodTEC, Newburgh, NY for a 1,125,000 Maloney, Sean
workforce development program, Patrick
including scholarships for
daycare facilities.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Franklin Pierce University, 825,000 Kuster
Rindge, NH for rural health care
education and training,
including technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... George Mason University, Fairfax, 1,000,000 Connolly
VA for a cybersecurity and IT
modernization program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Georgia State University, 400,000 Johnson (GA)
Atlanta, GA for programs to
expand access to postsecondary
education, including English
language proficiency support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Glendale College Foundation, 1,250,000 Schiff
Glendale, CA for student basic
needs support, including rental
assistance.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Goodwin University, East 2,200,000 Larson (CT)
Hartford, CT for a mobile
manufacturing and nursing
program, including equipment and
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Goucher College, Towson, MD for 1,255,800 Ruppersberger
life and health sciences
teaching labs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Grambling State University, 2,500,000 Letlow
Grambling, LA for a
cybersecurity initiative,
including scholarships, stipends
and purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Hamline University, Saint Paul, 1,000,000 McCollum
MN for academic internship
programs, including student
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Hampton University, Hampton, VA 2,200,000 Scott (VA)
for an allied health services
and workforce development
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Harper College Aviation 500,000 Krishnamoorth
Maintenance Program, Palatine, i
IL for an aviation technical
training program, including
scholarships and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Harris County Public Library, 578,000 Fletcher
Houston, TX for college and
career guidance programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Hispanic Federation, Orlando, FL 200,000 Demings
for college preparatory support
for middle and high school
students, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Hostos Community College of the 1,000,000 Torres (NY)
City University of New York, The
Bronx, NY, for community college
articulation agreement support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Hudson County Community College, 2,200,000 Sires
Jersey City, NJ for
technological enhancements to
student learning, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Hudson Valley Community College, 2,065,000 Tonko
Troy, NY for STEM and healthcare
workforce development.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Husson University, Bangor, ME for 725,491 Golden
science laboratory programming,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Joan B Kroc School of Peace 580,000 Jacobs (CA)
Studies at the University of San
Diego, CA for a research lab
program to combat violence,
including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Johnson & Wales University, 1,012,000 Langevin
Providence, RI for cybersecurity
training for teachers, including
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Kirkwood Community College, Cedar 360,000 Hinson
Rapids, IA for the purchase of
aviation information technology
and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Lehman College of the City 500,000 Torres (NY)
University of New York, Bronx,
NY for a digital equity
initiative, including technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Local 212 MATC Believe in 250,000 Moore (WI)
Students FAST Fund, Milwaukee,
WI for financial assistance to
low-income students.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Loisaida, New York, NY for an 300,000 Velazquez
environmental and community
science program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Los Angeles Community College 1,000,000 Bass
District, Los Angeles, CA for
mobile work-based workforce
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Los Angeles Mission College, 2,000,000 Cardenas
Sylmar, CA for allied health
programs and STEM services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Louisiana Delta Community 1,555,000 Letlow
College, Monroe, LA for a health
science and education program,
including scholarships, purchase
of equipment, and support
services.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Louisiana State University of 990,000 Letlow
Alexandria, Alexandria, LA for a
teacher education program,
including scholarships and
tuition reimbursement.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Manor College, Jenkintown, PA for 1,275,667 Dean
wraparound services, advising,
and basic needs supports for at-
risk student populations,
including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Maria College, Albany, NY for 770,088 Tonko
nursing programs, including
technology and equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Marquette University, Milwaukee, 799,500 Moore (WI)
WI for college readiness and
STEM pipeline services.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Maryville College, Maryville, TN 645,000 Burchett
for a STEM project, including
scholarships, stipends, and
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Marywood University, Scranton, PA 2,607,464 Cartwright
for healthcare workforce
expansion programs, including
equipment and scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Mass. Bay Community College, 400,000 Clark (MA)
Wellesley, MA for a center for
health sciences, early
education, and human services,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Massachusetts College of Liberal 620,000 Neal
Arts, North Adams, MA for a
nursing program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... McLennan Community College, Waco, 1,100,000 Sessions
TX for the purchase of
information technology and
equipment for healthcare
training programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Mid-America Christian University, 555,000 Cole
Oklahoma City, OK for the
purchase of STEM lab equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Middlesex College, Edison, NJ for 1,000,000 Pallone
adult and justice-impacted
learner support, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Midlands Technical College, 1,000,000 Clyburn
Columbia, SC for a skilled
trades training program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... MiraCosta Community College 1,000,000 Levin (CA)
District, Oceanside, CA for
accelerated skills-based
training, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Modesto Junior College, Modesto, 2,000,000 Harder (CA)
CA for regional fire science
training programs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Montgomery County Community 100,000 Dean
College, Blue Bell, PA for early
college programs, including
equipment and tuition support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Moorpark College, Moorpark, CA 300,000 Brownley
for a work-based learning
cybersecurity program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Moraine Valley Community College, 500,000 Newman
Palos Hills, IL for non-
destructive testing training,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Nevada State College, Henderson, 1,624,294 Lee (NV)
NV for a career advancement and
training center, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Nevada State College, Henderson, 611,968 Lee (NV)
NV for a nursing program,
including equipment and
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... New Hampshire Technical 767,000 Kuster
Institute, Concord, NH for
dental training program
modernization, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Niagara University, NY for study 750,000 Higgins (NY)
and research in scientific
disciplines, including equipment
and materials.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Nichols College, Dudley, MA for 680,000 Neal
an intelligent business
automation program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Normandale Community College, 188,875 Phillips
Bloomington, MN for health
sciences education.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Northampton County Community 2,729,288 Wild
College, Bethlehem, PA for
healthcare and workforce
development programs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Northeastern University, Boston, 1,000,000 Pressley
MA for an associate's to
master's degree accelerator
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Northern Illinois University, 1,500,000 Underwood
DeKalb, IL for microchip
research and training, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Northern Virginia Community 685,000 Wexton
College, Annandale, VA for a
diesel technology certificate
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Northern Virginia Community 2,200,000 Connolly
College, Annandale, VA for a
nursing program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Nova Southeastern University, 2,000,000 Deutch
Fort Lauderdale, FL for a
spatial computing and robotics
program, including equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Nova Southeastern University, 2,500,000 Wasserman
Fort Lauderdale, FL for Schultz
cybersecurity research,
including equipment and
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Oklahoma State University-- 3,000,000 Bice (OK)
Oklahoma City, Oklahoma City, OK
for an education program,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Oxnard College, Oxnard, CA for 628,600 Brownley
faculty professional development.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Palm Beach State College, Lake 1,000,000 Frankel, Lois
Worth, FL for an artificial
intelligence workforce
development program, including
equipment and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Pasadena Community College 500,000 Chu
District, Pasadena, CA for a
family resource center,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Pierce College, Woodland Hills, 2,000,000 Sherman
CA for biotech baccalaureate
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Pima Community College District, 1,000,000 Kirkpatrick
Tucson, AZ for a building and
construction technology program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Pima County Community College 1,000,000 Grijalva
District, Tucson, AZ for a
building and construction
technology program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Prairie State College, Chicago 1,000,000 Kelly (IL)
Heights, IL for a dental hygiene
program, including enhancements
and the installation of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Prairie View A&M University, 2,400,000 McCaul
Prairie View, TX for the
purchase of science and
engineering lab equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Ready to Succeed, Santa Monica, 1,000,000 Lieu
CA for support for college-going
foster youth, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Research Foundation of the City 534,982 Clarke (NY)
University of New York,
Brooklyn, NY for a pre-law
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Research Foundation of the City 792,000 Espaillat
University of New York, NY for a
learning hub for the study of
history and culture, including
equipment and space furnishings.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Riverside Community College 3,000,000 Calvert
District, Riverside, CA for a
military articulation platform
expansion, including the
purchase of equipment and
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Riverside Community College 3,000,000 Takano
District, Riverside, CA for
career training programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Rust College, Holly Springs, MS 500,000 Kelly (MS)
for a leadership development
program, including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Rutgers University-Camden, NJ for 1,404,800 Norcross
community partnership centers.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Saint Augustine's University, 490,000 Ross
Raleigh, NC for public health
education, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Salt Lake Community College, Salt 390,000 Owens
Lake City, UT for an educational
program, including student
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... San Diego Community College 1,200,000 Jacobs (CA)
District, San Diego, CA for
centers to support LGBT students.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... San Diego Community College 1,200,000 Vargas
District, San Diego, CA for
student support services for
DACA recipients.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... San Joaquin Delta College, 3,800,000 Harder (CA),
Stockton, CA for nursing McNerney
programs, including equipment
and technology for simulation
labs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Santa Clarita Community College 1,000,000 Garcia (CA)
District -- College of the
Canyons, Santa Clarita, CA for
the purchase of robotics
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Seminole State College of 404,114 Murphy (FL)
Florida, Sanford, FL for a fire
science program, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Siena Heights University, Adrian, 1,000,000 Walberg
MI for student scholarships and
the purchase of lab equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Simmons College of Kentucky, 602,500 Yarmuth
Louisville, KY for academic
support programs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Snead State Community College, 1,000,000 Aderholt
Boaz, AL for the purchase of
information technology and
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Social Enterprise Center, 1,500,000 Stansbury
Albuquerque, NM for computing
infrastructure and workforce
development, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... St. Francis College, Brooklyn, NY 1,500,000 Velazquez
for nursing programs, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... St. Joseph's College New York, 754,000 Jeffries
Brooklyn, NY for a cybersecurity
lab program, including equipment
installation, furnishings, and
refurbishments.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Stevens Institute of Technology, 960,000 Sires
Hoboken, NJ for computer science
programs, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Sustainable Cities Institute, 1,156,695 DeFazio
Eugene, OR for a sustainability
and student support program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Tennessee Technological 3,000,000 Rose
University, Cookeville, TN for
the purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Texas A&M International 1,000,000 Cuellar
University, Laredo, TX for a
center to combat human
trafficking, including equipment
and technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Texas A&M Transportation 1,600,000 Sessions
Institute, Bryan, TX for an
electric vehicle program,
including the purchase of
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Texas A&M University, College 1,500,000 McCaul
Station, TX for a forensic
science education program,
including student support for
fellowships and internships and
the purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Texas A&M University-Commerce, 516,614 Allred
Dallas, TX for a teacher
certification program, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Texas Wesleyan University, Fort 1,439,695 Veasey
Worth, TX for STEM education
programs, including lab
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... The National Veteran Memorial and 204,800 Beatty
Museum Operating Corporation,
Columbus, OH for graduate-level
instruction to veterans,
including scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... The Ohio State University, 1,045,000 Carey
Columbus, OH for a quantum
network research program,
including the purchase of
equipment and information
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... The University of North Georgia, 399,952 Bourdeaux
Dahlonega, GA for a teacher
candidate residency program,
including equipment and stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... The University of Texas at 3,000,000 Allred
Dallas, Richardson, TX for
semiconductor workforce
development programs, including
equipment infrastructure and
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Towson University, Towson, MD for 950,000 Ruppersberger
a teacher workforce pipeline , Sarbanes
program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of California 1,000,000 Takano
Riverside, CA for agricultural
innovation programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of California, Davis, 1,205,967 Thompson (CA)
CA for wildfire smoke research,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of California-San 2,160,000 Peters
Diego, La Jolla, CA for
pipelines into STEM careers.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Central Florida, 500,000 Soto
Orlando, FL for academic
research on Puerto Rico.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Colorado Anschutz 783,580 Crow
Medical Center, Aurora, CO for a
rural public health certificate
program, including student
project support.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Colorado Anschutz 460,584 Crow
Medical Center, Aurora, CO for
an injury and violence
prevention center, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Georgia College of 1,000,000 Scott, David
Agricultural and Environmental
Sciences, Athens, GA for a
poultry science program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Hawaii--Office of 1,000,000 Case
Strategic Health Initiatives,
Honolulu, HI for an indigenous
data science hub.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of La Verne, CA for a 2,200,000 Napolitano
mental health practitioner
program, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Maryland Global 246,000 Hoyer
Campus, Adelphi, MD for a peer
tutoring program, including
technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Nevada Las Vegas, 3,000,000 Lee (NV)
NV for advanced sports research,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of New Hampshire, 1,000,000 Pappas
Durham, NH for child study and
development education.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of North Alabama, 500,000 Aderholt
Florence, AL for new program
development, including the
purchase of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of North Florida, 750,000 Rutherford
Jacksonville, FL for information
technology equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of North Florida, 375,000 Rutherford
Jacksonville, FL for the
purchase of information
technology and equipment,
including associated software.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of South Florida, 2,000,000 Steube
Sarasota, FL for a cybersecurity
program, including the purchase
of information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of the District of 1,000,000 Norton
Columbia, Washington, DC for a
math teacher training institute,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... University of Wisconsin -- 1,000,000 Pocan
Madison, WI for STEM education
programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Utah System of Higher Education, 1,250,000 Owens
Salt Lake City, UT for the
purchase of equipment and
supplies to expand healthcare
training programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Utah Tech University, St. George, 790,000 Stewart
UT for a science training
program, including purchase of
equipment and teacher stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Valdosta State University, 750,000 Carter (GA)
Valdosta, GA for an online
educational degree program,
including purchase of
information technology.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Vida Mobile Clinic, Granada 1,350,000 Cardenas
Hills, CA for programs to
support pre-health postsecondary
students, including student
stipends.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Virginia Commonwealth University, 1,073,550 McEachin
Richmond, VA for pipelines into
STEM professions, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Virginia Foundation for Community 254,910 Wexton
College Education, Richmond, VA
for early childhood educator
development programs, including
scholarships.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Virginia State University, 2,200,000 McEachin
Petersburg, VA for broadband
improvement, including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Virginia Union University, 2,000,000 McEachin
Richmond, VA for cybersecurity
programming, including
installation and reconfiguration
of equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Wake Technical Community College, 939,041 Ross
Raleigh, NC for electric vehicle
technical training, including
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Wayne County Community College 212,400 Lawrence
District, Detroit, MI for an
automotive electrification and
testing program.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Western Kentucky University, 460,000 Guthrie
Bowling Green, KY for the
purchase of applied research and
technology equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Western University of Health 100,000 Torres (CA)
Sciences, Ontario, CA for health
career student support programs.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Western Washington University, 450,000 Larsen (WA)
Bellingham, WA for a food
security program, including
furnishing a longhouse with
equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... Westfield State University, 1,000,000 Neal
Westfield, MA for a nursing and
health sciences program,
including equipment.
----------------------------------------------------------------------------------------------------------------
Department of Education Higher Education....... William Paterson University, 1,000,000 Sherrill
Wayne, NJ for student support,
including scholarships.
----------------------------------------------------------------------------------------------------------------
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 ``State Unemployment Insurance
and Employment Services Operations'' which provides for the
transfer of funds to ``Office of Disability Employment
Policy.''
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 permitting up to one
percent of any discretionary appropriation to be transferred
between a program, project, or activity of the Department of
Labor, provided that no such program, project, or activity is
increased by more than three percent by any such transfer.
A general provision is included that provides for the
transfer of funds from the ``Employment and Training
Administration'' for technical assistance services to grantees
to ``Program Administration''. The provision does not apply to
section 171 of the WIOA. The general provision also authorizes
the transfer of up 0.5 percent of each discretionary
appropriation for ``Employment and Training Administration'' to
carry out program integrity activities subject to certain
limitations related to ``Job Corps.''
A general provision is included that provides for the
transfer of up to 0.75 percent of appropriated funds to carry
out program evaluations of ``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'', funding made available to the
``Bureau of International Labor 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 ``Centers for Disease Control
and Prevention, CDC-Wide Activities and Program Support'' for
funds to be transferred to and merged with the Infectious
Disease Rapid Response Reserve Fund.
Language is included under ``National Institutes of Health,
Office of the Director'' to transfer $5,000,000 to the ``Office
of Inspector General'' for oversight of grant programs and
operations of NIH.
Language is included under ``National Institutes of Health,
Innovation Account'' to allow the transfer of funds to other
Institutes and Centers to support activities authorized in the
21st Century Cures Act (PL 114-255).
Language is included under ``Administration for Community
Living, Aging and Disability Services Programs'' for transfer
to the Secretary of Agriculture to carryout section 311 of the
Older Americans Act of 1965.
A general provision is included that allows not to exceed
one percent of any discretionary funds to be transferred
between appropriation accounts of the ``Department of Health
and Human Services'', provided that no appropriation account is
increased by more than three percent by such transfer.
A general provision is included that allows the transfer of
up to three percent among the institutes and centers of the
``National Institutes of Health'' from amounts identified as
pertaining to the human immunodeficiency virus.
A general provision is included that allows the transfer of
funding determined to be related to the human immunodeficiency
virus to the ``Office of AIDS Research''.
A general provision is included that transfers one percent
of the amount made available for ``National Research Service
Awards'' at the ``National Institutes of Health'' to the
``Health Resources and Services Administration''.
A general provision is included to direct the transfer of
the ``Prevention and Public Health Fund'' as specified in the
committee report accompanying this Act.
A general provision is included that allows the transfer of
funding related to research on opioid misuse, opioid
alternatives, pain management, and substance use disorder
treatment between the institutes and centers of the ``National
Institute of Health''.
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 funds from 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.
Compliance With Rule XIII, Cl. 3(e) (Ramseyer Rule)
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS
Part A--Administration
* * * * * * *
pay and allowances
Sec. 208. (a)(1) Commissioned officers of the Regular Corps
and Ready Reserve Corps shall be entitled to receive such pay
and allowances as are now or may hereafter be authorized by
law.
(2) For provisions relating to the receipt of special pay by
commissioned officers of the Regular Corps and Ready Reserve
Corps while on active duty, see section 303a(b) or 373 of title
37, United States Code.
(b) Commissioned officers on active duty, and retired
officers entitled to retired pay pursuant to section 210(g)(3),
section 211 or section 221(a), shall be permitted to purchase
supplies from the Army, Navy, Air Force, and Marine Corps at
the same price as is charged officers thereof.
(c) Members of the National Advisory Health Council and
members of other national advisory or review councils or
committees established under this Act, including members of the
Technical Electronic Product Radiation Safety Standards
Committee and the Board of Regents of the National Library of
Medicine, but excluding ex officio members, while attending
conferences or meetings of their respective councils or
committees or while otherwise serving at the request of the
Secretary shall be entitled to receive compensation at rates to
be fixed by the Secretary, but at rates not exceeding the daily
equivalent of the rate specified at the time of such service
for grade GS-18 of the General Schedule, including traveltime;
and while away from their homes or regular places of business
they may be allowed travel expenses, including per diem in lieu
of subsistence, as authorized by section 5703 of title 5 of the
United States Code for persons in the Government service
employed intermittently.
(d) Field employees of the Service, except those employed on
a per diem or fee basis, who render part-time duty and are also
subject to call at any time for services not contemplated in
their regular part-time employment, may be paid annual
compensation for such part-time duty and, in addition, such
fees for such other services as the Surgeon General may
determine; but in no case shall the total paid to any such
employee for any fiscal year exceed the amount of the minimum
annual salary rate of the classification grade of the employee.
(e) Any civilian employee of the Service who is employed at
the Gillis W. Long Hansen's Disease Center on the date of the
enactment of the Consolidated Omnibus Budget Reconciliation Act
of 1985 shall be entitled to receive, in addition to any
compensation to which the employee may otherwise be entitled
and for so long as the employee remains employed at the Center,
an amount equal to one-fourth of such compensation.
(f) Individuals appointed under subsection (g) shall have
included in their fellowships such stipends or allowances,
including travel and subsistence expenses, as the Surgeon
General may deem necessary to procure qualified fellows.
(g) The Secretary is authorized to establish and fix the
compensation for, within the Public Health Service, not more
than one hundred and seventy-nine positions, of which not less
than one hundred and fifteen shall be for the National
Institutes of Health, not less than five shall be for the
[National Institute on Alcohol Abuse and Alcoholism] National
Institute on Alcohol Effects and Alcohol-Associated Disorders
for individuals engaged in research on alcohol and alcoholism,
not less than ten shall be for the National Center for Health
Services Research, not less than twelve shall be for the
National Center for Health Statistics, and not less than seven
shall be for the National Center for Health Care Technology, in
the professional, scientific, and executive service, each such
position being established to effectuate those research and
development activities of the Public Health Service which
require the services of specially qualified scientific,
professional, and administrative personnel: Provided, That the
rates of compensation for positions established pursuant to the
provisions of this subsection shall not be less than the
minimum rate of grade 16 of the General Schedule of the
Classification Act of 1949, as amended, nor more than (1) the
highest rate of grade 18 of the General Schedule of such Act,
or (2) in the case of two such positions, the rate specified,
at the time the service in the position is performed, for level
II of the Executive Schedule (5 U.S.C. 5313); and such rates of
compensation for all positions included in this proviso shall
be subject to the approval of the Civil Service Commission.
Positions created pursuant to this subsection shall be included
in the classified civil service of the United States, but
appointments to such positions shall be made without
competitive examination upon approval of the proposed
appointee's qualifications by the Civil Service Commission or
such officers or agents as it may designate for this purpose.
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part B--Federal-State Cooperation
* * * * * * *
SEC. 317G. FELLOWSHIP AND TRAINING PROGRAMS.
The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall establish fellowship and
training programs to be conducted by such Centers to train
individuals to develop skills in epidemiology, surveillance,
laboratory analysis, and other disease detection and prevention
methods. Such programs shall be designed to enable health
professionals and health personnel trained under such programs
to work, after receiving such training, in local, State,
national, and international efforts toward the prevention and
control of diseases, injuries, and disabilities. Such
fellowships and training may be administered through the use of
either appointment or nonappointment procedures. The Secretary
may, no later than 120 days after the end of an individual's
participation in such a fellowship or training program, and
without regard to those provisions of title 5, United States
Code, governing appointments in the competitive service,
appoint a participant in such a fellowship or training program
to a term or permanent position in the Centers for Disease
Control and Prevention.
* * * * * * *
TITLE IV--NATIONAL RESEARCH INSTITUTES
Part A--National Institutes of Health
SEC. 401. ORGANIZATION OF NATIONAL INSTITUTES OF HEALTH.
(a) Relation to Public Health Service.--The National
Institutes of Health is an agency of the Service.
(b) National Research Institutes and National Centers.--The
following agencies of the National Institutes of Health are
national research institutes or national centers:
(1) The National Cancer Institute.
(2) The National Heart, Lung, and Blood Institute.
(3) The National Institute of Diabetes and Digestive
and Kidney Diseases.
(4) The National Institute of Arthritis and
Musculoskeletal and Skin Diseases.
(5) The National Institute on Aging.
(6) The National Institute of Allergy and Infectious
Diseases.
(7) The Eunice Kennedy Shriver National Institute of
Child Health and Human Development.
(8) The National Institute of Dental and Craniofacial
Research.
(9) The National Eye Institute.
(10) The National Institute of Neurological Disorders
and Stroke.
(11) The National Institute on Deafness and Other
Communication Disorders.
(12) The [National Institute on Alcohol Abuse and
Alcoholism] National Institute on Alcohol Effects and
Alcohol-Associated Disorders.
(13) The [National Institute on Drug Abuse] National
Institute on Drugs and Addiction.
(14) The National Institute of Mental Health.
(15) The National Institute of General Medical
Sciences.
(16) The National Institute of Environmental Health
Sciences.
(17) The National Institute of Nursing Research.
(18) The National Institute of Biomedical Imaging and
Bioengineering.
(19) The National Human Genome Research Institute.
(20) The National Library of Medicine.
(21) The National Center for Advancing Translational
Sciences.
(22) The John E. Fogarty International Center for
Advanced Study in the Health Sciences.
(23) The National Center for Complementary and
IntegrativeHealth.
(24) The National Institute on Minority Health and
Health Disparities.
(25) Any other national center that, as an agency
separate from any national research institute, was
established within the National Institutes of Health as
of the day before the date of the enactment of the
National Institutes of Health Reform Act of 2006.
(c) Division of Program Coordination, Planning, and Strategic
Initiatives.--
(1) In general.--Within the Office of the Director of
the National Institutes of Health, there shall be a
Division of Program Coordination, Planning, and
Strategic Initiatives (referred to in this subsection
as the ``Division'').
(2) Offices within division.--
(A) Offices.--The following offices are
within the Division: The Office of AIDS
Research, the Office of Research on Women's
Health, the Office of Behavioral and Social
Sciences Research, the Office of Disease
Prevention, the Office of Dietary Supplements,
and any other office located within the Office
of the Director of NIH as of the day before the
date of the enactment of the National
Institutes of Health Reform Act of 2006. In
addition to such offices, the Director of NIH
may establish within the Division such
additional offices or other administrative
units as the Director determines to be
appropriate.
(B) Authorities.--Each office in the
Division--
(i) shall continue to carry out the
authorities that were in effect for the
office before the date of enactment
referred to in subparagraph (A); and
(ii) shall, as determined appropriate
by the Director of NIH, support the
Division with respect to the
authorities described in section
402(b)(7).
(d) Organization.--
(1) Number of institutes and centers.--In the
National Institutes of Health, the number of national
research institutes and national centers may not exceed
a total of 27, including any such institutes or centers
established under authority of paragraph (2) or under
authority of this title as in effect on the day before
the date of the enactment of the National Institutes of
Health Reform Act of 2006.
(2) Reorganization of institutes.--
(A) In general.--The Secretary may establish
in the National Institutes of Health one or
more additional national research institutes to
conduct and support research, training, health
information, and other programs with respect to
any particular disease or groups of diseases or
any other aspect of human health if--
(i) the Secretary determines that an
additional institute is necessary to
carry out such activities; and
(ii) the additional institute is not
established before the expiration of
180 days after the Secretary has
provided the Committee on Energy and
Commerce of the House of
Representatives and the Committee on
Health, Education, Labor, and Pensions
of the Senate written notice of the
determination made under clause (i)
with respect to the institute.
(B) Additional authority.--The Secretary may
reorganize the functions of any national
research institute and may abolish any national
research institute if the Secretary determines
that the institute is no longer required. A
reorganization or abolition may not take effect
under this paragraph before the expiration of
180 days after the Secretary has provided the
Committee on Energy and Commerce of the House
of Representatives and the Committee on Health,
Education, Labor, and Pensions of the Senate
written notice of the reorganization or
abolition.
(3) Reorganization of office of director.--
Notwithstanding subsection (c), the Director of NIH
may, after a series of public hearings, and with the
approval of the Secretary, reorganize the offices
within the Office of the Director, including the
addition, removal, or transfer of functions of such
offices, and the establishment or termination of such
offices, if the Director determines that the overall
management and operation of programs and activities
conducted or supported by such offices would be more
efficiently carried out under such a reorganization.
(4) Internal reorganization of institutes and
centers.--Notwithstanding any conflicting provisions of
this title, the director of a national research
institute or a national center may, after a series of
public hearings and with the approval of the Director
of NIH, reorganize the divisions, centers, or other
administrative units within such institute or center,
including the addition, removal, or transfer of
functions of such units, and the establishment or
termination of such units, if the director of such
institute or center determines that the overall
management and operation of programs and activities
conducted or supported by such divisions, centers, or
other units would be more efficiently carried out under
such a reorganization.
(e) Scientific Management Review Board for Periodic
Organizational Reviews.--
(1) In general.--Not later than 60 days after the
date of the enactment of the National Institutes of
Health Reform Act of 2006, the Secretary shall
establish an advisory council within the National
Institutes of Health to be known as the Scientific
Management Review Board (referred to in this subsection
as the ``Board'').
(2) Duties.--
(A) Reports on organizational issues.--The
Board shall provide advice to the appropriate
officials under subsection (d) regarding the
use of the authorities established in
paragraphs (2), (3), and (4) of such subsection
to reorganize the National Institutes of Health
(referred to in this subsection as
``organizational authorities''). Not less
frequently than once each 7 years, the Board
shall--
(i) determine whether and to what
extent the organizational authorities
should be used; and
(ii) issue a report providing the
recommendations of the Board regarding
the use of the authorities and the
reasons underlying the recommendations.
(B) Certain responsibilities regarding
reports.--The activities of the Board with
respect to a report under subparagraph (A)
shall include the following:
(i) Reviewing the research portfolio
of the National Institutes of Health
(referred to in this subsection as
``NIH'') in order to determine the
progress and effectiveness and value of
the portfolio and the allocation among
the portfolio activities of the
resources of NIH.
(ii) Determining pending scientific
opportunities, and public health needs,
with respect to research within the
jurisdiction of NIH.
(iii) For any proposal for
organizational changes to which the
Board gives significant consideration
as a possible recommendation in such
report--
(I) analyzing the budgetary
and operational consequences of
the proposed changes;
(II) taking into account
historical funding and support
for research activities at
national research institutes
and centers that have been
established recently relative
to national research institutes
and centers that have been in
existence for more than two
decades;
(III) estimating the level of
resources needed to implement
the proposed changes;
(IV) assuming the proposed
changes will be made and making
a recommendation for the
allocation of the resources of
NIH among the national research
institutes and national
centers; and
(V) analyzing the
consequences for the progress
of research in the areas
affected by the proposed
changes.
(C) Consultation.--In carrying out
subparagraph (A), the Board shall consult
with--
(i) the heads of national research
institutes and national centers whose
directors are not members of the Board;
(ii) other scientific leaders who are
officers or employees of NIH and are
not members of the Board;
(iii) advisory councils of the
national research institutes and
national centers;
(iv) organizations representing the
scientific community; and
(v) organizations representing
patients.
(3) Composition of board.--The Board shall consist of
the Director of NIH, who shall be a permanent nonvoting
member on an ex officio basis, and an odd number of
additional members, not to exceed 21, all of whom shall
be voting members. The voting members of the Board
shall be the following:
(A) Not fewer than 9 officials who are
directors of national research institutes or
national centers. The Secretary shall designate
such officials for membership and shall ensure
that the group of officials so designated
includes directors of--
(i) national research institutes
whose budgets are substantial relative
to a majority of the other institutes;
(ii) national research institutes
whose budgets are small relative to a
majority of the other institutes;
(iii) national research institutes
that have been in existence for a
substantial period of time without
significant organizational change under
subsection (d);
(iv) as applicable, national research
institutes that have undergone
significant organization changes under
such subsection, or that have been
established under such subsection,
other than national research institutes
for which such changes have been in
place for a substantial period of time;
and
(v) national centers.
(B) Members appointed by the Secretary from
among individuals who are not officers or
employees of the United States. Such members
shall include--
(i) individuals representing the
interests of public or private
institutions of higher education that
have historically received funds from
NIH to conduct research; and
(ii) individuals representing the
interests of private entities that have
received funds from NIH to conduct
research or that have broad expertise
regarding how the National Institutes
of Health functions, exclusive of
private entities to which clause (i)
applies.
(4) Chair.--The Chair of the Board shall be selected
by the Secretary from among the members of the Board
appointed under paragraph (3)(B). The term of office of
the Chair shall be 2 years.
(5) Meetings.--
(A) In general.--The Board shall meet at the
call of the Chair or upon the request of the
Director of NIH, but not fewer than 5 times
with respect to issuing any particular report
under paragraph (2)(A). The location of the
meetings of the Board is subject to the
approval of the Director of NIH.
(B) Particular forums.--Of the meetings held
under subparagraph (A) with respect to a report
under paragraph (2)(A)--
(i) one or more shall be directed
toward the scientific community to
address scientific needs and
opportunities related to proposals for
organizational changes under subsection
(d), or as the case may be, related to
a proposal that no such changes be
made; and
(ii) one or more shall be directed
toward consumer organizations to
address the needs and opportunities of
patients and their families with
respect to proposals referred to in
clause (i).
(C) Availability of information from
forums.--For each meeting under subparagraph
(B), the Director of NIH shall post on the
Internet site of the National Institutes of
Health a summary of the proceedings.
(6) Compensation; term of office.--The provisions of
subsections (b)(4) and (c) of section 406 apply with
respect to the Board to the same extent and in the same
manner as such provisions apply with respect to an
advisory council referred to in such subsections,
except that the reference in such subsection (c) to 4
years regarding the term of an appointed member is
deemed to be a reference to 5 years.
(7) Reports.--
(A) Recommendations for changes.--Each report
under paragraph (2)(A) shall be submitted to--
(i) the Committee on Energy and
Commerce and the Committee on
Appropriations of the House of
Representatives;
(ii) the Committee on Health,
Education, Labor, and Pensions and the
Committee on Appropriations of the
Senate;
(iii) the Secretary; and
(iv) officials with organizational
authorities, other than any such
official who served as a member of the
Board with respect to the report
involved.
(B) Availability to public.--The Director of
NIH shall post each report under paragraph (2)
on the Internet site of the National Institutes
of Health.
(C) Report on board activities.--Not later
than 18 months after the date of the enactment
of the National Institutes of Health Reform Act
of 2006, the Board shall submit to the
committees specified in subparagraph (A) a
report describing the activities of the Board.
(f) Organizational Changes per Recommendation of Scientific
Management Review Board.--
(1) In general.--With respect to an official who has
organizational authorities within the meaning of
subsection (e)(2)(A), if a recommendation to the
official for an organizational change is made in a
report under such subsection, the official shall,
except as provided in paragraphs (2), (3), and (4) of
this subsection, make the change in accordance with the
following:
(A) Not later than 100 days after the report
is submitted under subsection (e)(7)(A), the
official shall initiate the applicable public
process required in subsection (d) toward
making the change.
(B) The change shall be fully implemented not
later than the expiration of the 3-year period
beginning on the date on which such process is
initiated.
(2) Inapplicability to certain reorganizations.--
Paragraph (1) does not apply to a recommendation made
in a report under subsection (e)(2)(A) if the
recommendation is for--
(A) an organizational change under subsection
(d)(2) that constitutes the establishment,
termination, or consolidation of one or more
national research institutes or national
centers; or
(B) an organizational change under subsection
(d)(3).
(3) Objection by director of nih.--
(A) In general.--Paragraph (1) does not apply
to a recommendation for an organizational
change made in a report under subsection
(e)(2)(A) if, not later than 90 days after the
report is submitted under subsection (e)(7)(A),
the Director of NIH submits to the committees
specified in such subsection a report providing
that the Director objects to the change, which
report includes the reasons underlying the
objection.
(B) Scope of objection.--For purposes of
subparagraph (A), an objection by the Director
of NIH may be made to the entirety of a
recommended organizational change or to 1 or
more aspects of the change. Any aspect of a
change not objected to by the Director in a
report under subparagraph (A) shall be
implemented in accordance with paragraph (1).
(4) Congressional review.--An organizational change
under subsection (d)(2) that is initiated pursuant to
paragraph (1) shall be carried out by regulation in
accordance with the procedures for substantive rules
under section 553 of title 5, United States Code. A
rule under the preceding sentence shall be considered a
major rule for purposes of chapter 8 of such title
(relating to congressional review of agency
rulemaking).
(g) Definitions.--For purposes of this title:
(1) The term ``Director of NIH'' means the Director
of the National Institutes of Health.
(2) The terms ``national research institute'' and
``national center'' mean an agency of the National
Institutes of Health that is--
(A) listed in subsection (b) and not
terminated under subsection (d)(2)(A); or
(B) established by the Director of NIH under
such subsection.
(h) References to NIH.--For purposes of this title, a
reference to the National Institutes of Health includes its
agencies.
* * * * * * *
Part C--Specific Provisions Respecting National Research Institutes
* * * * * * *
Subpart 14--[National Institute on Alcohol Abuse and Alcoholism]
National Institute on Alcohol Effects and Alcohol-Associated Disorders
purpose of institute
Sec. 464H. (a) In General.--The general purpose of the
[National Institute on Alcohol Abuse and Alcoholism] National
Institute on Alcohol Effects and Alcohol-Associated Disorders
(hereafter in this subpart referred to as the ``Institute'') is
the conduct and support of biomedical and behavioral research,
health services research, research training, and health
information dissemination with respect to the [prevention of
alcohol abuse] prevention of alcohol misuse and the [treatment
of alcoholism] treatment of alcohol-associated disorders.
(b) Research Program.--The research program established under
this subpart shall encompass the social, behavioral, and
biomedical etiology, mental and physical health consequences,
and social and economic consequences of [alcohol abuse and
alcoholism] alcohol misuse, alcohol use disorder, and other
alcohol-associated disorders. In carrying out the program, the
Director of the Institute is authorized to--
(1) collect and disseminate through publications and
other appropriate means (including the development of
curriculum materials), information as to, and the
practical application of, the research and other
activities under the program;
(2) make available research facilities of the Public
Health Service to appropriate public authorities, and
to health officials and scientists engaged in special
study;
(3) make grants to universities, hospitals,
laboratories, and other public or nonprofit
institutions, and to individuals for such research
projects as are recommended by the [National Advisory
Council on Alcohol Abuse and Alcoholism] National
Advisory Council on Alcohol Effects and Alcohol-
Associated Disorders, giving special consideration to
projects relating to--
(A) the relationship between [alcohol abuse
and domestic violence] alcohol misuse and
domestic violence,
(B) the effects of alcohol use during
pregnancy,
(C) the impact of [alcoholism and alcohol
abuse] alcohol misuse, alcohol use disorder,
and other alcohol-associated disorders on the
family, the workplace, and systems for the
delivery of health services,
(D) the relationship between the [abuse of
alcohol] misuse of alcohol and other drugs,
[(E) the effect on the incidence of alcohol
abuse and alcoholism of social pressures, legal
requirements respecting the use of alcoholic
beverages, the cost of such beverages, and the
economic status and education of users of such
beverages,]**ERR02
(E) the effect of social pressures, legal
requirements regarding the use of alcoholic
beverages, the cost of such beverages, and the
economic status and education of users of such
beverages on the incidence of alcohol misuse,
alcohol use disorder, and other alcohol-
associated disorders,**ERR02
(F) the interrelationship between alcohol use
and other health problems,
(G) the comparison of the cost and
effectiveness of various treatment methods for
[alcoholism and alcohol abuse] alcohol misuse,
alcohol use disorder, and other alcohol-
associated disorders and the effectiveness of
prevention and intervention programs for
[alcoholism and alcohol abuse] alcohol misuse,
alcohol use disorder, and other alcohol-
associated disorders, and
(H) [alcoholism and alcohol abuse] alcohol
misuse, alcohol use disorder, and other
alcohol-associated disorders among women;
(4) secure from time to time and for such periods as
he deems advisable, the assistance and advice of
experts, scholars, and consultants from the United
States or abroad;
(5) promote the coordination of research programs
conducted by the Institute, and similar programs
conducted by the [National Institute of Drug Abuse]
National Institute on Drugs and Addiction and by other
departments, agencies, organizations, and individuals,
including all National Institutes of Health research
activities which are or may be related to the problems
of individuals suffering from alcoholism or alcohol
abuse or those of their families or the [impact of
alcohol abuse] impact of alcohol misuse on other health
problems;
(6) conduct an intramural program of biomedical,
behavioral, epidemiological, and social research,
including research into the most effective means of
treatment and service delivery, and including research
involving human subjects, which is--
(A) located in an institution capable of
providing all necessary medical care for such
human subjects, including complete 24-hour
medical diagnostic services by or under the
supervision of physicians, acute and intensive
medical care, including 24-hour emergency care,
psychiatric care, and such other care as is
determined to be necessary for individuals
suffering from [alcoholism and alcohol abuse]
alcohol misuse, alcohol use disorder, and other
alcohol-associated disorders; and
(B) associated with an accredited medical or
research training institution;
(7) for purposes of study, admit and treat at
institutions, hospitals, and stations of the Public
Health Service, persons not otherwise eligible for such
treatment;
(8) provide to health officials, scientists, and
appropriate public and other nonprofit institutions and
organizations, technical advice and assistance on the
application of statistical and other scientific
research methods to experiments, studies, and surveys
in health and medical fields;
(9) enter into contracts under this title without
regard to sections 3648 and 3709 of the Revised
Statutes (31 U.S.C. 529; 41 U.S.C. 5); and
(10) adopt, upon recommendation of the [National
Advisory Council on Alcohol Abuse and Alcoholism]
National Advisory Council on Alcohol Effects and
Alcohol-Associated Disorders, such additional means as
he deems necessary or appropriate to carry out the
purposes of this section.
(c) Collaboration.--The Director of the Institute shall
collaborate with the Administrator of the [Substance Abuse and
Mental Health Services Administration] Substance Use And Mental
Health Services Administration in focusing the services
research activities of the Institute and in disseminating the
results of such research to health professionals and the
general public.
associate director for prevention
Sec. 464I. (a) In General.--There shall be in the Institute
an Associate Director for Prevention who shall be responsible
for the full-time coordination and promotion of the programs in
the Institute concerning the prevention of [alcohol abuse and
alcoholism] alcohol misuse, alcohol use disorder, and other
alcohol-associated disorders. The Associate Director shall be
appointed by the Director of the Institute from individuals who
because of their professional training or expertise are experts
in alcohol abuse and alcoholism or the prevention of such.
(b) Biennial Report.--The Associate Director for Prevention
shall prepare for inclusion in the biennial report made under
section 407 a description of the prevention activities of the
Institute, including a description of the staff and resources
allocated to those activities.
national alcohol research center
Sec. 464J. (a) The Secretary acting through the Institute may
designate National Alcohol Research Centers for the purpose of
interdisciplinary research relating to alcoholism and other
biomedical, behavioral, and social issues related to alcoholism
and alcohol abuse. No entity may be designated as a Center
unless an application therefor has been submitted to, and
approved by, the Secretary. Such an application shall be
submitted in such manner and contain such information as the
Secretary may reasonably require. The Secretary may not approve
such an application unless--
(1) the application contains or is supported by
reasonable assurances that--
(A) the applicant has the experience, or
capability, to conduct, through biomedical,
behavioral, social, and related disciplines,
long-term research on [alcoholism and other
alcohol problems] alcohol misuse, alcohol use
disorder, and other alcohol-associated
disorders and to provide coordination of such
research among such disciplines;
(B) the applicant has available to it
sufficient facilities (including laboratory,
reference, and data analysis facilities) to
carry out the research plan contained in the
application,
(C) the applicant has facilities and
personnel to provide training in the prevention
and treatment of [alcoholism and other alcohol
problems] alcohol misuse, alcohol use disorder,
and other alcohol-associated disorders;
(D) the applicant has the capacity to train
predoctoral and postdoctoral students for
careers in research on [alcoholism and other
alcohol problems] alcohol misuse, alcohol use
disorder, and other alcohol-associated
disorders;
(E) the applicant has the capacity to conduct
courses on [alcohol problems] alcohol misuse,
alcohol use disorder, and other alcohol-
associated disorders and research on [alcohol
problems] alcohol misuse, alcohol use disorder,
and other alcohol-associated disorders for
undergraduate and graduate students, and
medical and osteopathic, nursing, social work,
and other specialized graduate students; and
(F) the applicant has the capacity to conduct
programs of continuing education in such
medical, legal, and social service fields as
the Secretary may require.
(2) the application contains a detailed five-year
plan for research relating to [alcoholism and other
alcohol problems] alcohol misuse, alcohol use disorder,
and other alcohol-associated disorders.
(b) The Secretary shall, under such conditions as the
Secretary may reasonably require, make annual grants to Centers
which have been designated under this section. No funds
provided under a grant under this subsection may be used for
the purchase of any land or the purchase, construction,
preservation, or repair of any building. For the purposes of
the preceding sentence, the term ``construction'' has the
meaning given that term by section 701(1). The Secretary shall
include in the grants made under this section for fiscal year
beginning after September 30, 1981, a grant to a designated
Center for research on the effects of alcohol on the elderly.
Subpart 15--National Institute on Drug Abuse
purpose of institute
Sec. 464L. (a) In General.--The general purpose of the
[National Institute on Drug Abuse] National Institute on Drugs
and Addiction (hereafter in this subpart referred to as the
``Institute'') is the conduct and support of biomedical and
behavioral research, health services research, research
training, and health information dissemination with respect to
the prevention of [drug abuse] drug use and the [treatment of
drug abusers] treatment of drug addiction.
(b) Research Program.--The research program established under
this subpart shall encompass the social, behavioral, and
biomedical etiology, mental and physical health consequences,
and social and economic consequences of [drug abuse] drug use.
In carrying out the program, the Director of the Institute
shall give special consideration to projects relating to [drug
abuse] drug use among women (particularly with respect to
pregnant women).
(c) Collaboration.--The Director of the Institute shall
collaborate with the [Substance Abuse and Mental Health
Services Administration] Substance Use And Mental Health
Services Administration in focusing the services research
activities of the Institute and in disseminating the results of
such research to health professionals and the general public.
associate director for prevention
Sec. 464M. (a) In General.--There shall be in the Institute
an Associate Director for Prevention who shall be responsible
for the full-time coordination and promotion of the programs in
the Institute concerning the prevention of [drug abuse] drug
use. The Associate Director shall be appointed by the Director
of the Institute from individuals who because of their
professional training or expertise are experts in [drug abuse]
drug use and the [prevention of such abuse] prevention of such
use.
(b) Report.--The Associate Director for Prevention shall
prepare for inclusion in the biennial report made under section
407 a description of the prevention activities of the
Institute, including a description of the staff and resources
allocated to those activities.
[drug abuse research centers] drugs and addiction research centers
Sec. 464N. (a) Authority.--The Director of the Institute may
designate [National Drug Abuse Research Centers] National Drugs
and Addiction Research Centers for the purpose of
interdisciplinary research relating to [drug abuse] drug use
and other biomedical, behavioral, and social issues related to
[drug abuse] drug use. No entity may be designated as a Center
unless an application therefore has been submitted to, and
approved by, the Secretary. Such an application shall be
submitted in such manner and contain such information as the
Secretary may reasonably require. The Secretary may not approve
such an application unless--
(1) the application contains or is supported by
reasonable assurances that--
(A) the applicant has the experience, or
capability, to conduct, through biomedical,
behavioral, social, and related disciplines,
long-term research on [drug abuse] drug use and
to provide coordination of such research among
such disciplines;
(B) the applicant has available to it
sufficient facilities (including laboratory,
reference, and data analysis facilities) to
carry out the research plan contained in the
application;
(C) the applicant has facilities and
personnel to provide training in the prevention
and [treatment of drug abuse] treatment of drug
addiction;
(D) the applicant has the capacity to train
predoctoral and postdoctoral students for
careers in research on [drug abuse] drug use;
(E) the applicant has the capacity to conduct
courses on [drug abuse] drug use problems and
research on [drug abuse] drug use for
undergraduate and graduate students, and
medical and osteopathic, nursing, social work,
and other specialized graduate students; and
(F) the applicant has the capacity to conduct
programs of continuing education in such
medical, legal, and social service fields as
the Secretary may require.
(2) the application contains a detailed five-year
plan for research relating to [drug abuse] drug use.
(b) Grants.--The Director of the Institute shall, under such
conditions as the Secretary may reasonably require, make annual
grants to Centers which have been designated under this
section. No funds provided under a grant under this subsection
may be used for the purchase of any land or the purchase,
construction, preservation, or repair of any building. For the
purposes of the preceding sentence, the term ``construction''
has the meaning given that term by section 701(1).
(c) [Drug Abuse and Addition Research] Drugs and Addiction
Research Centers.--
(1) Grants or cooperative agreements.--The Director
of the Institute may make grants or enter into
cooperative agreements to expand the current and
ongoing interdisciplinary research and clinical trials
with treatment centers of the [National Drug Abuse
Treatment Clinical Trials Network] National Drug
Addiction Treatment Clinical Trials Network relating to
[drug abuse] drug use and addiction, including related
biomedical, behavioral, and social issues.
(2) Use of funds.--Amounts made available under a
grant or cooperative agreement under paragraph (1) for
[drug abuse] drug use and addiction may be used for
research and clinical trials relating to--
(A) the effects of [drug abuse] drug use on
the human body, including the brain;
(B) the addictive nature of drugs and how
such effects differ with respect to different
individuals;
(C) the connection between [drug abuse] drug
use and mental health;
(D) the identification and evaluation of the
most effective methods of prevention of [drug
abuse] drug use and addiction;
(E) the identification and development of the
most effective methods of treatment of drug
addiction, including pharmacological
treatments;
(F) risk factors for [drug abuse] drug use;
(G) effects of [drug abuse] drug use and
addiction on pregnant women and their fetuses;
and
(H) cultural, social, behavioral,
neurological, and psychological [reasons that
individuals abuse drugs, or refrain from
abusing drugs] reasons that individuals use
drugs or refrain from using drugs.
(3) Research results.--The Director shall promptly
disseminate research results under this subsection to
Federal, State, and local entities involved in
combating [drug abuse] drug use and addiction.
office on aids
Sec. 464O. The Director of the Institute shall establish
within the Institute an Office on AIDS. The Office shall be
responsible for the coordination of research and determining
the direction of the Institute with respect to AIDS research
related to--
(1) primary prevention of the spread of HIV,
including transmission via [drug abuse] drug use;
(2) [drug abuse] drug use services research; and
(3) other matters determined appropriate by the
Director.
medication development program
Sec. 464P. (a) Establishment.--There is established in the
Institute a Medication Development Program through which the
Director of such Institute shall--
(1) conduct periodic meetings with the Commissioner
of Food and Drugs to discuss measures that may
facilitate the approval process of [drug abuse
treatments] drug addiction treatments;
(2) encourage and promote (through grants, contracts,
international collaboration, or otherwise) expanded
research programs, investigations, experiments,
community trials, and studies, into the development and
use of medications to treat drug addiction;
(3) establish or provide for the establishment of
research facilities;
(4) report on the activities of other relevant
agencies relating to the development and use of
pharmacotherapeutic treatments for drug addiction;
(5) collect, analyze, and disseminate data useful in
the development and use of pharmacotherapeutic
treatments for drug addiction and collect, catalog,
analyze, and disseminate through international
channels, the results of such research;
(6) directly or through grants, contracts, or
cooperative agreements, support training in the
fundamental sciences and clinical disciplines related
to the pharmacotherapeutic [treatment of drug abuse]
treatment of drug addiction, including the use of
training stipends, fellowships, and awards where
appropriate; and
(7) coordinate the activities conducted under this
section with related activities conducted within the
[National Institute on Alcohol Abuse and Alcoholism]
National Institute on Alcohol Effects and Alcohol-
Associated Disorders, the National Institute of Mental
Health, and other appropriate institutes and shall
consult with the Directors of such Institutes.
(b) Duties.--In carrying out the activities described in
subsection (a), the Director of the Institute--
(1) shall collect and disseminate through
publications and other appropriate means, information
pertaining to the research and other activities under
this section;
(2) shall make grants to or enter into contracts and
cooperative agreements with individuals and public and
private entities to further the goals of the program;
(3) may, in accordance with section 496, and in
consultation with the [National Advisory Council on
Drug Abuse] National Advisory Council on Drugs and
Addiction, acquire, construct, improve, repair,
operate, and maintain pharmacotherapeutic research
centers, laboratories, and other necessary facilities
and equipment, and such other real or personal property
as the Director determines necessary, and may, in
consultation with such Advisory Council, make grants
for the construction or renovation of facilities to
carry out the purposes of this section;
(4) may accept voluntary and uncompensated services;
(5) may accept gifts, or donations of services,
money, or property, real, personal, or mixed, tangible
or intangible; and
(6) shall take necessary action to ensure that all
channels for the dissemination and exchange of
scientific knowledge and information are maintained
between the Institute and the other scientific,
medical, and biomedical disciplines and organizations
nationally and internationally.
(c) Report.--
(1) In general.--Not later than December 31, 1992,
and each December 31 thereafter, the Director of the
Institute shall submit to the Office of National Drug
Control Policy established under section 1002 of the
Anti-Drug Abuse Act of 1988 (21 U.S.C. 1501) a report,
in accordance with paragraph (3), that describes the
objectives and activities of the program assisted under
this section.
(2) National drug control strategy.--The Director of
National Drug Control Policy shall incorporate, by
reference or otherwise, each report submitted under
this subsection in the National Drug Control Strategy
submitted the following February 1 under section 1005
of the Anti-Drug Abuse Act of 1988 (21 U.S.C. 1504).
(d) Definition.--For purposes of this section, the term
``pharmacotherapeutics'' means medications used to treat the
symptoms and [disease of drug abuse] disease of drug addiction,
including medications to--
(1) block the effects of [abused drugs] addictive
drugs;
(2) reduce the craving for [abused drugs] addictive
drugs;
(3) moderate or eliminate withdrawal symptoms;
(4) block or reverse the toxic effect of [abused
drugs] addictive drugs; or
(5) prevent relapse in persons who have been
detoxified from [drugs of abuse] drugs of addiction.
Subpart 16--National Institute of Mental Health
purpose of institute
Sec. 464R. (a) In General.--The general purpose of the
National Institute of Mental Health (hereafter in this subpart
referred to as the ``Institute'') is the conduct and support of
biomedical and behavioral research, health services research,
research training, and health information dissemination with
respect to the cause, diagnosis, treatment, control and
prevention of mental illness.
(b) Research Program.--The research program established under
this subpart shall include support for biomedical and
behavioral neuroscience and shall be designed to further the
treatment and prevention of mental illness, the promotion of
mental health, and the study of the psychological, social and
legal factors that influence behavior.
(c) Collaboration.--The Director of the Institute shall
collaborate with the Administrator of the [Substance Abuse and
Mental Health Services Administration] Substance Use And Mental
Health Services Administration in focusing the services
research activities of the Institute and in disseminating the
results of such research to health professionals and the
general public.
(d) Information With Respect to Suicide.--
(1) In general.--The Director of the Institute
shall--
(A) develop and publish information with
respect to the causes of suicide and the means
of preventing suicide; and
(B) make such information generally available
to the public and to health professionals.
(2) Youth suicide.--Information described in
paragraph (1) shall especially relate to suicide among
individuals under 24 years of age.
(e) Associate Director for Special Populations.--
(1) In general.--The Director of the Institute shall
designate an Associate Director for Special
Populations.
(2) Duties.--The Associate Director for Special
Populations shall--
(A) develop and coordinate research policies
and programs to assure increased emphasis on
the mental health needs of women and minority
populations;
(B) support programs of basic and applied
social and behavioral research on the mental
health problems of women and minority
populations;
(C) study the effects of discrimination on
institutions and individuals, including
majority institutions and individuals;
(D) support and develop research designed to
eliminate institutional discrimination; and
(E) provide increased emphasis on the
concerns of women and minority populations in
training programs, service delivery programs,
and research endeavors of the Institute.
* * * * * * *
Part H--General Provisions
* * * * * * *
collaborative use of certain health services research funds
Sec. 494A. The Secretary shall ensure that amounts made
available under subparts 14, 15 and 16 of part C for health
services research relating to [alcohol abuse and alcoholism]
alcohol misuse, alcohol use disorder, and other alcohol-
associated disorders, [drug abuse] drug use and mental health
be used collaboratively, as appropriate, and in consultation
with the Agency for Health Care Policy Research.
* * * * * * *
TITLE V-- [SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION]
SUBSTANCE USE AND MENTAL HEALTH SERVICES ADMINISTRATION
Part A--Organization and General Authorities
SEC. 501. [SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION]
SUBSTANCE USE AND MENTAL HEALTH SERVICES
ADMINISTRATION.
(a) Establishment.--The [Substance Abuse and Mental Health
Services Administration] Substance Use And Mental Health
Services Administration [(hereafter referred to in this title
as the ``Administration'')] (hereafter referred to in this
title as ``SAMHSA'' or the ``Administration'') is an agency of
the Service.
(b) Centers.--The following Centers are agencies of the
Administration:
(1) The [Center for Substance Abuse Treatment] Center
for Substance Use Services.
(2) The [Center for Substance Abuse Prevention]
Center for Substance Use Prevention Services.
(3) The Center for Mental Health Services.
(c) Assistant Secretary and Deputy Assistant Secretary.--
(1) Assistant secretary.--The Administration shall be
headed by an official to be known as the Assistant
Secretary for Mental Health and Substance Use
(hereinafter in this title referred to as the
``Assistant Secretary'') who shall be appointed by the
President, by and with the advice and consent of the
Senate.
(2) Deputy assistant secretary.--The Assistant
Secretary, with the approval of the Secretary, may
appoint a Deputy Assistant Secretary and may employ and
prescribe the functions of such officers and employees,
including attorneys, as are necessary to administer the
activities to be carried out through the
Administration.
(d) Authorities.--The Secretary, acting through the Assistant
Secretary, shall--
(1) supervise the functions of the Centers of the
Administration in order to assure that the programs
carried out through each such Center receive
appropriate and equitable support and that there is
cooperation among the Centers in the implementation of
such programs;
(2) establish and implement, through the respective
Centers, a comprehensive program to improve the
provision of treatment and related services to
individuals with respect to substance use disorders and
mental illness and to improve prevention services,
promote mental health and protect the legal rights of
individuals with mental illnesses and individuals with
substance use disorders;
(3) carry out the administrative and financial
management, policy development and planning,
evaluation, knowledge dissemination, and public
information functions that are required for the
implementation of this title;
(4) assure that the Administration conduct and
coordinate demonstration projects, evaluations, and
service system assessments and other activities
necessary to improve the availability and quality of
treatment, prevention and related services;
(5) support activities that will improve the
provision of treatment, prevention and related
services, including the development of national mental
health and substance use disorder goals and model
programs;
(6) in cooperation with the National Institutes of
Health, the Centers for Disease Control and Prevention,
and the Health Resources and Services Administration,
develop educational materials and intervention
strategies to reduce the risks of HIV, hepatitis,
tuberculosis, and other communicable diseases among
individuals with mental or substance use disorders, and
to develop appropriate mental health services for
individuals with such diseases or disorders;
(7) coordinate Federal policy with respect to the
provision of treatment services for substance use
disorders, including services that utilize drugs or
devices approved or cleared by the Food and Drug
Administration for the treatment of substance use
disorders;
(8) conduct programs, and assure the coordination of
such programs with activities of the National
Institutes of Health and the Agency for Healthcare
Research and Quality, as appropriate, to evaluate the
process, outcomes and community impact of prevention
and treatment services and systems of care in order to
identify the manner in which such services can most
effectively be provided;
(9) collaborate with the Director of the National
Institutes of Health in the development and maintenance
of a system by which the relevant research findings of
the [National Institute on Drug Abuse] National
Institute on Drugs and Addiction, the [National
Institute on Alcohol Abuse and Alcoholism] National
Institute on Alcohol Effects and Alcohol-Associated
Disorders, the National Institute of Mental Health,
and, as appropriate, the Agency for Healthcare Research
and Quality are disseminated to service providers in a
manner designed to improve the delivery and
effectiveness of prevention, treatment, and recovery
support services and are appropriately incorporated
into programs carried out by the Administration;
(10) encourage public and private entities that
provide health insurance to provide benefits for
substance use disorder and mental health services;
(11) work with relevant agencies of the Department of
Health and Human Services on integrating mental health
promotion and substance use disorder prevention with
general health promotion and disease prevention and
integrating mental and substance use disorders
treatment services with physical health treatment
services;
(12) monitor compliance by hospitals and other
facilities with the requirements of sections 542 and
543;
(13) with respect to grant programs authorized under
this title or part B of title XIX, or grant programs
otherwise funded by the Administration--
(A) require that all grants that are awarded
for the provision of services are subject to
performance and outcome evaluations;
(B) ensure that the director of each Center
of the Administration consistently documents
the application of criteria when awarding
grants and the ongoing oversight of grantees
after such grants are awarded;
(C) require that all grants that are awarded
to entities other than States are awarded only
after the State in which the entity intends to
provide services--
(i) is notified of the pendency of
the grant application; and
(ii) is afforded an opportunity to
comment on the merits of the
application; and
(D) inform a State when any funds are awarded
through such a grant to any entity within such
State;
(14) assure that services provided with amounts
appropriated under this title are provided bilingually,
if appropriate;
(15) improve coordination among prevention programs,
treatment facilities and nonhealth care systems such as
employers, labor unions, and schools, and encourage the
adoption of employee assistance programs and student
assistance programs;
(16) maintain a clearinghouse for substance use
disorder information, including evidence-based and
promising best practices for prevention, treatment, and
recovery support services for individuals with mental
and substance use disorders, to assure the widespread
dissemination of such information to States, political
subdivisions, educational agencies and institutions,
treatment providers, and the general public;
(17) in collaboration with the National Institute on
Aging, and in consultation with the [National Institute
on Drug Abuse] National Institute on Drugs and
Addiction, the [National Institute on Alcohol Abuse and
Alcoholism] National Institute on Alcohol Effects and
Alcohol-Associated Disorders and the National Institute
of Mental Health, as appropriate, promote and evaluate
substance use disorder services for older Americans in
need of such services, and mental health services for
older Americans who are seriously mentally ill;
(18) promote the coordination of service programs
conducted by other departments, agencies, organizations
and individuals that are or may be related to the
problems of individuals suffering from mental illness
or substance abuse, including liaisons with the Social
Security Administration, Centers for Medicare &
Medicaid Services, and other programs of the
Department, as well as liaisons with the Department of
Education, Department of Justice, and other Federal
Departments and offices, as appropriate;
(19) consult with State, local, and tribal
governments, nongovernmental entities, and individuals
with mental illness, particularly adults with a serious
mental illness, children with a serious emotional
disturbance, and the family members of such adults and
children, with respect to improving community-based and
other mental health services;
(20) collaborate with the Secretary of Defense and
the Secretary of Veterans Affairs to improve the
provision of mental and substance use disorder services
provided by the Department of Defense and the
Department of Veterans Affairs to members of the Armed
Forces, veterans, and the family members of such
members and veterans, including through the provision
of services using the telehealth capabilities of the
Department of Defense and the Department of Veterans
Affairs;
(21) collaborate with the heads of relevant Federal
agencies and departments, States, communities, and
nongovernmental experts to improve mental and substance
use disorders services for chronically homeless
individuals, including by designing strategies to
provide such services in supportive housing;
(22) work with States and other stakeholders to
develop and support activities to recruit and retain a
workforce addressing mental and substance use
disorders;
(23) collaborate with the Attorney General and
representatives of the criminal justice system to
improve mental and substance use disorders services for
individuals who have been arrested or incarcerated;
(24) after providing an opportunity for public input,
set standards for grant programs under this title for
mental and substance use disorders services and
prevention programs, which standards may address--
(A) the capacity of the grantee to implement
the award;
(B) requirements for the description of the
program implementation approach;
(C) the extent to which the grant plan
submitted by the grantee as part of its
application must explain how the grantee will
reach the population of focus and provide a
statement of need, which may include
information on how the grantee will increase
access to services and a description of
measurable objectives for improving outcomes;
(D) the extent to which the grantee must
collect and report on required performance
measures; and
(E) the extent to which the grantee is
proposing to use evidence-based practices; and
(25) advance, through existing programs, the use of
performance metrics, including those based on the
recommendations on performance metrics from the
Assistant Secretary for Planning and Evaluation under
section 6021(d) of the Helping Families in Mental
Health Crisis Reform Act of 2016.
(e) Associate Administrator for Alcohol Prevention and
Treatment Policy.--
(1) In general.--There may be in the Administration
an Associate Administrator for Alcohol Prevention and
Treatment Policy to whom the Assistant Secretary may
delegate the functions of promoting, monitoring, and
evaluating service programs for the prevention and
treatment of alcoholism and alcohol abuse within the
[Center for Substance Abuse Prevention] Center for
Substance Use Prevention Services, the [Center for
Substance Abuse Treatment] Center for Substance Use
Services and the Center for Mental Health Services, and
coordinating such programs among the Centers, and among
the Centers and other public and private entities. The
Associate Administrator also may ensure that alcohol
prevention, education, and policy strategies are
integrated into all programs of the Centers that
address substance abuse prevention, education, and
policy, and that the [Center for Substance Abuse
Prevention] Center for Substance Use Prevention
Services addresses the Healthy People 2010 goals and
the National Dietary Guidelines of the Department of
Health and Human Services and the Department of
Agriculture related to alcohol consumption.
(2) Plan.--
(A) The Assistant Secretary, acting through
the Associate Administrator for Alcohol
Prevention and Treatment Policy, shall develop,
and periodically review and as appropriate
revise, a plan for programs and policies to
treat and prevent alcoholism and alcohol abuse.
The plan shall be developed (and reviewed and
revised) in collaboration with the Directors of
the Centers of the Administration and in
consultation with members of other Federal
agencies and public and private entities.
(B) Not later than 1 year after the date of
the enactment of the ADAMHA Reorganization Act,
the Assistant Secretary shall submit to the
Congress the first plan developed under
subparagraph (A).
(3) Report.--
(A) Not less than once during each 2 years,
the Assistant Secretary, acting through the
Associate Administrator for Alcohol Prevention
and Treatment Policy, shall prepare a report
describing the alcoholism and alcohol abuse
prevention and treatment programs undertaken by
the Administration and its agencies, and the
report shall include a detailed statement of
the expenditures made for the activities
reported on and the personnel used in
connection with such activities.
(B) Each report under subparagraph (A) shall
include a description of any revisions in the
plan under paragraph (2) made during the
preceding 2 years.
(C) Each report under subparagraph (A) shall
be submitted to the Assistant Secretary for
inclusion in the biennial report under
subsection (m).
(f) Associate Administrator for Women's Services.--
(1) Appointment.--The Assistant Secretary, with the
approval of the Secretary, shall appoint an Associate
Administrator for Women's Services who shall report
directly to the Assistant Secretary.
(2) Duties.--The Associate Administrator appointed
under paragraph (1) shall--
(A) establish a committee to be known as the
Coordinating Committee for Women's Services
(hereafter in this subparagraph referred to as
the ``Coordinating Committee''), which shall be
composed of the Directors of the agencies of
the Administration (or the designees of the
Directors);
(B) acting through the Coordinating
Committee, with respect to women's substance
abuse and mental health services--
(i) identify the need for such
services, and make an estimate each
fiscal year of the funds needed to
adequately support the services;
(ii) identify needs regarding the
coordination of services;
(iii) encourage the agencies of the
Administration to support such
services; and
(iv) assure that the unique needs of
minority women, including Native
American, Hispanic, African-American
and Asian women, are recognized and
addressed within the activities of the
Administration; and
(C) establish an advisory committee to be
known as the Advisory Committee for Women's
Services, which shall be composed of not more
than 10 individuals, a majority of whom shall
be women, who are not officers or employees of
the Federal Government, to be appointed by the
Assistant Secretary from among physicians,
practitioners, treatment providers, and other
health professionals, whose clinical practice,
specialization, or professional expertise
includes a significant focus on women's
substance abuse and mental health conditions,
that shall--
(i) advise the Associate
Administrator on appropriate activities
to be undertaken by the agencies of the
Administration with respect to women's
substance abuse and mental health
services, including services which
require a multidisciplinary approach;
(ii) collect and review data,
including information provided by the
Secretary (including the material
referred to in paragraph (3)), and
report biannually to the Assistant
Secretary regarding the extent to which
women are represented among senior
personnel, and make recommendations
regarding improvement in the
participation of women in the workforce
of the Administration; and
(iii) prepare, for inclusion in the
biennial report required pursuant to
subsection (m), a description of
activities of the Committee, including
findings made by the Committee
regarding--
(I) the extent of
expenditures made for women's
substance abuse and mental
health services by the agencies
of the Administration; and
(II) the estimated level of
funding needed for substance
abuse and mental health
services to meet the needs of
women;
(D) improve the collection of data on women's
health by--
(i) reviewing the current data at the
Administration to determine its
uniformity and applicability;
(ii) developing standards for all
programs funded by the Administration
so that data are, to the extent
practicable, collected and reported
using common reporting formats,
linkages and definitions; and
(iii) reporting to the Assistant
Secretary a plan for incorporating the
standards developed under clause (ii)
in all Administration programs and a
plan to assure that the data so
collected are accessible to health
professionals, providers, researchers,
and members of the public; and
(E) shall establish, maintain, and operate a
program to provide information on women's
substance abuse and mental health services.
(3) Study.--
(A) The Secretary, acting through the
Assistant Secretary for Personnel, shall
conduct a study to evaluate the extent to which
women are represented among senior personnel at
the Administration.
(B) Not later than 90 days after the date of
the enactment of the ADAMHA Reorganization Act,
the Assistant Secretary for Personnel shall
provide the Advisory Committee for Women's
Services with a study plan, including the
methodology of the study and any sampling
frames. Not later than 180 days after such date
of enactment, the Assistant Secretary shall
prepare and submit directly to the Advisory
Committee a report concerning the results of
the study conducted under subparagraph (A).
(C) The Secretary shall prepare and provide
to the Advisory Committee for Women's Services
any additional data as requested.
(4) Office.--Nothing in this subsection shall be
construed to preclude the Secretary from establishing
within the Substance Abuse and Mental Health
Administration an Office of Women's Health.
(5) Definition.--For purposes of this subsection, the
term ``women's substance abuse and mental health
conditions'', with respect to women of all age, ethnic,
and racial groups, means all aspects of substance abuse
and mental illness--
(A) unique to or more prevalent among women;
or
(B) with respect to which there have been
insufficient services involving women or
insufficient data.
(g) Chief Medical Officer.--
(1) In general.--The Assistant Secretary, with the
approval of the Secretary, shall appoint a Chief
Medical Officer to serve within the Administration.
(2) Eligible candidates.--The Assistant Secretary
shall select the Chief Medical Officer from among
individuals who--
(A) have a doctoral degree in medicine or
osteopathic medicine;
(B) have experience in the provision of
mental or substance use disorder services;
(C) have experience working with mental or
substance use disorder programs;
(D) have an understanding of biological,
psychosocial, and pharmaceutical treatments of
mental or substance use disorders; and
(E) are licensed to practice medicine in one
or more States.
(3) Duties.--The Chief Medical Officer shall--
(A) serve as a liaison between the
Administration and providers of mental and
substance use disorders prevention, treatment,
and recovery services;
(B) assist the Assistant Secretary in the
evaluation, organization, integration, and
coordination of programs operated by the
Administration;
(C) promote evidence-based and promising best
practices, including culturally and
linguistically appropriate practices, as
appropriate, for the prevention and treatment
of, and recovery from, mental and substance use
disorders, including serious mental illness and
serious emotional disturbances;
(D) participate in regular strategic planning
with the Administration;
(E) coordinate with the Assistant Secretary
for Planning and Evaluation to assess the use
of performance metrics to evaluate activities
within the Administration related to mental and
substance use disorders; and
(F) coordinate with the Assistant Secretary
to ensure mental and substance use disorders
grant programs within the Administration
consistently utilize appropriate performance
metrics and evaluation designs.
(h) Services of Experts.--
(1) In general.--The Assistant Secretary may obtain
(in accordance with section 3109 of title 5, United
States Code, but without regard to the limitation in
such section on the number of days or the period of
service) the services of not more than 20 experts or
consultants who have professional qualifications. Such
experts and consultants shall be obtained for the
Administration and for each of its agencies.
(2) Compensation and expenses.--
(A) Experts and consultants whose services
are obtained under paragraph (1) shall be paid
or reimbursed for their expenses associated
with traveling to and from their assignment
location in accordance with sections 5724,
5724a(a), 5724a(c), and 5726(c) of title 5,
United States Code.
(B) Expenses specified in subparagraph (A)
may not be allowed in connection with the
assignment of an expert or consultant whose
services are obtained under paragraph (1),
unless and until the expert or consultant
agrees in writing to complete the entire period
of assignment or one year, whichever is
shorter, unless separated or reassigned for
reasons beyond the control of the expert or
consultant that are acceptable to the
Secretary. If the expert or consultant violates
the agreement, the money spent by the United
States for the expenses specified in
subparagraph (A) is recoverable from the expert
or consultant as a debt of the United States.
The Secretary may waive in whole or in part a
right of recovery under this subparagraph.
(i) Peer Review Groups.--The Assistant Secretary shall,
without regard to the provisions of title 5, United States
Code, governing appointments in the competitive service, and
without regard to the provisions of chapter 51 and subchapter
III of chapter 53 of such title, relating to classification and
General Schedule pay rates, establish such peer review groups
and program advisory committees as are needed to carry out the
requirements of this title and appoint and pay members of such
groups, except that officers and employees of the United States
shall not receive additional compensation for services as
members of such groups. The Federal Advisory Committee Act
shall not apply to the duration of a peer review group
appointed under this subsection.
(j) Voluntary Services.--The Assistant Secretary may accept
voluntary and uncompensated services.
(k) Administration.--The Assistant Secretary shall ensure
that programs and activities assigned under this title to the
Administration are fully administered by the respective Centers
to which such programs and activities are assigned.
(l) Strategic Plan.--
(1) In general.--Not later than September 30, 2018,
and every 4 years thereafter, the Assistant Secretary
shall develop and carry out a strategic plan in
accordance with this subsection for the planning and
operation of activities carried out by the
Administration, including evidence-based programs.
(2) Coordination.--In developing and carrying out the
strategic plan under this subsection, the Assistant
Secretary shall take into consideration the findings
and recommendations of the Assistant Secretary for
Planning and Evaluation under section 6021(d) of the
Helping Families in Mental Health Crisis Reform Act of
2016 and the report of the Interdepartmental Serious
Mental Illness Coordinating Committee under section
6031 of such Act.
(3) Publication of plan.--Not later than September
30, 2018, and every 4 years thereafter, the Assistant
Secretary shall--
(A) submit the strategic plan developed under
paragraph (1) to the Committee on Energy and
Commerce and the Committee on Appropriations of
the House of Representatives and the Committee
on Health, Education, Labor, and Pensions and
the Committee on Appropriations of the Senate;
and
(B) post such plan on the Internet website of
the Administration.
(4) Contents.--The strategic plan developed under
paragraph (1) shall--
(A) identify strategic priorities, goals, and
measurable objectives for mental and substance
use disorders activities and programs operated
and supported by the Administration, including
priorities to prevent or eliminate the burden
of mental and substance use disorders;
(B) identify ways to improve the quality of
services for individuals with mental and
substance use disorders, and to reduce
homelessness, arrest, incarceration, violence,
including self-directed violence, and
unnecessary hospitalization of individuals with
a mental or substance use disorder, including
adults with a serious mental illness or
children with a serious emotional disturbance;
(C) ensure that programs provide, as
appropriate, access to effective and evidence-
based prevention, diagnosis, intervention,
treatment, and recovery services, including
culturally and linguistically appropriate
services, as appropriate, for individuals with
a mental or substance use disorder;
(D) identify opportunities to collaborate
with the Health Resources and Services
Administration to develop or improve--
(i) initiatives to encourage
individuals to pursue careers
(especially in rural and underserved
areas and with rural and underserved
populations) as psychiatrists,
including child and adolescent
psychiatrists, psychologists,
psychiatric nurse practitioners,
physician assistants, clinical social
workers, certified peer support
specialists, licensed professional
counselors, or other licensed or
certified mental health or substance
use disorder professionals, including
such professionals specializing in the
diagnosis, evaluation, or treatment of
adults with a serious mental illness or
children with a serious emotional
disturbance; and
(ii) a strategy to improve the
recruitment, training, and retention of
a workforce for the treatment of
individuals with mental or substance
use disorders, or co-occurring
disorders;
(E) identify opportunities to improve
collaboration with States, local governments,
communities, and Indian tribes and tribal
organizations (as such terms are defined in
section 4 of the Indian Self-Determination and
Education Assistance Act); and
(F) specify a strategy to disseminate
evidence-based and promising best practices
related to prevention, diagnosis, early
intervention, treatment, and recovery services
related to mental illness, particularly for
adults with a serious mental illness and
children with a serious emotional disturbance,
and for individuals with a substance use
disorder.
(m) Biennial Report Concerning Activities and Progress.--Not
later than September 30, 2020, and every 2 years thereafter,
the Assistant Secretary shall prepare and submit to the
Committee on Energy and Commerce and the Committee on
Appropriations of the House of Representatives and the
Committee on Health, Education, Labor, and Pensions and the
Committee on Appropriations of the Senate, and post on the
Internet website of the Administration, a report containing at
a minimum--
(1) a review of activities conducted or supported by
the Administration, including progress toward strategic
priorities, goals, and objectives identified in the
strategic plan developed under subsection (l);
(2) an assessment of programs and activities carried
out by the Assistant Secretary, including the extent to
which programs and activities under this title and part
B of title XIX meet identified goals and performance
measures developed for the respective programs and
activities;
(3) a description of the progress made in addressing
gaps in mental and substance use disorders prevention,
treatment, and recovery services and improving outcomes
by the Administration, including with respect to
serious mental illnesses, serious emotional
disturbances, and co-occurring disorders;
(4) a description of the manner in which the
Administration coordinates and partners with other
Federal agencies and departments related to mental and
substance use disorders, including activities related
to--
(A) the implementation and dissemination of
research findings into improved programs,
including with respect to how advances in
serious mental illness and serious emotional
disturbance research have been incorporated
into programs;
(B) the recruitment, training, and retention
of a mental and substance use disorders
workforce;
(C) the integration of mental disorder
services, substance use disorder services, and
physical health services;
(D) homelessness; and
(E) veterans;
(5) a description of the manner in which the
Administration promotes coordination by grantees under
this title, and part B of title XIX, with State or
local agencies; and
(6) a description of the activities carried out under
section 501A(e), with respect to mental and substance
use disorders, including--
(A) the number and a description of grants
awarded;
(B) the total amount of funding for grants
awarded;
(C) a description of the activities supported
through such grants, including outcomes of
programs supported; and
(D) information on how the National Mental
Health and Substance Use Policy Laboratory is
consulting with the Assistant Secretary for
Planning and Evaluation and collaborating with
the [Center for Substance Abuse Treatment]
Center for Substance Use Services, the [Center
for Substance Abuse Prevention] Center for
Substance Use Prevention Services, the Center
for Behavioral Health Statistics and Quality,
and the Center for Mental Health Services to
carry out such activities; and
(7) recommendations made by the Assistant Secretary
for Planning and Evaluation under section 6021 of the
Helping Families in Mental Health Crisis Reform Act of
2016 to improve programs within the Administration, and
actions taken in response to such recommendations to
improve programs within the Administration.
The Assistant Secretary may meet reporting requirements
established under this title by providing the contents of such
reports as an addendum to the biennial report established under
this subsection, notwithstanding the timeline of other
reporting requirements in this title. Nothing in this
subsection shall be construed to alter the content requirements
of such reports or authorize the Assistant Secretary to alter
the timeline of any such reports to be less frequent than
biennially, unless as specified in this title.
(n) Applications for Grants and Contracts.--With respect to
awards of grants, cooperative agreements, and contracts under
this title, the Assistant Secretary, or the Director of the
Center involved, as the case may be, may not make such an award
unless--
(1) an application for the award is submitted to the
official involved;
(2) with respect to carrying out the purpose for
which the award is to be provided, the application
provides assurances of compliance satisfactory to such
official; and
(3) the application is otherwise in such form, is
made in such manner, and contains such agreements,
assurances, and information as the official determines
to be necessary to carry out the purpose for which the
award is to be provided.
(o) Emergency Response.--
(1) In general.--Notwithstanding section 504 and
except as provided in paragraph (2), the Secretary may
use not to exceed 2.5 percent of all amounts
appropriated under this title for a fiscal year to make
noncompetitive grants, contracts or cooperative
agreements to public entities to enable such entities
to address emergency substance abuse or mental health
needs in local communities.
(2) Exceptions.--Amounts appropriated under part C
shall not be subject to paragraph (1).
(3) Emergencies.--The Secretary shall establish
criteria for determining that a substance abuse or
mental health emergency exists and publish such
criteria in the Federal Register prior to providing
funds under this subsection.
(4) Emergency response.--Amounts made available for
carrying out this subsection shall remain available
through the end of the fiscal year following the fiscal
year for which such amounts are appropriated.
(p) Limitation on the Use of Certain Information.--No
information, if an establishment or person supplying the
information or described in it is identifiable, obtained in the
course of activities undertaken or supported under section 505
may be used for any purpose other than the purpose for which it
was supplied unless such establishment or person has consented
(as determined under regulations of the Secretary) to its use
for such other purpose. Such information may not be published
or released in other form if the person who supplied the
information or who is described in it is identifiable unless
such person has consented (as determined under regulations of
the Secretary) to its publication or release in other form.
(q) Authorization of Appropriations.--For the purpose of
providing grants, cooperative agreements, and contracts under
this section, there are authorized to be appropriated
$25,000,000 for fiscal year 2001, and such sums as may be
necessary for each of the fiscal years 2002 and 2003.
SEC. 501A. NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY LABORATORY.
(a) In General.--There shall be established within the
Administration a National Mental Health and Substance Use
Policy Laboratory (referred to in this section as the
``Laboratory'').
(b) Responsibilities.--The Laboratory shall--
(1) continue to carry out the authorities and
activities that were in effect for the Office of
Policy, Planning, and Innovation as such Office existed
prior to the date of enactment of the Helping Families
in Mental Health Crisis Reform Act of 2016;
(2) identify, coordinate, and facilitate the
implementation of policy changes likely to have a
significant effect on mental health, mental illness,
recovery supports, and the prevention and treatment of
substance use disorder services;
(3) work with the Center for Behavioral Health
Statistics and Quality to collect, as appropriate,
information from grantees under programs operated by
the Administration in order to evaluate and disseminate
information on evidence-based practices, including
culturally and linguistically appropriate services, as
appropriate, and service delivery models;
(4) provide leadership in identifying and
coordinating policies and programs, including evidence-
based programs, related to mental and substance use
disorders;
(5) periodically review programs and activities
operated by the Administration relating to the
diagnosis or prevention of, treatment for, and recovery
from, mental and substance use disorders to--
(A) identify any such programs or activities
that are duplicative;
(B) identify any such programs or activities
that are not evidence-based, effective, or
efficient; and
(C) formulate recommendations for
coordinating, eliminating, or improving
programs or activities identified under
subparagraph (A) or (B) and merging such
programs or activities into other successful
programs or activities;
(6) issue and periodically update information for
entities applying for grants or cooperative agreements
from the [Substance Abuse and Mental Health Services
Administration] Substance Use And Mental Health
Services Administration in order to--
(A) encourage the implementation and
replication of evidence-based practices; and
(B) provide technical assistance to
applicants for funding, including with respect
to justifications for such programs and
activities; and
(7) carry out other activities as deemed necessary to
continue to encourage innovation and disseminate
evidence-based programs and practices.
(c) Evidence-based Practices and Service Delivery Models.--
(1) In general.--In carrying out subsection (b)(3),
the Laboratory--
(A) may give preference to models that
improve--
(i) the coordination between mental
health and physical health providers;
(ii) the coordination among such
providers and the justice and
corrections system; and
(iii) the cost effectiveness,
quality, effectiveness, and efficiency
of health care services furnished to
adults with a serious mental illness,
children with a serious emotional
disturbance, or individuals in a mental
health crisis; and
(B) may include clinical protocols and
practices that address the needs of individuals
with early serious mental illness.
(2) Consultation.--In carrying out this section, the
Laboratory shall consult with--
(A) the Chief Medical Officer appointed under
section 501(g);
(B) representatives of the National Institute
of Mental Health, the [National Institute on
Drug Abuse] National Institute on Drugs and
Addiction, and the [National Institute on
Alcohol Abuse and Alcoholism] National
Institute on Alcohol Effects and Alcohol-
Associated Disorders, on an ongoing basis;
(C) other appropriate Federal agencies;
(D) clinical and analytical experts with
expertise in psychiatric medical care and
clinical psychological care, health care
management, education, corrections health care,
and mental health court systems, as
appropriate; and
(E) other individuals and agencies as
determined appropriate by the Assistant
Secretary.
(d) Deadline for Beginning Implementation.--The Laboratory
shall begin implementation of this section not later than
January 1, 2018.
(e) Promoting Innovation.--
(1) In general.--The Assistant Secretary, in
coordination with the Laboratory, may award grants to
States, local governments, Indian tribes or tribal
organizations (as such terms are defined in section 4
of the Indian Self-Determination and Education
Assistance Act), educational institutions, and
nonprofit organizations to develop evidence-based
interventions, including culturally and linguistically
appropriate services, as appropriate, for--
(A) evaluating a model that has been
scientifically demonstrated to show promise,
but would benefit from further applied
development, for--
(i) enhancing the prevention,
diagnosis, intervention, and treatment
of, and recovery from, mental illness,
serious emotional disturbances,
substance use disorders, and co-
occurring illness or disorders; or
(ii) integrating or coordinating
physical health services and mental and
substance use disorders services; and
(B) expanding, replicating, or scaling
evidence-based programs across a wider area to
enhance effective screening, early diagnosis,
intervention, and treatment with respect to
mental illness, serious mental illness, serious
emotional disturbances, and substance use
disorders, primarily by--
(i) applying such evidence-based
programs to the delivery of care,
including by training staff in
effective evidence-based treatments; or
(ii) integrating such evidence-based
programs into models of care across
specialties and jurisdictions.
(2) Consultation.--In awarding grants under this
subsection, the Assistant Secretary shall, as
appropriate, consult with the Chief Medical Officer,
appointed under section 501(g), the advisory councils
described in section 502, the National Institute of
Mental Health, the [National Institute on Drug Abuse]
National Institute on Drugs and Addiction, and the
[National Institute on Alcohol Abuse and Alcoholism]
National Institute on Alcohol Effects and Alcohol-
Associated Disorders, as appropriate.
(3) Authorization of appropriations.--There are
authorized to be appropriated--
(A) to carry out paragraph (1)(A), $7,000,000
for the period of fiscal years 2018 through
2020; and
(B) to carry out paragraph (1)(B), $7,000,000
for the period of fiscal years 2018 through
2020.
advisory councils
Sec. 502. (a) Appointment.--
(1) In general.--The Secretary shall appoint an
advisory council for--
(A) the [Substance Abuse and Mental Health
Services Administration] Substance Use And
Mental Health Services Administration;
(B) the [Center for Substance Abuse
Treatment] Center for Substance Use Services;
(C) the [Center for Substance Abuse
Prevention] Center for Substance Use Prevention
Services; and
(D) the Center for Mental Health Services.
Each such advisory council shall advise, consult with,
and make recommendations to the Secretary and the
Assistant Secretary or Director of the Administration
or Center for which the advisory council is established
concerning matters relating to the activities carried
out by and through the Administration or Center and the
policies respecting such activities.
(2) Function and activities.--An advisory council--
(A)(i) may on the basis of the materials
provided by the organization respecting
activities conducted at the organization, make
recommendations to the Assistant Secretary or
Director of the Administration or Center for
which it was established respecting such
activities;
(ii) shall review applications submitted for
grants and cooperative agreements for
activities for which advisory council approval
is required under section 504(d)(2) and
recommend for approval applications for
projects that show promise of making valuable
contributions to the Administration's mission;
and
(iii) may review any grant, contract, or
cooperative agreement proposed to be made or
entered into by the organization;
(B) may collect, by correspondence or by
personal investigation, information as to
studies and services that are being carried on
in the United States or any other country as to
the diseases, disorders, or other aspects of
human health with respect to which the
organization was established and with the
approval of the Assistant Secretary or
Director, whichever is appropriate, make such
information available through appropriate
publications for the benefit of public and
private health entities and health professions
personnel and for the information of the
general public; and
(C) may appoint subcommittees and convene
workshops and conferences.
(b) Membership.--
(1) In general.--Each advisory council shall consist
of nonvoting ex officio members and not more than 12
members to be appointed by the Secretary under
paragraph (3).
(2) Ex officio members.--The ex officio members of an
advisory council shall consist of--
(A) the Secretary;
(B) the Assistant Secretary;
(C) the Director of the Center for which the
council is established;
(D) the Under Secretary for Health of the
Department of Veterans Affairs;
(E) the Assistant Secretary for Defense for
Health Affairs (or the designates of such
officers);
(F) the Chief Medical Officer, appointed
under section 501(g);
(G) the Director of the National Institute of
Mental Health for the advisory councils
appointed under subsections (a)(1)(A) and
(a)(1)(D);
(H) the Director of the [National Institute
on Drug Abuse] National Institute on Drugs and
Addiction for the advisory councils appointed
under subsections (a)(1)(A), (a)(1)(B), and
(a)(1)(C);
(I) the Director of the [National Institute
on Alcohol Abuse and Alcoholism] National
Institute on Alcohol Effects and Alcohol-
Associated Disorders for the advisory councils
appointed under subsections (a)(1)(A),
(a)(1)(B), and (a)(1)(C); and
(J) such additional officers or employees of
the United States as the Secretary determines
necessary for the advisory council to
effectively carry out its functions.
(3) Appointed members.--Individuals shall be
appointed to an advisory council under paragraph (1) as
follows:
(A) Nine of the members shall be appointed by
the Secretary from among the leading
representatives of the health disciplines
(including public health and behavioral and
social sciences) relevant to the activities of
the Administration or Center for which the
advisory council is established.
(B) Three of the members shall be appointed
by the Secretary from the general public and
shall include leaders in fields of public
policy, public relations, law, health policy
economics, or management.
(C) Not less than half of the members of the
advisory council appointed under subsection
(a)(1)(D)--
(i) shall--
(I) have a medical degree;
(II) have a doctoral degree
in psychology; or
(III) have an advanced degree
in nursing or social work from
an accredited graduate school
or be a certified physician
assistant; and
(ii) shall specialize in the mental
health field.
(D) Not less than half of the members of the
advisory councils appointed under subsections
(a)(1)(B) and (a)(1)(C)--
(i) shall--
(I) have a medical degree;
(II) have a doctoral degree;
or
(III) have an advanced degree
in nursing, public health,
behavioral or social sciences,
or social work from an
accredited graduate school or
be a certified physician
assistant; and
(ii) shall have experience in the
provision of substance use disorder
services or the development and
implementation of programs to prevent
substance misuse.
(4) Compensation.--Members of an advisory council who
are officers or employees of the United States shall
not receive any compensation for service on the
advisory council. The remaining members of an advisory
council shall receive, for each day (including travel
time) they are engaged in the performance of the
functions of the advisory council, compensation at
rates not to exceed the daily equivalent to the annual
rate in effect for grade GS-18 of the General Schedule.
(c) Terms of Office.--
(1) In general.--The term of office of a member of an
advisory council appointed under subsection (b) shall
be 4 years, except that any member appointed to fill a
vacancy for an unexpired term shall serve for the
remainder of such term. The Secretary shall make
appointments to an advisory council in such a manner as
to ensure that the terms of the members not all expire
in the same year. A member of an advisory council may
serve after the expiration of such member's term until
a successor has been appointed and taken office.
(2) Reappointments.--A member who has been appointed
to an advisory council for a term of 4 years may not be
reappointed to an advisory council during the 2-year
period beginning on the date on which such 4-year term
expired.
(3) Time for appointment.--If a vacancy occurs in an
advisory council among the members under subsection
(b), the Secretary shall make an appointment to fill
such vacancy within 90 days from the date the vacancy
occurs.
(d) Chair.--The Secretary shall select a member of an
advisory council to serve as the chair of the council. The
Secretary may so select an individual from among the appointed
members, or may select the Assistant Secretary or the Director
of the Center involved. The term of office of the chair shall
be 2 years.
(e) Meetings.--An advisory council shall meet at the call of
the chairperson or upon the request of the Assistant Secretary
or Director of the Administration or Center for which the
advisory council is established, but in no event less than 2
times during each fiscal year. The location of the meetings of
each advisory council shall be subject to the approval of the
Assistant Secretary or Director of Administration or Center for
which the council was established.
(f) Executive Secretary and Staff.--The Assistant Secretary
or Director of the Administration or Center for which the
advisory council is established shall designate a member of the
staff of the Administration or Center for which the advisory
council is established to serve as the Executive Secretary of
the advisory council. The Assistant Secretary or Director shall
make available to the advisory council such staff, information,
and other assistance as it may require to carry out its
functions. The Assistant Secretary or Director shall provide
orientation and training for new members of the advisory
council to provide for their effective participation in the
functions of the advisory council.
* * * * * * *
Part B--Centers and Programs
Subpart 1--Center for Substance Abuse Treatment
[center for substance abuse treatment] center for substance use
services
Sec. 507. (a) Establishment.--There is established in the
Administration a [Center for Substance Abuse Treatment] Center
for Substance Use Services (hereafter in this section referred
to as the ``Center''). The Center shall be headed by a Director
(hereafter in this section referred to as the ``Director'')
appointed by the Secretary from among individuals with
extensive experience or academic qualifications in the
treatment of substance use disorders or in the evaluation of
substance use disorder treatment systems.
(b) Duties.--The Director of the Center shall--
(1) administer the substance use disorder treatment
block grant program authorized in section 1921;
(2) ensure that emphasis is placed on children and
adolescents in the development of treatment programs;
(3) collaborate with the Attorney General to develop
programs to provide substance use disorder treatment
services to individuals who have had contact with the
Justice system, especially adolescents;
(4) collaborate with the Director of the [Center for
Substance Abuse Prevention] Center for Substance Use
Prevention Services in order to provide outreach
services to identify individuals in need of treatment
services, with emphasis on the provision of such
services to pregnant and postpartum women and their
infants and to individuals who illicitly use drugs
intravenously;
(5) collaborate with the Director of the [National
Institute on Drug Abuse] National Institute on Drugs
and Addiction, with the Director of the [National
Institute on Alcohol Abuse and Alcoholism] National
Institute on Alcohol Effects and Alcohol-Associated
Disorders, and with the States to promote the study,
dissemination, and implementation of research findings
that will improve the delivery and effectiveness of
treatment services;
(6) collaborate with the Administrator of the Health
Resources and Services Administration and the
Administrator of the Centers for Medicare & Medicaid
Services to promote the increased integration into the
mainstream of the health care system of the United
States of programs for providing treatment services;
(7) evaluate plans submitted by the States pursuant
to section 1932(a)(6) in order to determine whether the
plans adequately provide for the availability,
allocation, and effectiveness of treatment services;
(8) sponsor regional workshops on improving the
quality and availability of treatment services;
(9) provide technical assistance to public and
nonprofit private entities that provide treatment
services, including technical assistance with respect
to the process of submitting to the Director
applications for any program of grants or contracts;
(10) carry out activities to educate individuals on
the need for establishing treatment facilities within
their communities;
(11) encourage public and private entities that
provide health insurance to provide benefits for
outpatient treatment services and other nonhospital-
based treatment services;
(12) evaluate treatment programs to determine the
quality and appropriateness of various forms of
treatment, which shall be carried out through grants,
contracts, or cooperative agreements provided to public
or nonprofit private entities;
(13) ensure the consistent documentation of the
application of criteria when awarding grants and the
ongoing oversight of grantees after such grants are
awarded;
(14) work with States, providers, and individuals in
recovery, and their families, to promote the expansion
of recovery support services and systems of care
oriented toward recovery;
(15) in cooperation with the Secretary, implement and
disseminate, as appropriate, the recommendations in the
report entitled ``Protecting Our Infants Act: Final
Strategy'' issued by the Department of Health and Human
Services in 2017; and
(16) in cooperation with relevant stakeholders, and
through public-private partnerships, encourage
education about substance use disorders for pregnant
women and health care providers who treat pregnant
women and babies.
(c) Grants and Contracts.--In carrying out the duties
established in subsection (b), the Director may make grants to
and enter into contracts and cooperative agreements with public
and nonprofit private entities.
residential treatment programs for pregnant and postpartum women
Sec. 508. (a) In General.--The Director of the [Center for
Substance Abuse Treatment] Center for Substance Use Services
(referred to in this section as the ``Director'') shall provide
awards of grants, including the grants under subsection (r),
cooperative agreements or contracts to public and nonprofit
private entities for the purpose of providing to pregnant and
postpartum women treatment for substance use disorders through
programs in which, during the course of receiving treatment--
(1) the women reside in or receive outpatient
treatment services from facilities provided by the
programs;
(2) the minor children of the women reside with the
women in such facilities, if the women so request; and
(3) the services described in subsection (d) are
available to or on behalf of the women.
(b) Availability of Services for Each Participant.--A funding
agreement for an award under subsection (a) for an applicant is
that, in the program operated pursuant to such subsection--
(1) treatment services and each supplemental service
will be available through the applicant, either
directly or through agreements with other public or
nonprofit private entities; and
(2) the services will be made available to each woman
admitted to the program and her children.
(c) Individualized Plan of Services.--A funding agreement for
an award under subsection (a) for an applicant is that--
(1) in providing authorized services for an eligible
woman pursuant to such subsection, the applicant will,
in consultation with the women, prepare an
individualized plan for the provision of services for
the woman and her children; and
(2) treatment services under the plan will include--
(A) individual, group, and family counseling,
as appropriate, regarding substance use
disorders; and
(B) follow-up services to assist the woman in
preventing a relapse into such a disorder.
(d) Required Supplemental Services.--In the case of an
eligible woman, the services referred to in subsection (a)(3)
are as follows:
(1) Prenatal and postpartum health care.
(2) Referrals for necessary hospital services.
(3) For the infants and children of the woman--
(A) pediatric health care, including
treatment for any perinatal effects of a
maternal substance use disorder and including
screenings regarding the physical and mental
development of the infants and children;
(B) counseling and other mental health
services, in the case of children; and
(C) comprehensive social services.
(4) Providing therapeutic, comprehensive child care
for children during the periods in which the woman is
engaged in therapy or in other necessary health and
rehabilitative activities.
(5) Training in parenting.
(6) Counseling on the human immunodeficiency virus
and on acquired immune deficiency syndrome.
(7) Counseling on domestic violence and sexual abuse.
(8) Counseling on obtaining employment, including the
importance of graduating from a secondary school.
(9) Reasonable efforts to preserve and support the
family unit of the woman, including promoting the
appropriate involvement of parents and others, and
counseling the children of the woman.
(10) Planning for and counseling to assist reentry
into society, both before and after discharge,
including referrals to any public or nonprofit private
entities in the community involved that provide
services appropriate for the woman and the children of
the woman.
(11) Case management services, including--
(A) assessing the extent to which authorized
services are appropriate for the woman and any
child of such woman;
(B) in the case of the services that are
appropriate, ensuring that the services are
provided in a coordinated manner;
(C) assistance in establishing eligibility
for assistance under Federal, State, and local
programs providing health services, mental
health services, housing services, employment
services, educational services, or social
services; and
(D) family reunification with children in
kinship or foster care arrangements, where safe
and appropriate.
(e) Minimum Qualifications For Receipt of Award.--
(1) Certification by relevant state agency.--With
respect to the principal agency of the State involved
that administers programs relating to substance use
disorders, the Director may make an award under
subsection (a) to an applicant only if the agency has
certified to the Director that--
(A) the applicant has the capacity to carry
out a program described in subsection (a);
(B) the plans of the applicant for such a
program are consistent with the policies of
such agency regarding the treatment of
substance use disorders; and
(C) the applicant, or any entity through
which the applicant will provide authorized
services, meets all applicable State licensure
or certification requirements regarding the
provision of the services involved.
(2) Status as medicaid provider.--
(A) In general.--Subject to subparagraphs (B)
and (C), the Director may make an award under
subsection (a) only if, in the case of any
authorized service that is available pursuant
to the State plan approved under title XIX of
the Social Security Act for the State
involved--
(i) the applicant for the award will
provide the service directly, and the
applicant has entered into a
participation agreement under the State
plan and is qualified to receive
payments under such plan; or
(ii) the applicant will enter into an
agreement with a public or nonprofit
private entity under which the entity
will provide the service, and the
entity has entered into such a
participation agreement plan and is
qualified to receive such payments.
(B) Waiver of participation agreements.--
(i) In general.--In the case of an
entity making an agreement pursuant to
subparagraph (A)(ii) regarding the
provision of services, the requirement
established in such subparagraph
regarding a participation agreement
shall be waived by the Director if the
entity does not, in providing health
care services, impose a charge or
accept reimbursement available from any
third-party payor, including
reimbursement under any insurance
policy or under any Federal or State
health benefits plan.
(ii) Donations.--A determination by
the Director of whether an entity
referred to in clause (i) meets the
criteria for a waiver under such clause
shall be made without regard to whether
the entity accepts voluntary donations
regarding the provision of services to
the public.
(C) Nonapplication of certain requirements.--
With respect to any authorized service that is
available pursuant to the State plan described
in subparagraph (A), the requirements
established in such subparagraph shall not
apply to the provision of any such service by
an institution for mental diseases to an
individual who has attained 21 years of age and
who has not attained 65 years of age. For
purposes of the preceding sentence, the term
``institution for mental diseases'' has the
meaning given such term in section 1905(i) of
the Social Security Act.
(f) Requirement of Matching Funds.--
(1) In general.--With respect to the costs of the
program to be carried out by an applicant pursuant to
subsection (a), a funding agreement for an award under
such subsection is that the applicant will make
available (directly or through donations from public or
private entities) non-Federal contributions toward such
costs in an amount that--
(A) for the first fiscal year for which the
applicant receives payments under an award
under such subsection, is not less than $1 for
each $9 of Federal funds provided in the award;
(B) for any second such fiscal year, is not
less than $1 for each $9 of Federal funds
provided in the award; and
(C) for any subsequent such fiscal year, is
not less than $1 for each $3 of Federal funds
provided in the award.
(2) Determination of amount contributed.--Non-Federal
contributions required in paragraph (1) may be in cash
or in kind, fairly evaluated, including plant,
equipment, or services. Amounts provided by the Federal
Government, or services assisted or subsidized to any
significant extent by the Federal Government, may not
be included in determining the amount of such non-
Federal contributions.
(g) Outreach.--A funding agreement for an award under
subsection (a) for an applicant is that the applicant will
provide outreach services in the community involved to identify
women who have a substance use disorder and to encourage the
women to undergo treatment for such disorder.
(h) Accessibility of Program; Cultural Context of Services.--
A funding agreement for an award under subsection (a) for an
applicant is that--
(1) the program operated pursuant to such subsection
will be operated at a location that is accessible to
low-income pregnant and postpartum women; and
(2) authorized services will be provided in the
language and the cultural context that is most
appropriate.
(i) Continuing Education.--A funding agreement for an award
under subsection (a) is that the applicant involved will
provide for continuing education in treatment services for the
individuals who will provide treatment in the program to be
operated by the applicant pursuant to such subsection.
(j) Imposition of Charges.--A funding agreement for an award
under subsection (a) for an applicant is that, if a charge is
imposed for the provision of authorized services to or on
behalf of an eligible woman, such charge--
(1) will be made according to a schedule of charges
that is made available to the public;
(2) will be adjusted to reflect the income of the
woman involved; and
(3) will not be imposed on any such woman with an
income of less than 185 percent of the official poverty
line, as established by the Director of the Office of
Management and Budget and revised by the Secretary in
accordance with section 673(2) of the Omnibus Budget
Reconciliation Act of 1981.
(k) Reports to Director.--A funding agreement for an award
under subsection (a) is that the applicant involved will submit
to the Director a report--
(1) describing the utilization and costs of services
provided under the award;
(2) specifying the number of women served, the number
of infants served, and the type and costs of services
provided; and
(3) providing such other information as the Director
determines to be appropriate.
(l) Requirement of Application.--The Director may make an
award under subsection (a) only if an application for the award
is submitted to the Director containing such agreements, and
the application is in such form, is made in such manner, and
contains such other agreements and such assurances and
information as the Director determines to be necessary to carry
out this section.
(m) Allocation of Awards.--In making awards under subsection
(a), the Director shall give priority to an applicant that
agrees to use the award for a program serving an area that is a
rural area, an area designated under section 332 by the
Secretary as a health professional shortage area, or an area
determined by the Director to have a shortage of family-based
substance use disorder treatment options.
(n) Duration of Award.--The period during which payments are
made to an entity from an award under subsection (a) may not
exceed 5 years. The provision of such payments shall be subject
to annual approval by the Director of the payments and subject
to the availability of appropriations for the fiscal year
involved to make the payments. This subsection may not be
construed to establish a limitation on the number of awards
under such subsection that may be made to an entity.
(o) Evaluations; Dissemination of Findings.--The Director
shall, directly or through contract, provide for the conduct of
evaluations of programs carried out pursuant to subsection (a).
The Director shall disseminate to the States the findings made
as a result of the evaluations.
(p) Reports to Congress.--Not later than October 1, 1994, the
Director shall submit to the Committee on Energy and Commerce
of the House of Representatives, and to the Committee on Labor
and Human Resources of the Senate, a report describing programs
carried out pursuant to this section (other than subsection
(r)). Every 2 years thereafter, the Director shall prepare a
report describing such programs carried out during the
preceding 2 years, and shall submit the report to the Assistant
Secretary for inclusion in the biennial report under section
501(m). Each report under this subsection shall include a
summary of any evaluations conducted under subsection (m)
during the period with respect to which the report is prepared.
(q) Definitions.--For purposes of this section:
(1) The term ``authorized services'' means treatment
services and supplemental services.
(2) The term ``eligible woman'' means a woman who has
been admitted to a program operated pursuant to
subsection (a).
(3) The term ``funding agreement'', with respect to
an award under subsection (a), means that the Director
may make the award only if the applicant makes the
agreement involved.
(4) The term ``treatment services'' means treatment
for a substance use disorder, including the counseling
and services described in subsection (c)(2).
(5) The term ``supplemental services'' means the
services described in subsection (d).
(r) Pilot Program for State Substance Abuse Agencies.--
(1) In general.--From amounts made available under
subsection (s), the Director of the [Center for
Substance Abuse Treatment] Center for Substance Use
Services shall carry out a pilot program under which
competitive grants are made by the Director to State
substance abuse agencies--
(A) to enhance flexibility in the use of
funds designed to support family-based services
for pregnant and postpartum women with a
primary diagnosis of a substance use disorder,
including opioid use disorders;
(B) to help State substance abuse agencies
address identified gaps in services furnished
to such women along the continuum of care,
including services provided to women in
nonresidential-based settings; and
(C) to promote a coordinated, effective, and
efficient State system managed by State
substance abuse agencies by encouraging new
approaches and models of service delivery.
(2) Requirements.--In carrying out the pilot program
under this subsection, the Director shall--
(A) require State substance abuse agencies to
submit to the Director applications, in such
form and manner and containing such information
as specified by the Director, to be eligible to
receive a grant under the program;
(B) identify, based on such submitted
applications, State substance abuse agencies
that are eligible for such grants;
(C) require services proposed to be furnished
through such a grant to support family-based
treatment and other services for pregnant and
postpartum women with a primary diagnosis of a
substance use disorder, including opioid use
disorders;
(D) not require that services furnished
through such a grant be provided solely to
women that reside in facilities;
(E) not require that grant recipients under
the program make available through use of the
grant all the services described in subsection
(d); and
(F) consider not applying the requirements
described in paragraphs (1) and (2) of
subsection (f) to an applicant, depending on
the circumstances of the applicant.
(3) Required services.--
(A) In general.--The Director shall specify a
minimum set of services required to be made
available to eligible women through a grant
awarded under the pilot program under this
subsection. Such minimum set of services--
(i) shall include the services
requirements described in subsection
(c) and be based on the recommendations
submitted under subparagraph (B); and
(ii) may be selected from among the
services described in subsection (d)
and include other services as
appropriate.
(B) Stakeholder input.--The Director shall
convene and solicit recommendations from
stakeholders, including State substance abuse
agencies, health care providers, persons in
recovery from substance abuse, and other
appropriate individuals, for the minimum set of
services described in subparagraph (A).
(4) Duration.--The pilot program under this
subsection shall not exceed 5 years.
(5) Evaluation and report to congress.--
(A) In general.--The Director of the Center
for Behavioral Health Statistics and Quality
shall evaluate the pilot program at the
conclusion of the first grant cycle funded by
the pilot program.
(B) Report.--The Director of the Center for
Behavioral Health Statistics and Quality, in
coordination with the Director of the [Center
for Substance Abuse Treatment] Center for
Substance Use Services shall submit to the
relevant committees of jurisdiction of the
House of Representatives and the Senate a
report on the evaluation under subparagraph
(A). The report shall include, at a minimum--
(i) outcomes information from the
pilot program, including any resulting
reductions in the use of alcohol and
other drugs;
(ii) engagement in treatment
services;
(iii) retention in the appropriate
level and duration of services;
(iv) increased access to the use of
medications approved by the Food and
Drug Administration for the treatment
of substance use disorders in
combination with counseling; and
(v) other appropriate measures.
(C) Recommendation.--The report under
subparagraph (B) shall include a recommendation
by the Director of the [Center for Substance
Abuse Treatment] Center for Substance Use
Services as to whether the pilot program under
this subsection should be extended.
(6) State substance abuse agencies defined.--For
purposes of this subsection, the term ``State substance
abuse agency'' means, with respect to a State, the
agency in such State that manages the Substance Abuse
Prevention and Treatment Block Grant under part B of
title XIX.
(s) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $29,931,000 for each of fiscal years 2019 through
2023. Of the amounts made available for a year pursuant to the
previous sentence to carry out this section, not more than 25
percent of such amounts shall be made available for such year
to carry out subsection (r), other than paragraph (5) of such
subsection. Notwithstanding the preceding sentence, no funds
shall be made available to carry out subsection (r) for a
fiscal year unless the amount made available to carry out this
section for such fiscal year is more than the amount made
available to carry out this section for fiscal year 2016.
* * * * * * *
action by national institute on drug abuse and states concerning
military facilities
Sec. 513. (a) [Center for Substance Abuse Treatment] Center
for Substance Use Services.--The Director of the [Center for
Substance Abuse Treatment] Center for Substance Use Services
shall--
(1) coordinate with the agencies represented on the
Commission on Alternative Utilization of Military
Facilities the utilization of military facilities or
parts thereof, as identified by such Commission,
established under the National Defense Authorization
Act of 1989, that could be utilized or renovated to
house nonviolent persons for drug treatment purposes;
(2) notify State agencies responsible for the
oversight of drug abuse treatment entities and programs
of the availability of space at the installations
identified in paragraph (1); and
(3) assist State agencies responsible for the
oversight of drug abuse treatment entities and programs
in developing methods for adapting the installations
described in paragraph (1) into residential treatment
centers.
(b) States.--With regard to military facilities or parts
thereof, as identified by the Commission on Alternative
Utilization of Military Facilities established under section
3042 of the Comprehensive Alcohol Abuse, Drug Abuse, and Mental
Health Amendments Act of 1988, that could be utilized or
renovated to house nonviolent persons for drug treatment
purposes, State agencies responsible for the oversight of drug
abuse treatment entities and programs shall--
(1) establish eligibility criteria for the treatment
of individuals at such facilities;
(2) select treatment providers to provide drug abuse
treatment at such facilities;
(3) provide assistance to treatment providers
selected under paragraph (2) to assist such providers
in securing financing to fund the cost of the programs
at such facilities; and
(4) establish, regulate, and coordinate with the
military official in charge of the facility, work
programs for individuals receiving treatment at such
facilities.
(c) Reservation of Space.--Prior to notifying States of the
availability of space at military facilities under subsection
(a)(2), the Director may reserve space at such facilities to
conduct research or demonstration projects.
* * * * * * *
Subpart 2--Center for Substance Abuse Prevention
[center for substance abuse prevention] center for substance use
prevention services
Sec. 515. (a) There is established in the Administration a
[Center for Substance Abuse Prevention] Center for Substance
Use Prevention Services (hereafter referred to in this part as
the ``Prevention Center''). The Prevention Center shall be
headed by a Director appointed by the Secretary from
individuals with extensive experience or academic
qualifications in the prevention of drug or alcohol abuse.
(b) The Director of the Prevention Center shall--
(1) sponsor regional workshops on the prevention of
drug and alcohol abuse through the reduction of risk
and the promotion of resiliency;
(2) coordinate the findings of research sponsored by
agencies of the Service on the prevention of drug and
alcohol abuse;
(3) collaborate with the Director of the [National
Institute on Drug Abuse] National Institute on Drugs
and Addiction, the Director of the [National Institute
on Alcohol Abuse and Alcoholism] National Institute on
Alcohol Effects and Alcohol-Associated Disorders, and
States to promote the study of substance abuse
prevention and the dissemination and implementation of
research findings that will improve the delivery and
effectiveness of substance abuse prevention activities;
(4) develop effective drug and alcohol abuse
prevention literature (including educational
information on the effects of drugs abused by
individuals, including drugs that are emerging as
abused drugs);
(5) in cooperation with the Secretary of Education,
assure the widespread dissemination of prevention
materials among States, political subdivisions, and
school systems;
(6) support clinical training programs for health
professionals who provide substance use and misuse
prevention and treatment services and other health
professionals involved in illicit drug use education
and prevention;
(7) in cooperation with the Director of the Centers
for Disease Control and Prevention, develop and
disseminate educational materials to increase awareness
for individuals at greatest risk for substance use
disorders to prevent the transmission of communicable
diseases, such as HIV, hepatitis, tuberculosis, and
other communicable diseases;
(8) conduct training, technical assistance, data
collection, and evaluation activities of programs
supported under the Drug Free Schools and Communities
Act of 1986;
(9) support the development of model, innovative,
community-based programs that reduce the risk of
alcohol and drug abuse among young people and promote
resiliency;
(10) collaborate with the Attorney General of the
Department of Justice to develop programs to prevent
drug abuse among high risk youth;
(11) prepare for distribution documentary films and
public service announcements for television and radio
to educate the public, especially adolescent audiences,
concerning the dangers to health resulting from the
consumption of alcohol and drugs and, to the extent
feasible, use appropriate private organizations and
business concerns in the preparation of such
announcements;
(12) develop and support innovative demonstration
programs designed to identify and deter the improper
use or abuse of anabolic steroids by students,
especially students in secondary schools;
(13) ensure the consistent documentation of the
application of criteria when awarding grants and the
ongoing oversight of grantees after such grants are
awarded;
(14) assist and support States in preventing illicit
drug use, including emerging illicit drug use issues;
and
(15) in consultation with relevant stakeholders and
in collaboration with the Director of the Centers for
Disease Control and Prevention, develop educational
materials for clinicians to use with pregnant women for
shared decision making regarding pain management and
the prevention of substance use disorders during
pregnancy.
(c) The Director may make grants and enter into contracts and
cooperative agreements in carrying out subsection (b).
(d) The Director of the Prevention Center shall establish a
national data base providing information on programs for the
prevention of substance abuse. The data base shall contain
information appropriate for use by public entities and
information appropriate for use by nonprofit private entities.
* * * * * * *
SEC. 519B. PROGRAMS TO REDUCE UNDERAGE DRINKING.
(a) Definitions.--For purposes of this section:
(1) The term ``alcohol beverage industry'' means the
brewers, vintners, distillers, importers, distributors,
and retail or online outlets that sell or serve beer,
wine, and distilled spirits.
(2) The term ``school-based prevention'' means
programs, which are institutionalized, and run by staff
members or school-designated persons or organizations
in any grade of school, kindergarten through 12th
grade.
(3) The term ``youth'' means persons under the age of
21.
(4) The term ``IOM report'' means the report released
in September 2003 by the National Research Council,
Institute of Medicine, and entitled ``Reducing Underage
Drinking: A Collective Responsibility''.
(b) Sense of Congress.--It is the sense of the Congress that:
(1) A multi-faceted effort is needed to more
successfully address the problem of underage drinking
in the United States. A coordinated approach to
prevention, intervention, treatment, enforcement, and
research is key to making progress. This Act recognizes
the need for a focused national effort, and addresses
particulars of the Federal portion of that effort, as
well as Federal support for State activities.
(2) The Secretary of Health and Human Services shall
continue to conduct research and collect data on the
short and long-range impact of alcohol use and abuse
upon adolescent brain development and other organ
systems.
(3) States and communities, including colleges and
universities, are encouraged to adopt comprehensive
prevention approaches, including--
(A) evidence-based screening, programs and
curricula;
(B) brief intervention strategies;
(C) consistent policy enforcement; and
(D) environmental changes that limit underage
access to alcohol.
(4) Public health groups, consumer groups, and the
alcohol beverage industry should continue and expand
evidence-based efforts to prevent and reduce underage
drinking.
(5) The entertainment industries have a powerful
impact on youth, and they should use rating systems and
marketing codes to reduce the likelihood that underage
audiences will be exposed to movies, recordings, or
television programs with unsuitable alcohol content.
(6) The National Collegiate Athletic Association, its
member colleges and universities, and athletic
conferences should affirm a commitment to a policy of
discouraging alcohol use among underage students and
other young fans.
(7) Alcohol is a unique product and should be
regulated differently than other products by the States
and Federal Government. States have primary authority
to regulate alcohol distribution and sale, and the
Federal Government should support and supplement these
State efforts. States also have a responsibility to
fight youth access to alcohol and reduce underage
drinking. Continued State regulation and licensing of
the manufacture, importation, sale, distribution,
transportation and storage of alcoholic beverages are
clearly in the public interest and are critical to
promoting responsible consumption, preventing illegal
access to alcohol by persons under 21 years of age from
commercial and non-commercial sources, maintaining
industry integrity and an orderly marketplace, and
furthering effective State tax collection.
(c) Interagency Coordinating Committee; Annual Report on
State Underage Drinking Prevention and Enforcement
Activities.--
(1) Interagency coordinating committee on the
prevention of underage drinking.--
(A) In general.--The Secretary, in
collaboration with the Federal officials
specified in subparagraph (B), shall formally
establish and enhance the efforts of the
interagency coordinating committee, that began
operating in 2004, focusing on underage
drinking (referred to in this subsection as the
``Committee'').
(B) Other agencies.--The officials referred
to in paragraph (1) are the Secretary of
Education, the Attorney General, the Secretary
of Transportation, the Secretary of the
Treasury, the Secretary of Defense, the Surgeon
General, the Director of the Centers for
Disease Control and Prevention, the Director of
the [National Institute on Alcohol Abuse and
Alcoholism] National Institute on Alcohol
Effects and Alcohol-Associated Disorders, the
Assistant Secretary for Mental Health and
Substance Use, the Director of the [National
Institute on Drug Abuse] National Institute on
Drugs and Addiction, the Assistant Secretary
for Children and Families, the Director of the
Office of National Drug Control Policy, the
Administrator of the National Highway Traffic
Safety Administration, the Administrator of the
Office of Juvenile Justice and Delinquency
Prevention, the Chairman of the Federal Trade
Commission, and such other Federal officials as
the Secretary of Health and Human Services
determines to be appropriate.
(C) Chair.--The Secretary of Health and Human
Services shall serve as the chair of the
Committee.
(D) Duties.--The Committee shall guide policy
and program development across the Federal
Government with respect to underage drinking,
provided, however, that nothing in this section
shall be construed as transferring regulatory
or program authority from an Agency to the
Coordinating Committee.
(E) Consultations.--The Committee shall
actively seek the input of and shall consult
with all appropriate and interested parties,
including States, public health research and
interest groups, foundations, and alcohol
beverage industry trade associations and
companies.
(F) Annual report.--
(i) In general.--The Secretary, on
behalf of the Committee, shall annually
submit to the Congress a report that
summarizes--
(I) all programs and policies
of Federal agencies designed to
prevent and reduce underage
drinking;
(II) the extent of progress
in preventing and reducing
underage drinking nationally;
(III) data that the Secretary
shall collect with respect to
the information specified in
clause (ii); and
(IV) such other information
regarding underage drinking as
the Secretary determines to be
appropriate.
(ii) Certain information.--The report
under clause (i) shall include
information on the following:
(I) Patterns and consequences
of underage drinking as
reported in research and
surveys such as, but not
limited to Monitoring the
Future, Youth Risk Behavior
Surveillance System, the
National Survey on Drug Use and
Health, and the Fatality
Analysis Reporting System.
(II) Measures of the
availability of alcohol from
commercial and non-commercial
sources to underage
populations.
(III) Measures of the
exposure of underage
populations to messages
regarding alcohol in
advertising and the
entertainment media as reported
by the Federal Trade
Commission.
(IV) Surveillance data,
including information on the
onset and prevalence of
underage drinking, consumption
patterns and the means of
underage access. The Secretary
shall develop a plan to improve
the collection, measurement and
consistency of reporting
Federal underage alcohol data.
(V) Any additional findings
resulting from research
conducted or supported under
subsection (f).
(VI) Evidence-based best
practices to prevent and reduce
underage drinking and provide
treatment services to those
youth who need them.
(2) Annual report on state underage drinking
prevention and enforcement activities.--
(A) In general.--The Secretary shall, with
input and collaboration from other appropriate
Federal agencies, States, Indian tribes,
territories, and public health, consumer, and
alcohol beverage industry groups, annually
issue a report on each State's performance in
enacting, enforcing, and creating laws,
regulations, and programs to prevent or reduce
underage drinking.
(B) State performance measures.--
(i) In general.--The Secretary shall
develop, in consultation with the
Committee, a set of measures to be used
in preparing the report on best
practices.
(ii) Categories.--In developing these
measures, the Secretary shall consider
categories including, but not limited
to:
(I) Whether or not the State
has comprehensive anti-underage
drinking laws such as for the
illegal sale, purchase, attempt
to purchase, consumption, or
possession of alcohol; illegal
use of fraudulent ID; illegal
furnishing or obtaining of
alcohol for an individual under
21 years; the degree of
strictness of the penalties for
such offenses; and the
prevalence of the enforcement
of each of these infractions.
(II) Whether or not the State
has comprehensive liability
statutes pertaining to underage
access to alcohol such as dram
shop, social host, and house
party laws, and the prevalence
of enforcement of each of these
laws.
(III) Whether or not the
State encourages and conducts
comprehensive enforcement
efforts to prevent underage
access to alcohol at retail
outlets, such as random
compliance checks and shoulder
tap programs, and the number of
compliance checks within
alcohol retail outlets measured
against the number of total
alcohol retail outlets in each
State, and the result of such
checks.
(IV) Whether or not the State
encourages training on the
proper selling and serving of
alcohol for all sellers and
servers of alcohol as a
condition of employment.
(V) Whether or not the State
has policies and regulations
with regard to direct sales to
consumers and home delivery of
alcoholic beverages.
(VI) Whether or not the State
has programs or laws to deter
adults from purchasing alcohol
for minors; and the number of
adults targeted by these
programs.
(VII) Whether or not the
State has programs targeted to
youths, parents, and caregivers
to deter underage drinking; and
the number of individuals
served by these programs.
(VIII) Whether or not the
State has enacted graduated
drivers licenses and the extent
of those provisions.
(IX) The amount that the
State invests, per youth
capita, on the prevention of
underage drinking, further
broken down by the amount spent
on--
(aa) compliance check
programs in retail
outlets, including
providing technology to
prevent and detect the
use of false
identification by
minors to make alcohol
purchases;
(bb) checkpoints and
saturation patrols that
include the goal of
reducing and deterring
underage drinking;
(cc) community-based,
school-based, and
higher-education-based
programs to prevent
underage drinking;
(dd) underage
drinking prevention
programs that target
youth within the
juvenile justice and
child welfare systems;
and
(ee) other State
efforts or programs as
deemed appropriate.
(3) Authorization of appropriations.--There are
authorized to be appropriated to carry out this
subsection $1,000,000 for each of the fiscal years 2018
through 2022.
(d) National Media Campaign To Prevent Underage Drinking.--
(1) Scope of the campaign.--The Secretary shall
continue to fund and oversee the production,
broadcasting, and evaluation of the national adult-
oriented media public service campaign if the Secretary
determines that such campaign is effective in achieving
the media campaign's measurable objectives.
(2) Report.--The Secretary shall provide a report to
the Congress annually detailing the production,
broadcasting, and evaluation of the campaign referred
to in paragraph (1), and to detail in the report the
effectiveness of the campaign in reducing underage
drinking, the need for and likely effectiveness of an
expanded adult-oriented media campaign, and the
feasibility and the likely effectiveness of a national
youth-focused media campaign to combat underage
drinking.
(3) Consultation requirement.--In carrying out the
media campaign, the Secretary shall direct the entity
carrying out the national adult-oriented media public
service campaign to consult with interested parties
including both the alcohol beverage industry and public
health and consumer groups. The progress of this
consultative process is to be covered in the report
under paragraph (2).
(4) Authorization of appropriations.--There are
authorized to be appropriated to carry out this
subsection, $1,000,000 for each of the fiscal years
2018 through 2022.
(e) Interventions.--
(1) Community-based coalition enhancement grants to
prevent underage drinking.--
(A) Authorization of program.--The Assistant
Secretary for Mental Health and Substance Use,
in consultation with the Director of the Office
of National Drug Control Policy, shall award,
if the Assistant Secretary determines that the
Department of Health and Human Services is not
currently conducting activities that duplicate
activities of the type described in this
subsection, ``enhancement grants'' to eligible
entities to design, test, evaluate and
disseminate effective strategies to maximize
the effectiveness of community-wide approaches
to preventing and reducing underage drinking.
This subsection is subject to the availability
of appropriations.
(B) Purposes.--The purposes of this paragraph
are to--
(i) prevent and reduce alcohol use
among youth in communities throughout
the United States;
(ii) strengthen collaboration among
communities, the Federal Government,
and State, local, and tribal
governments;
(iii) enhance intergovernmental
cooperation and coordination on the
issue of alcohol use among youth;
(iv) serve as a catalyst for
increased citizen participation and
greater collaboration among all sectors
and organizations of a community that
first demonstrates a long-term
commitment to reducing alcohol use
among youth;
(v) disseminate to communities timely
information regarding state-of-the-art
practices and initiatives that have
proven to be effective in preventing
and reducing alcohol use among youth;
and
(vi) enhance, not supplant, effective
local community initiatives for
preventing and reducing alcohol use
among youth.
(C) Application.--An eligible entity desiring
an enhancement grant under this paragraph shall
submit an application to the Assistant
Secretary at such time, and in such manner, and
accompanied by such information as the
Assistant Secretary may require. Each
application shall include--
(i) a complete description of the
entity's current underage alcohol use
prevention initiatives and how the
grant will appropriately enhance the
focus on underage drinking issues; or
(ii) a complete description of the
entity's current initiatives, and how
it will use this grant to enhance those
initiatives by adding a focus on
underage drinking prevention.
(D) Uses of funds.--Each eligible entity that
receives a grant under this paragraph shall use
the grant funds to carry out the activities
described in such entity's application
submitted pursuant to subparagraph (C). Grants
under this paragraph shall not exceed $50,000
per year and may not exceed four years.
(E) Supplement not supplant.--Grant funds
provided under this paragraph shall be used to
supplement, not supplant, Federal and non-
Federal funds available for carrying out the
activities described in this paragraph.
(F) Evaluation.--Grants under this paragraph
shall be subject to the same evaluation
requirements and procedures as the evaluation
requirements and procedures imposed on
recipients of drug free community grants.
(G) Definitions.--For purposes of this
paragraph, the term ``eligible entity'' means
an organization that is currently receiving or
has received grant funds under the Drug-Free
Communities Act of 1997 (21 U.S.C. 1521 et
seq.).
(H) Administrative expenses.--Not more than 6
percent of a grant under this paragraph may be
expended for administrative expenses.
(I) Authorization of appropriations.--There
are authorized to be appropriated to carry out
this paragraph $5,000,000 for each of the
fiscal years 2018 through 2022.
(2) Grants directed at preventing and reducing
alcohol abuse at institutions of higher education.--
(A) Authorization of program.--The Secretary
shall award grants to eligible entities to
enable the entities to prevent and reduce the
rate of underage alcohol consumption including
binge drinking among students at institutions
of higher education.
(B) Applications.--An eligible entity that
desires to receive a grant under this paragraph
shall submit an application to the Secretary at
such time, in such manner, and accompanied by
such information as the Secretary may require.
Each application shall include--
(i) a description of how the eligible
entity will work to enhance an
existing, or where none exists to build
a, statewide coalition;
(ii) a description of how the
eligible entity will target underage
students in the State;
(iii) a description of how the
eligible entity intends to ensure that
the statewide coalition is actually
implementing the purpose of this
section and moving toward indicators
described in subparagraph (D);
(iv) a list of the members of the
statewide coalition or interested
parties involved in the work of the
eligible entity;
(v) a description of how the eligible
entity intends to work with State
agencies on substance abuse prevention
and education;
(vi) the anticipated impact of funds
provided under this paragraph in
preventing and reducing the rates of
underage alcohol use;
(vii) outreach strategies, including
ways in which the eligible entity
proposes to--
(I) reach out to students and
community stakeholders;
(II) promote the purpose of
this paragraph;
(III) address the range of
needs of the students and the
surrounding communities; and
(IV) address community norms
for underage students regarding
alcohol use; and
(viii) such additional information as
required by the Secretary.
(C) Uses of funds.--Each eligible entity that
receives a grant under this paragraph shall use
the grant funds to carry out the activities
described in such entity's application
submitted pursuant to subparagraph (B).
(D) Accountability.--On the date on which the
Secretary first publishes a notice in the
Federal Register soliciting applications for
grants under this paragraph, the Secretary
shall include in the notice achievement
indicators for the program authorized under
this paragraph. The achievement indicators
shall be designed--
(i) to measure the impact that the
statewide coalitions assisted under
this paragraph are having on the
institutions of higher education and
the surrounding communities, including
changes in the number of incidents of
any kind in which students have abused
alcohol or consumed alcohol while under
the age of 21 (including violations,
physical assaults, sexual assaults,
reports of intimidation, disruptions of
school functions, disruptions of
student studies, mental health
referrals, illnesses, or deaths);
(ii) to measure the quality and
accessibility of the programs or
information offered by the eligible
entity; and
(iii) to provide such other measures
of program impact as the Secretary
determines appropriate.
(E) Supplement not supplant.--Grant funds
provided under this paragraph shall be used to
supplement, and not supplant, Federal and non-
Federal funds available for carrying out the
activities described in this paragraph.
(F) Definitions.--For purposes of this
paragraph:
(i) Eligible entity.--The term
``eligible entity'' means a State,
institution of higher education, or
nonprofit entity.
(ii) Institution of higher
education.--The term ``institution of
higher education'' has the meaning
given the term in section 101(a) of the
Higher Education Act of 1965 (20 U.S.C.
1001(a)).
(iii) Secretary.--The term
``Secretary'' means the Secretary of
Education.
(iv) State.--The term ``State'' means
each of the 50 States, the District of
Columbia, and the Commonwealth of
Puerto Rico.
(v) Statewide coalition.--The term
``statewide coalition'' means a
coalition that--
(I) includes, but is not
limited to--
(aa) institutions of
higher education within
a State; and
(bb) a nonprofit
group, a community
underage drinking
prevention coalition,
or another substance
abuse prevention group
within a State; and
(II) works toward lowering
the alcohol abuse rate by
targeting underage students at
institutions of higher
education throughout the State
and in the surrounding
communities.
(vi) Surrounding community.--The term
``surrounding community'' means the
community--
(I) that surrounds an
institution of higher education
participating in a statewide
coalition;
(II) where the students from
the institution of higher
education take part in the
community; and
(III) where students from the
institution of higher education
live in off-campus housing.
(G) Administrative expenses.--Not more than 5
percent of a grant under this paragraph may be
expended for administrative expenses.
(H) Authorization of appropriations.--There
are authorized to be appropriated to carry out
this paragraph $5,000,000 for fiscal year 2007,
and $5,000,000 for each of the fiscal years
2008 through 2010.
(f) Additional Research.--
(1) Additional research on underage drinking.--
(A) In general.--The Secretary shall, subject
to the availability of appropriations, collect
data, and conduct or support research that is
not duplicative of research currently being
conducted or supported by the Department of
Health and Human Services, on underage
drinking, with respect to the following:
(i) Comprehensive community-based
programs or strategies and statewide
systems to prevent and reduce underage
drinking, across the underage years
from early childhood to age 21,
including programs funded and
implemented by government entities,
public health interest groups and
foundations, and alcohol beverage
companies and trade associations.
(ii) Annually obtain and report more
precise information than is currently
collected on the scope of the underage
drinking problem and patterns of
underage alcohol consumption, including
improved knowledge about the problem
and progress in preventing, reducing
and treating underage drinking; as well
as information on the rate of exposure
of youth to advertising and other media
messages encouraging and discouraging
alcohol consumption.
(iii) Compiling information on the
involvement of alcohol in unnatural
deaths of persons ages 12 to 20 in the
United States, including suicides,
homicides, and unintentional injuries
such as falls, drownings, burns,
poisonings, and motor vehicle crash
deaths.
(B) Certain matters.--The Secretary shall
carry out activities toward the following
objectives with respect to underage drinking:
(i) Obtaining new epidemiological
data within the national or targeted
surveys that identify alcohol use and
attitudes about alcohol use during pre-
and early adolescence, including harm
caused to self or others as a result of
adolescent alcohol use such as
violence, date rape, risky sexual
behavior, and prenatal alcohol
exposure.
(ii) Developing or identifying
successful clinical treatments for
youth with alcohol problems.
(C) Peer review.--Research under subparagraph
(A) shall meet current Federal standards for
scientific peer review.
(2) Authorization of appropriations.--There are
authorized to be appropriated to carry out this
subsection $3,000,000 for each of the fiscal years 2018
through 2022
(g) Reducing Underage Drinking Through Screening and Brief
Intervention.--
(1) Grants to pediatric health care providers to
reduce underage drinking.--The Assistant Secretary may
make grants to eligible entities to increase
implementation of practices for reducing the prevalence
of alcohol use among individuals under the age of 21,
including college students.
(2) Purposes.--Grants under this subsection shall be
made to improve--
(A) screening children and adolescents for
alcohol use;
(B) offering brief interventions to children
and adolescents to discourage such use;
(C) educating parents about the dangers of,
and methods of discouraging, such use;
(D) diagnosing and treating alcohol use
disorders; and
(E) referring patients, when necessary, to
other appropriate care.
(3) Use of funds.--An entity receiving a grant under
this subsection may use such funding for the purposes
identified in paragraph (2) by--
(A) providing training to health care
providers;
(B) disseminating best practices, including
culturally and linguistically appropriate best
practices, as appropriate, and developing and
distributing materials; and
(C) supporting other activities, as
determined appropriate by the Assistant
Secretary.
(4) Application.--To be eligible to receive a grant
under this subsection, an entity shall submit an
application to the Assistant Secretary at such time,
and in such manner, and accompanied by such information
as the Assistant Secretary may require. Each
application shall include--
(A) a description of the entity;
(B) a description of activities to be
completed;
(C) a description of how the services
specified in paragraphs (2) and (3) will be
carried out and the qualifications for
providing such services; and
(D) a timeline for the completion of such
activities.
(5) Definitions.--For the purpose of this subsection:
(A) Brief intervention.--The term ``brief
intervention'' means, after screening a
patient, providing the patient with brief
advice and other brief motivational enhancement
techniques designed to increase the insight of
the patient regarding the patient's alcohol
use, and any realized or potential consequences
of such use, to effect the desired related
behavioral change.
(B) Children and adolescents.--The term
``children and adolescents'' means any person
under 21 years of age.
(C) Eligible entity.--The term ``eligible
entity'' means an entity consisting of
pediatric health care providers and that is
qualified to support or provide the activities
identified in paragraph (2).
(D) Pediatric health care provider.--The term
``pediatric health care provider'' means a
provider of primary health care to individuals
under the age of 21 years.
(E) Screening.--The term ``screening'' means
using validated patient interview techniques to
identify and assess the existence and extent of
alcohol use in a patient.
* * * * * * *
Part G--Services Provided Through Religious Organizations
SEC. 581. APPLICABILITY TO DESIGNATED PROGRAMS.
(a) Designated Programs.--Subject to subsection (b), this
part applies to discretionary and formula grant programs
administered by the [Substance Abuse and Mental Health Services
Administration] Substance Use And Mental Health Services
Administration that make awards of financial assistance to
public or private entities for the purpose of carrying out
activities to prevent or treat substance abuse (in this part
referred to as a ``designated program''). Designated programs
include the program under subpart II of part B of title XIX
(relating to formula grants to the States).
(b) Limitation.--This part does not apply to any award of
financial assistance under a designated program for a purpose
other than the purpose specified in subsection (a).
(c) Definitions.--For purposes of this part (and subject to
subsection (b)):
(1) The term ``designated program'' has the meaning
given such term in subsection (a).
(2) The term ``financial assistance'' means a grant,
cooperative agreement, or contract.
(3) The term ``program beneficiary'' means an
individual who receives program services.
(4) The term ``program participant'' means a public
or private entity that has received financial
assistance under a designated program.
(5) The term ``program services'' means treatment for
substance abuse, or preventive services regarding such
abuse, provided pursuant to an award of financial
assistance under a designated program.
(6) The term ``religious organization'' means a
nonprofit religious organization.
* * * * * * *
TITLE XIX--BLOCK GRANTS
* * * * * * *
Part B--Block Grants Regarding Mental Health and Substance Abuse
Subpart I--Block Grants for Community Mental Health Services
* * * * * * *
SEC. 1918. DETERMINATION OF AMOUNT OF ALLOTMENT.
(a) States.--
(1) Determination under formula.--Subject to
subsection (b), the Secretary shall determine the
amount of the allotment required in section 1911 for a
State for a fiscal year in accordance with the
following formula:
X
A ( ---- )
U
------------------------------------------------------------------------
(2) Determination of term ``a''.--For purposes of
paragraph (1), the term ``A'' means the difference
between--
(A) the amount appropriated under section
1920(a) for allotments under section 1911 for
the fiscal year involved; and
(B) an amount equal to 1.5 percent of the
amount referred to in subparagraph (A).
(3) Determination of term ``u''.--For purposes of
paragraph (1), the term ``U'' means the sum of the
respective terms ``X'' determined for the States under
paragraph (4).
(4) Determination of term ``x''.--For purposes of
paragraph (1), the term ``X'' means the product of--
(A) an amount equal to the product of--
(i) the term ``P'', as determined for
the State involved under paragraph (5);
and
(ii) the factor determined under
paragraph (8) for the State; and
(B) the greater of--
(i) 0.4; and
(ii) an amount equal to an amount
determined for the State in accordance
with the following formula:
R%
1-.35 ( ---- )
P%
------------------------------------------------------------------------
(5) Determination of term ``p''.--
(A) For purposes of paragraph (4), the term
``P'' means the sum of--
(i) an amount equal to the product of
0.107 and the number of individuals in
the State who are between 18 and 24
years of age (inclusive);
(ii) an amount equal to the product
of 0.166 and the number of individuals
in the State who are between 25 and 44
years of age (inclusive);
(iii) an amount equal to the product
of 0.099 and the number of individuals
in the State who are between 45 and 64
years of age (inclusive); and
(iv) an amount equal to the product
of 0.082 and the number of individuals
in the State who are 65 years of age or
older.
(B) With respect to data on population that
is necessary for purposes of making a
determination under subparagraph (A), the
Secretary shall use the most recent data that
is available from the Secretary of Commerce
pursuant to the decennial census and pursuant
to reasonable estimates by such Secretary of
changes occurring in the data in the ensuing
period.
(6) Determination of term ``r%''.--
(A) For purposes of paragraph (4), the term
``R%'', except as provided in subparagraph (D),
means the percentage constituted by the ratio
of the amount determined under subparagraph (B)
for the State involved to the amount determined
under subparagraph (C).
(B) The amount determined under this
subparagraph for the State involved is the
quotient of--
(i) the most recent 3-year arithmetic
mean of the total taxable resources of
the State, as determined by the
Secretary of the Treasury; divided by
(ii) the factor determined under
paragraph (8) for the State.
(C) The amount determined under this
subparagraph is the sum of the respective
amounts determined for the States under
subparagraph (B) (including the District of
Columbia).
(D)(i) In the case of the District of
Columbia, for purposes of paragraph (4), the
term ``R%'' means the percentage constituted by
the ratio of the amount determined under clause
(ii) for such District to the amount determined
under clause (iii).
(ii) The amount determined under this clause
for the District of Columbia is the quotient
of--
(I) the most recent 3-year arithmetic
mean of total personal income in such
District, as determined by the
Secretary of Commerce; divided by
(II) the factor determined under
paragraph (8) for the District.
(iii) The amount determined under this clause
is the sum of the respective amounts determined
for the States (including the District of
Columbia) by making, for each State, the same
determination as is described in clause (ii)
for the District of Columbia.
(7) Determination of term ``p%''.--For purposes of
paragraph (4), the term ``P%'' means the percentage
constituted by the ratio of the term ``P'' determined
under paragraph (5) for the State involved to the sum
of the respective terms ``P'' determined for the
States.
(8) Determination of certain factor.--
(A) The factor determined under this
paragraph for the State involved is a factor
whose purpose is to adjust the amount
determined under clause (i) of paragraph
(4)(A), and the amounts determined under each
of subparagraphs (B)(i) and (D)(ii)(I) of
paragraph (6), to reflect the differences that
exist between the State and other States in the
costs of providing comprehensive community
mental health services to adults with a serious
mental illness and to children with a serious
emotional disturbance.
(B) Subject to subparagraph (C), the factor
determined under this paragraph and in effect
for the fiscal year involved shall be
determined according to the methodology
described in the report entitled ``Adjusting
the Alcohol, Drug Abuse and Mental Health
Services Block Grant Allocations for Poverty
Populations and Cost of Service'', dated March
30, 1990, and prepared by Health Economics
Research, a corporation, pursuant to a contract
with the [National Institute on Drug Abuse]
National Institute on Drugs and Addiction.
(C) The factor determined under this
paragraph for the State involved may not for
any fiscal year be greater than 1.1 or less
than 0.9.
(D)(i) Not later than October 1, 1992, the
Secretary, after consultation with the
Comptroller General, shall in accordance with
this section make a determination for each
State of the factor that is to be in effect for
the State under this paragraph. The factor so
determined shall remain in effect through
fiscal year 1994, and shall be recalculated
every third fiscal year thereafter.
(ii) After consultation with the Comptroller
General, the Secretary shall, through
publication in the Federal Register,
periodically make such refinements in the
methodology referred to in subparagraph (B) as
are consistent with the purpose described in
subparagraph (A).
(b) Minimum Allotments for States.--With respect to fiscal
year 2000, and subsequent fiscal years, the amount of the
allotment of a State under section 1911 shall not be less than
the amount the State received under such section for fiscal
year 1998.
(c) Territories.--
(1) Determination under formula.--Subject to
paragraphs (2) and (4), the amount of an allotment
under section 1911 for a territory of the United States
for a fiscal year shall be the product of--
(A) an amount equal to the amounts reserved
under paragraph (3) for the fiscal year; and
(B) a percentage equal to the quotient of--
(i) the civilian population of the
territory, as indicated by the most
recently available data; divided by
(ii) the aggregate civilian
population of the territories of the
United States, as indicated by such
data.
(2) Minimum allotment for territories.--The amount of
an allotment under section 1911 for a territory of the
United States for a fiscal year shall be the greater
of--
(A) the amount determined under paragraph (1)
for the territory for the fiscal year;
(B) $50,000; and
(C) with respect to fiscal years 1993 and
1994, an amount equal to 20.6 percent of the
amount received by the territory from
allotments made pursuant to this part for
fiscal year 1992.
(3) Reservation of amounts.--The Secretary shall each
fiscal year reserve for the territories of the United
States 1.5 percent of the amounts appropriated under
section 1920(a) for allotments under section 1911 for
the fiscal year.
(4) Availability of data on population.--With respect
to data on the civilian population of the territories
of the United States, if the Secretary determines for a
fiscal year that recent such data for purposes of
paragraph (1)(B) do not exist regarding a territory,
the Secretary shall for such purposes estimate the
civilian population of the territory by modifying the
data on the territory to reflect the average extent of
change occurring during the ensuing period in the
population of all territories with respect to which
recent such data do exist.
(5) Applicability of certain provisions.--For
purposes of subsection (a), the term ``State'' does not
include the territories of the United States.
* * * * * * *
Subpart II--Block Grants for Prevention and Treatment of Substance
Abuse
SEC. 1921. FORMULA GRANTS TO STATES.
(a) In General.--For the purpose described in subsection (b),
the Secretary, acting through the [Center for Substance Abuse
Treatment] Center for Substance Use Services, shall make an
allotment each fiscal year for each State in an amount
determined in accordance with section 1933. The Secretary shall
make a grant to the State of the allotment made for the State
for the fiscal year if the State submits to the Secretary an
application in accordance with section 1932.
(b) Authorized Activities.--A funding agreement for a grant
under subsection (a) is that, subject to section 1931, the
State involved will expend the grant only for the purpose of
carrying out the plan developed in accordance with section
1932(b) and for planning, carrying out, and evaluating
activities to prevent and treat substance use disorders and for
related activities authorized in section 1924.
* * * * * * *
SEC. 1932. APPLICATION FOR GRANT; APPROVAL OF STATE PLAN.
(a) In General.--For purposes of section 1921, an application
for a grant under such section for a fiscal year is in
accordance with this section if, subject to subsection (c)--
(1) the application is received by the Secretary not
later than October 1 of the fiscal year for which the
State is seeking funds;
(2) the application contains each funding agreement
that is described in this subpart or subpart III for
such a grant (other than any such agreement that is not
applicable to the State);
(3) the agreements are made through certification
from the chief executive officer of the State;
(4) with respect to such agreements, the application
provides assurances of compliance satisfactory to the
Secretary;
(5) the application contains the report required in
section 1942(a);
(6)(A) the application contains a plan in accordance
with subsection (b) and the plan is approved by the
Secretary; and
(B) the State provides assurances satisfactory to the
Secretary that the State complied with the provisions
of the plan under subparagraph (A) that was approved by
the Secretary for the most recent fiscal year for which
the State received a grant under section 1921; and
(7) the application (including the plan under
paragraph (6)) is otherwise in such form, is made in
such manner, and contains such agreements, assurances,
and information as the Secretary determines to be
necessary to carry out this subpart.
(b) State Plan.--
(1) In general.--In order for a State to be in
compliance with subsection (a)(6), the State shall
submit to the Secretary a plan that, at a minimum,
includes the following:
(A) A description of the State's system of
care that--
(i) identifies the single State
agency responsible for the
administration of the program,
including any third party who
administers substance use disorder
services and is responsible for
complying with the requirements of the
grant;
(ii) provides information on the need
for substance use disorder prevention
and treatment services in the State,
including estimates on the number of
individuals who need treatment, who are
pregnant women, women with dependent
children, individuals with a co-
occurring mental health and substance
use disorder, persons who inject drugs,
and persons who are experiencing
homelessness;
(iii) provides aggregate information
on the number of individuals in
treatment within the State, including
the number of such individuals who are
pregnant women, women with dependent
children, individuals with a co-
occurring mental health and substance
use disorder, persons who inject drugs,
and persons who are experiencing
homelessness;
(iv) provides a description of the
system that is available to provide
services by modality, including the
provision of recovery support services;
(v) provides a description of the
State's comprehensive statewide
prevention efforts, including the
number of individuals being served in
the system, target populations, and
priority needs, and provides a
description of the amount of funds from
the prevention set-aside expended on
primary prevention;
(vi) provides a description of the
financial resources available;
(vii) describes the existing
substance use disorders workforce and
workforce trained in treating co-
occurring substance use and mental
disorders;
(viii) includes a description of how
the State promotes evidence-based
practices; and
(ix) describes how the State
integrates substance use disorder
services and primary health care, which
in the case of those individuals with
co-occurring mental health and
substance use disorders may include
providing both mental health and
substance use disorder services in
primary care settings or providing
primary and specialty care services in
community-based mental health and
substance use disorder service
settings.
(B) The establishment of goals and objectives
for the period of the plan, including targets
and milestones that are intended to be met, and
the activities that will be undertaken to
achieve those targets.
(C) A description of how the State will
comply with each funding agreement for a grant
under section 1921 that is applicable to the
State, including a description of the manner in
which the State intends to expend grant funds.
(2) Modifications.--
(A) Authority of secretary.--As a condition;
of making a grant under section 1921 to a State
for a fiscal year, the Secretary may require
that the State modify any provision of the plan
submitted by the State under subsection (a)(6)
(including provisions on priorities in carrying
out authorized activities). If the Secretary
approves the plan and makes the grant to the
State for the fiscal year, the Secretary may
not during such year require the State to
modify the plan.
(B) State request for modification.--If the
State determines that a modification to such
plan is necessary, the State may request the
Secretary to approve the modification. Any such
modification shall be in accordance with
paragraph (1) and section 1941.
(3) Authority of [center for substance abuse
prevention] center for substance use prevention
services.--With respect to plans submitted by the
States under subsection (a)(6), including any
modification under paragraph (2), the Secretary, acting
through the Director of the [Center for Substance Abuse
Prevention] Center for Substance Use Prevention
Services, shall review and approve or disapprove the
provisions of the plans that relate to prevention
activities.
(c) Waivers Regarding Certain Territories.--In the case of
any territory of the United States except Puerto Rico, the
Secretary may waive such provisions of this subpart and subpart
III as the Secretary determines to be appropriate, other than
the provisions of section 1931.
(d) Issuance of Regulations; Precondition to Making Grants.--
(1) Regulations.--Not later than August 25, 1992, the
Secretary, acting as appropriate through the Director
of the Center for Treatment Improvement or the Director
of the [Center for Substance Abuse Prevention] Center
for Substance Use Prevention Services, shall by
regulation establish standards specifying the
circumstances in which the Secretary will consider an
application for a grant under section 1921 to be in
accordance with this section.
(2) Issuance as precondition to making grants.--The
Secretary may not make payments under any grant under
section 1921 for fiscal year 1993 on or after January
1, 1993, unless the Secretary has issued standards
under paragraph (1).
(e) Waiver Authority for Certain Requirements.--
(1) In general.--Upon the request of a State, the
Secretary may waive the requirements of all or part of
the sections described in paragraph (2) using objective
criteria established by the Secretary by regulation
after consultation with the States and other interested
parties including consumers and providers.
(2) Sections.--The sections described in paragraph
(1) are sections 1922(b), 1923, 1924 and 1928.
(3) Date certain for acting upon request.--The
Secretary shall approve or deny a request for a waiver
under paragraph (1) and inform the State of that
decision not later than 120 days after the date on
which the request and all the information needed to
support the request are submitted.
(4) Annual reporting requirement.--The Secretary
shall annually report to the general public on the
States that receive a waiver under this subsection.
* * * * * * *
SEC. 1935. FUNDING.
(a) Authorization of Appropriations.--For the purpose of
carrying out this subpart, subpart III and section 505(d) with
respect to substance abuse, and section 515(d), there are
authorized to be appropriated $1,858,079,000 for each of fiscal
years 2018 through 2022..
(b) Allocations for Technical Assistance, National Data Base,
Data Collection, and Program Evaluations.--
(1) In general.--
(A) For the purpose of carrying out section
1948(a) with respect to substance abuse,
section 515(d), and the purposes specified in
subparagraphs (B) and (C), the Secretary shall
obligate 5 percent of the amounts appropriated
under subsection (a) each fiscal year.
(B) The purpose specified in this
subparagraph is the collection of data in this
paragraph is carrying out sections 505(d) and
1971 with respect to substance abuse.
(C) The purpose specified in this
subparagraph is the conduct of evaluations of
authorized activities to determine methods for
improving the availability and quality of such
activities.
(2) Activities of [center for substance abuse
prevention] center for substance use prevention
services.--Of the amounts reserved under paragraph (1)
for a fiscal year, the Secretary, acting through the
Director of the [Center for Substance Abuse Prevention]
Center for Substance Use Prevention Services, shall
obligate 20 percent for carrying out paragraph (1)(C),
section 1948(a) with respect to prevention activities,
and section 515(d).
(3) Core data set.--A State that receives a new
grant, contract, or cooperative agreement from amounts
available to the Secretary under paragraph (1), for the
purposes of improving the data collection, analysis and
reporting capabilities of the State, shall be required,
as a condition of receipt of funds, to collect,
analyze, and report to the Secretary for each fiscal
year subsequent to receiving such funds a core data set
to be determined by the Secretary in conjunction with
the States.
* * * * * * *
----------
COMPREHENSIVE SMOKING EDUCATION ACT
* * * * * * *
smoking research, education, and information
Sec. 3. (a) The Secretary of Health and Human Services
(hereinafter in this section referred to as the ``Secretary'')
shall establish and carry out a program to inform the public of
any dangers to human health presented by cigarette smoking. In
canning out such program, the Secretary shall--
(1) conduct and support research on the effect of
cigarette smoking on human health and develop materials
for informing the public of such effect;
(2) coordinate all research and educational programs
and other activities within the Department of Health
and Human Services (hereinafter in this section
referred to as the ``Department'') which relate to the
effect of cigarette smoking on human health and
coordinate, through the Interagency Committee on
Smoking and Health (established under subsection (b)),
such activities with similar activities of other
Federal agencies and of private agencies;
(3) establish and maintain a liaison with appropriate
private entities, other Federal agencies, and State and
local public agencies respecting activities relating to
the effect of cigarette smoking on human health;
(4) collect, analyze, and disseminate (through
publications, bibliographies, and otherwise)
information, studies, and other data relating to the
effect of cigarette smoking on human health, and
develop standards, criteria, and methodologies for
improved information programs related to smoking and
health;
(5) compile and make available information on State
and local laws relating to the use and consumption of
cigarettes; and
(6) undertake any other additional information and
research activities which the Secretary determines
necessary and appropriate to carry out this section.
(b)(1) To carry out the activities described in paragraphs
(2) and (3) of subsection (a) there is established an
Interagency Committee on Smoking and Health. The Committee
shall be composed of--
(A) members appointed by the Secretary from
appropriate institutes and agencies of the Department,
which may include the National Cancer Institute, the
National Heart, Lung, and Blood Institute, the Eunice
Kennedy Shriver National Institute of Child Health and
Human Development, the [National Institute on Drug
Abuse] National Institute on Drugs and Addiction, the
Health Resources and Services Administration, and the
Centers for Disease Control and Prevention;
(B) at least one member appointed from the Federal
Trade Commission, the Department of Education, the
Department of Labor, and any other Federal agency
designated by the Secretary, the appointment of whom
shall be made by the head of the entity from which the
member is appointed; and
(C) five members appointed by the Secretary from
physicians and scientists who represent private
entities involved in informing the public about the
health effects of smoking.
The Secretary shall designate the chairman of the Committee.
(2) While away from their homes or regular places of business
in the performance of services for the Committee, members of
the Committee shall be allowed travel expenses, including per
diem in lieu of subsistance, in the manner provided by sections
5702 and 5703 of title 5 of the United States Code.
(3) The Secretary shall make available to the Committee such
staff, information, and other assistance as it may require to
carry out its activities effectively.
(c) The Secretary shall transmit a report to Congress not
later than January 1, 1986, and biennially thereafter which
shall contain--
(1) an overview and assessment of Federal activities
undertaken to inform the public of the health
consequences of smoking and the extent of public
knowledge of such consequences,
(2) a description of the Secretary's and Committee's
activities under subsection (a),
(3) information regarding the activities of the
private sector taken in response to the effects of
smoking on health, and
(4) such recommendations as the Secretary may
consider appropriate.
* * * * * * *
----------
COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2016
* * * * * * *
TITLE I--PREVENTION AND EDUCATION
* * * * * * *
SEC. 103. COMMUNITY-BASED COALITION ENHANCEMENT GRANTS TO ADDRESS LOCAL
DRUG CRISES.
(a) Definitions.--In this section:
(1) Administrator.--The term ``Administrator'' means
the Administrator of the Substance Abuse and Mental
Health Services Administration.
(2) Director.--The term ``Director'' means the
Director of the Office of National Drug Control Policy.
(3) Drug-free communities act of 1997.--The term
``Drug-Free Communities Act of 1997'' means chapter 2
of the National Narcotics Leadership Act of 1988 (21
U.S.C. 1521 et seq.).
(4) Eligible entity.--The term ``eligible entity''
means an organization that--
(A) on or before the date of submitting an
application for a grant under this section,
receives or has received a grant under the
Drug-Free Communities Act of 1997; and
(B) has documented, using local data, rates
of abuse of opioids or methamphetamines at
levels that are--
(i) significantly higher than the
national average as determined by the
Secretary (including appropriate
consideration of the results of the
Monitoring the Future Survey published
by the [National Institute on Drug
Abuse] National Institute on Drugs and
Addiction and the National Survey on
Drug Use and Health published by the
Substance Abuse and Mental Health
Services Administration); or
(ii) higher than the national
average, as determined by the Secretary
(including appropriate consideration of
the results of the surveys described in
clause (i)), over a sustained period of
time.
(5) Emerging drug abuse issue.--The term ``emerging
drug abuse issue'' means a substance use disorder
within an area involving--
(A) a sudden increase in demand for
particular drug abuse treatment services
relative to previous demand; and
(B) a lack of resources in the area to
address the emerging problem.
(6) Local drug crisis.--The term ``local drug
crisis'' means, with respect to the area served by an
eligible entity--
(A) a sudden increase in the abuse of opioids
or methamphetamines, as documented by local
data;
(B) the abuse of prescription medications,
specifically opioids or methamphetamines, that
is significantly higher than the national
average, over a sustained period of time, as
documented by local data; or
(C) a sudden increase in opioid-related
deaths, as documented by local data.
(7) Opioid.--The term ``opioid'' means any drug
having an addiction-forming or addiction-sustaining
liability similar to morphine or being capable of
conversion into a drug having such addiction-forming or
addiction-sustaining liability.
(b) Program Authorized.--The Director, in coordination with
the Administrator, may make grants to eligible entities to
implement comprehensive community-wide strategies that address
local drug crises and emerging drug abuse issues within the
area served by the eligible entity.
(c) Application.--
(1) In general.--An eligible entity seeking a grant
under this section shall submit an application to the
Director at such time, in such manner, and accompanied
by such information as the Director may require.
(2) Criteria.--As part of an application for a grant
under this section, the Director shall require an
eligible entity to submit a detailed, comprehensive,
multisector plan for addressing the local drug crisis
or emerging drug abuse issue within the area served by
the eligible entity.
(d) Use of funds.--An eligible entity shall use a grant
received under this section--
(1) for programs designed to implement comprehensive
community-wide prevention strategies to address the
local drug crisis in the area served by the eligible
entity, in accordance with the plan submitted under
subsection (c)(2);
(2) to obtain specialized training and technical
assistance from the organization funded under section 4
of Public Law 107-82 (21 U.S.C. 1521 note); and
(3) for programs designed to implement comprehensive
community-wide strategies to address emerging drug
abuse issues in the community.
(e) Supplement Not Supplant.--An eligible entity shall use
Federal funds received under this section only to supplement
the funds that would, in the absence of those Federal funds, be
made available from other Federal and non-Federal sources for
the activities described in this section, and not to supplant
those funds.
(f) Evaluation.--A grant under this section shall be subject
to the same evaluation requirements and procedures as the
evaluation requirements and procedures imposed on the recipient
of a grant under the Drug-Free Communities Act of 1997, and may
also include an evaluation of the effectiveness at reducing
abuse of opioids or methamphetamines.
(g) Limitation on Administrative Expenses.--Not more than 8
percent of the amounts made available to carry out this section
for a fiscal year may be used to pay for administrative
expenses.
(h) Delegation Authority.--The Director may enter into an
interagency agreement with the Administrator to delegate
authority for the execution of grants and for such other
activities as may be necessary to carry out this section.
(i) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $5,000,000 for each of fiscal years 2017 through
2021.
* * * * * * *
----------
PUBLIC LAW 92-255
AN ACT To establish a Special Action Office for Drug Abuse Prevention
and to concentrate the resources of the Nation against the problem of
drug abuse.
* * * * * * *
TITLE IV--OTHER FEDERAL PROGRAMS
* * * * * * *
Sec. 406. Additional drug abuse prevention functions of the Secretary
of Health and Human Services.
(b) After December 31, 1974, the Secretary shall carry out
his functions under subsection (a) through the [National
Institute on Drug Abuse] National Institute on Drugs and
Addiction.
* * * * * * *
Sec. 410. Grants and contracts for the demonstration of new and more
effective prevention, treatment, and rehabilitation
programs.
(a) The Secretary acting through the [National Institute on
Drug Abuse] National Institute on Drugs and Addiction, may make
grants to and enter into contracts with individuals and public
and private nonprofit entities--
(1) to provide training seminars, educational
programs, and technical assistance for the development,
demonstration, and evaluation of drug abuse prevention,
treatment, and rehabilitation programs; and
(2) to conduct demonstration and evaluation projects,
with a high priority on prevention and early
intervention projects and on identifying new and more
effective drug abuse prevention, treatment, and
rehabilitation programs.
In the implementation of his authority under this section, the
Secretary shall accord a high priority to applications for
grants or contracts for primary prevention programs. For
purposes of the preceding sentence, primary prevention programs
include programs designed to discourage persons from beginning
drug abuse. To the extent that appropriations authorized under
this section are used to fund treatment services, the Secretary
shall not limit such funding to treatment for opiate abuse, but
shall also provide support for treatment for nonopiate drug
abuse including polydrug abuse. Furthermore, nothing shall
prevent the use of funds provided under this section for
programs and projects aimed at the prevention, treatment, and
rehabilitation of alcohol abuse and alcoholism as well as drug
abuse.
(b) There are authorized to be appropriated $25,000,000 for
the fiscal year ending June 30, 1972; $65,000,000 for the
fiscal year ending June 30, 1973; $100,000,000 for the fiscal
year ending June 30, 1974; $160,000,000 for each of the fiscal
years ending June 30, 1975 and June 30, 1976; $40,000,000 for
the period July 1, 1976, through September 30, 1976; and
$160,000,000 for each of the fiscal years ending September 30,
1977, and September 30, 1978, to carry out this section. For
the fiscal year ending September 30, 1979, there is authorized
to be appropriated (1) $153,000,000 for grants and contracts
under paragraphs (3) and (6) of subsection (a) for drug abuse
treatment programs, and (2) $24,000,000 for grants and
contracts under such subsection for other programs and
activities. For grants and contracts under paragraphs (3) and
(6) of subsection (a) for drug abuse treatment programs there
is authorized to be appropriated $149,000,000 for the fiscal
year ending September 30, 1980, and $155,000,000 for the fiscal
year ending September 30, 1981; and for grants and contracts
under such subsection for other programs and activities there
is authorized to be appropriated $20,000,000 for the fiscal
year ending September 30, 1980, and $30,000,000 for the fiscal
year ending September 30, 1981. Of the funds appropriated under
the preceding sentence for the fiscal year ending September 30,
1980, at least 7 percent of the funds shall be obligated for
grants and contracts for primary prevention and intervention
programs designed to discourage individuals, particularly those
in high risk populations, from abusing drugs; and of the funds
appropriated under the preceding sentence for the next fiscal
year, at least 10 percent of the funds shall be obligated for
such grants and contracts. For carrying out the purposes of
this section, there are authorized to be appropriated
$15,000,000 for the fiscal year ending September 30, 1982. Of
the funds appropriated under the preceding sentence, at least
25 per centum of the funds shall be obligated for grants and
contracts for primary prevention and intervention programs
designed to discourage individuals, particularly individuals in
high risk populations, from abusing drugs.
(c)(1) In carrying out this section, the Secretary shall
require coordination of all applications for programs in a
State and shall not give precedence to public agencies over
private agencies, institutions, and organizations, or to State
agencies over local agencies.
(2) Each applicant within a State, upon filing its
application with the Secretary for a grant or contract under
this section, shall submit a copy of its application for review
by the State agency (if any) responsible for the administration
of drug abuse prevention activities. Such State agency shall be
given not more than thirty days from the date of receipt of the
application to submit to the Secretary, in writing, an
evaluation of the project set forth in the application. Such
evaluation shall include comments on the relationship of the
project to other projects pending and approved and to any State
comprehensive plan for treatment and prevention of drug abuse.
The State shall furnish the applicant a copy of any such
evaluation. A State if it so desires may, in writing, waive its
rights under this paragraph.
(3) Approval of any application for a grant or contract under
this section by the Secretary, including the earmarking of
financial assistance for a program or project, may be granted
only if the application substantially meets a set of criteria
that
(A) provide that the activities and services for
which assistance under this section is sought will be
substantially administered by or under the supervision
of the applicant;
(B) provide for such methods of administration as are
necessary for the proper and efficient operation of
such programs or projects; and
(C) provide for such fiscal control and fund
accounting procedures as may be necessary to assure
proper disbursement of and accounting for Federal funds
paid to the applicant.
(4) Each applicant within a State, upon filing its
application with the Secretary for a grant or contract to
provide treatment or rehabilitation services shall provide a
proposed performance standard or standards, to measure, or
research protocol to determine, the effectiveness of such
treatment or rehabilitation program or project.
(d) The Secretary shall encourage the submission of and give
special consideration to applications under this section to
programs and projects aimed at underserved populations such as
racial and ethnic minorities, Native Americans (including
Native Hawaiians and Native American Pacific Islanders, youth,
the elderly, women, handicapped individuals, and families of
drug abusers.
(e) Payment under grants or contracts under this section may
be made in advance or by way of reimbursement and in such
installments as the Secretary may determine.
(f) Projects and programs for which grants and contracts are
made or entered into under this section shall, in the case of
prevention and treatment services, seek to (1) be responsive to
special requirements of handicapped individuals in receiving
such services; (2) whenever possible, be community based,
insure care of good quality in general community care
facilities and under health insurance plans, and be integrated
with, and provide for the active participation of, a wide range
of public and nongovernmental agencies, organizations,
institutions, and individuals; (3) where a substantial number
of the individuals in the population served by the project or
program are of limited English-speaking ability (A) utilize the
services of outreach workers fluent in the language spoken by a
predominant number of such individuals and develop a plan and
make arrangements responsive to the needs of such population
for providing services to the extent practicable in the
language and cultural context most appropriate to such
individuals, and (B) identify an individual who is fluent both
in that language and English and whose responsibilities shall
include providing guidance to the individuals of limited
English speaking ability and to appropriate staff members with
respect to cultural sensitivities and bridging linguistic and
cultural differences; and (4) where appropriate, utilize
existing community resources (including community mental health
centers).
(g)(1) No grant may be made under this section to a State or
to any entity within the government of a State unless the grant
application has been duly authorized by the chief executive
officer of such State.
(2) No grant or contract may be made under this section for a
period in excess of five years.
(3)(A) The amount of any grant or contract under this section
may not exceed 100 per centum of the cost of carrying out the
grant or contract in the first fiscal year for which the grant
or contract is made under this section, 80 per centum of such
cost in the second fiscal year for which the grant or contract
is made under this section, 70 per centum of such cost in the
third fiscal year for which the grant or contract is made under
this section, and 60 per centum of such cost in each of the
fourth and fifth fiscal years for which the grant or contract
is made under this section.
(B) For purposes of this paragraph, no grant or contract
shall be considered to have been made under this section for a
fiscal year ending before September 30, 1981.
* * * * * * *
Sec. 412. National Drug Abuse Training Center.
(a) The Director shall establish a National Drug Abuse
Training Center (hereinafter in this section referred to as the
``Center'') to develop, conduct, and support a full range of
training programs relating to drug abuse prevention functions.
The Director shall consult with the National Advisory Council
for Drug Abuse Prevention regarding the general policies of the
Center. The Director may supervise the operation of the Center
initially, but shall transfer the supervision of the operation
of the Center to the [National Institute on Drug Abuse]
National Institute on Drugs and Addiction not later than
December 31, 1974.
(b) The Center shall conduct or arrange for training
programs, seminars, meetings, conferences, and other related
activities, including the furnishing of training and
educational materials for use by others.
(c) The services and facilities of the Center shall, in
accordance with regulations prescribed by the Director, be
available to (1) Federal, State, and local government
officials, and their respective staffs, (2) medical and
paramedical personnel, and educators, and (3) other persons,
including drug dependent persons, requiring training or
education in drug abuse prevention.
(d)(1) For the purpose of carrying out this section, there
are authorized to be appropriated $1,000,000 for the fiscal
year ending June 30, 1972, $3,000,000 for the fiscal year
ending June 30, 1973, $5,000,000 for the fiscal year ending
June 30, 1974, and $6,000,000 for the fiscal year ending June
30, 1975.
(2) Sums appropriated under this subsection shall remain
available for obligation or expenditure in the fiscal year for
which appropriated and in the fiscal year next following.
* * * * * * *
----------
OMNIBUS CRIME CONTROL AND SAFE STREETS ACT OF 1968
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled, That this
Act may be cited as the ``Omnibus Crime Control and Safe
Streets Act of 1968''.
TITLE I--JUSTICE SYSTEM IMPROVEMENT
* * * * * * *
PART FF--OFFENDER REENTRY AND COMMUNITY SAFETY
SEC. 2976. ADULT AND JUVENILE OFFENDER STATE AND LOCAL REENTRY
DEMONSTRATION PROJECTS.
(a) Grant Authorization.--The Attorney General shall make
grants to States, local governments, territories, or Indian
tribes, or any combination thereof (in this section referred to
as an ``eligible entity''), in partnership with interested
persons (including Federal corrections and supervision
agencies), service providers, and nonprofit organizations for
the purpose of strategic planning and implementation of adult
and juvenile offender reentry projects.
(b) Adult Offender Reentry Demonstration Projects.--Funds for
adult offender demonstration projects may be expended for--
(1) providing offenders in prisons, jails, or
juvenile facilities with educational, literacy,
vocational, and job placement services to facilitate
re-entry into the community;
(2) providing substance abuse treatment and services
(including providing a full continuum of substance
abuse treatment services that encompasses outpatient
and comprehensive residential services and recovery);
(3) providing coordinated supervision and
comprehensive services for offenders upon release from
prison, jail, or a juvenile facility, including housing
and mental and physical health care to facilitate re-
entry into the community, or reentry courts, and which,
to the extent applicable, are provided by community-
based entities (including coordinated reentry veteran-
specific services for eligible veterans);
(4) providing programs that--
(A) encourage offenders to develop safe,
healthy, and responsible family relationships
and parent-child relationships; and
(B) involve the entire family unit in
comprehensive reentry services (as appropriate
to the safety, security, and well-being of the
family and child);
(5) encouraging the involvement of prison, jail, or
juvenile facility mentors in the reentry process and
enabling those mentors to remain in contact with
offenders while in custody and after reentry into the
community;
(6) providing victim-appropriate services,
encouraging the timely and complete payment of
restitution and fines by offenders to victims, and
providing services such as security and counseling to
victims upon release of offenders;
(7) protecting communities against dangerous
offenders by using validated assessment tools to assess
the risk factors of returning inmates and developing or
adopting procedures to ensure that dangerous felons are
not released from prison prematurely; and
(8) promoting employment opportunities consistent
with the Transitional Jobs strategy (as defined in
section 4 of the Second Chance Act of 2007 (34 U.S.C.
60502)).
(c) Juvenile Offender Reentry Demonstration Projects.--Funds
for the juvenile offender reentry demonstration projects may be
expended for any activity described in subsection (b).
(d) Combined Grant Application; Priority Consideration.--
(1) In general.--The Attorney General shall develop a
procedure to allow applicants to submit a single
application for a planning grant under subsection (e)
and an implementation grant under subsection (f).
(2) Priority consideration.--The Attorney General
shall give priority consideration to grant applications
under subsections (e) and (f) that include a commitment
by the applicant to partner with a local evaluator to
identify and analyze data that will--
(A) enable the grantee to target the intended
offender population; and
(B) serve as a baseline for purposes of the
evaluation.
(e) Planning Grants.--
(1) In general.--Except as provided in paragraph (3),
the Attorney General may make a grant to an eligible
entity of not more than $75,000 to develop a strategic,
collaborative plan for an adult or juvenile offender
reentry demonstration project as described in
subsection (h) that includes--
(A) a budget and a budget justification;
(B) a description of the outcome measures
that will be used to measure the effectiveness
of the program in promoting public safety and
public health;
(C) the activities proposed;
(D) a schedule for completion of the
activities described in subparagraph (C); and
(E) a description of the personnel necessary
to complete the activities described in
subparagraph (C).
(2) Maximum total grants and geographic diversity.--
(A) Maximum amount.--The Attorney General may
not make initial planning grants and
implementation grants to 1 eligible entity in a
total amount that is more than a $1,000,000.
(B) Geographic diversity.--The Attorney
General shall make every effort to ensure
equitable geographic distribution of grants
under this section and take into consideration
the needs of underserved populations, including
rural and tribal communities.
(3) Period of grant.--A planning grant made under
this subsection shall be for a period of not longer
than 1 year, beginning on the first day of the month in
which the planning grant is made.
(f) Implementation Grants.--
(1) Applications.--An eligible entity desiring an
implementation grant under this subsection shall submit
to the Attorney General an application that--
(A) contains a reentry strategic plan as
described in subsection (h), which describes
the long-term strategy and incorporates a
detailed implementation schedule, including the
plans of the applicant to fund the program
after Federal funding is discontinued;
(B) identifies the local government role and
the role of governmental agencies and nonprofit
organizations that will be coordinated by, and
that will collaborate on, the offender reentry
strategy of the applicant, and certifies the
involvement of such agencies and organizations;
(C) describes the evidence-based methodology
and outcome measures that will be used to
evaluate the program funded with a grant under
this subsection, and specifically explains how
such measurements will provide valid measures
of the impact of that program; and
(D) describes how the project could be
broadly replicated if demonstrated to be
effective.
(2) Requirements.--The Attorney General may make a
grant to an applicant under this subsection only if the
application--
(A) reflects explicit support of the chief
executive officer, or their designee, of the
State, unit of local government, territory, or
Indian tribe applying for a grant under this
subsection;
(B) provides discussion of the role of
Federal corrections, State corrections
departments, community corrections agencies,
juvenile justice systems, and tribal or local
jail systems in ensuring successful reentry of
offenders into their communities;
(C) provides evidence of collaboration with
State, local, or tribal government agencies
overseeing health, housing, child welfare,
education, substance abuse, victims services,
and employment services, and with local law
enforcement agencies;
(D) provides a plan for analysis of the
statutory, regulatory, rules-based, and
practice-based hurdles to reintegration of
offenders into the community;
(E) includes the use of a State, local,
territorial, or tribal task force, described in
subsection (i), to carry out the activities
funded under the grant;
(F) provides a plan for continued
collaboration with a local evaluator as
necessary to meeting the requirements under
subsection (h); and
(G) demonstrates that the applicant
participated in the planning grant process or
engaged in comparable planning for the reentry
project.
(3) Priority considerations.--The Attorney General
shall give priority to grant applications under this
subsection that best--
(A) focus initiative on geographic areas with
a disproportionate population of offenders
released from prisons, jails, and juvenile
facilities;
(B) include--
(i) input from nonprofit
organizations, in any case where
relevant input is available and
appropriate to the grant application;
(ii) consultation with crime victims
and offenders who are released from
prisons, jails, and juvenile
facilities;
(iii) coordination with families of
offenders;
(iv) input, where appropriate, from
the juvenile justice coordinating
council of the region;
(v) input, where appropriate, from
the reentry coordinating council of the
region; or
(vi) input, where appropriate, from
other interested persons;
(C) demonstrate effective case assessment and
management abilities in order to provide
comprehensive and continuous reentry,
including--
(i) planning for prerelease
transitional housing and community
release that begins upon admission for
juveniles and jail inmates, and, as
appropriate, for prison inmates,
depending on the length of the
sentence;
(ii) establishing prerelease planning
procedures to ensure that the
eligibility of an offender for Federal,
tribal, or State benefits upon release
is established prior to release,
subject to any limitations in law, and
to ensure that offenders obtain all
necessary referrals for reentry
services, including assistance
identifying and securing suitable
housing; or
(iii) delivery of continuous and
appropriate mental health services,
drug treatment, medical care, job
training and placement, educational
services, vocational services, and any
other service or support needed for
reentry;
(D) review the process by which the applicant
adjudicates violations of parole, probation, or
supervision following release from prison,
jail, or a juvenile facility, taking into
account public safety and the use of graduated,
community-based sanctions for minor and
technical violations of parole, probation, or
supervision (specifically those violations that
are not otherwise, and independently, a
violation of law);
(E) provide for an independent evaluation of
reentry programs that include, to the maximum
extent possible, random assignment and
controlled studies to determine the
effectiveness of such programs;
(F) target moderate and high-risk offenders
for reentry programs through validated
assessment tools; or
(G) target offenders with histories of
homelessness, substance abuse, or mental
illness, including a prerelease assessment of
the housing status of the offender and
behavioral health needs of the offender with
clear coordination with mental health,
substance abuse, and homelessness services
systems to achieve stable and permanent housing
outcomes with appropriate support service.
(4) Period of grant.--A grant made under this
subsection shall be effective for a 2-year period--
(A) beginning on the date on which the
planning grant awarded under subsection (e)
concludes; or
(B) in the case of an implementation grant
awarded to an eligible entity that did not
receive a planning grant, beginning on the date
on which the implementation grant is awarded.
(g) Uses of Grant Funds.--
(1) Federal share.--
(A) In general.--The Federal share of a grant
received under this section may not exceed 50
percent of the project funded under such grant.
(B) In-kind contributions.--
(i) In general.--Subject to clause
(ii), the recipient of a grant under
this section may meet the matching
requirement under subparagraph (A) by
making in-kind contributions of goods
or services that are directly related
to the purpose for which such grant was
awarded.
(ii) Maximum percentage.--Not more
than 50 percent of the amount provided
by a recipient of a grant under this
section to meet the matching
requirement under subparagraph (A) may
be provided through in-kind
contributions under clause (i).
(2) Supplement not supplant.--Federal funds received
under this section shall be used to supplement, not
supplant, non-Federal funds that would otherwise be
available for the activities funded under this section.
(h) Reentry Strategic Plan.--
(1) In general.--As a condition of receiving
financial assistance under subsection (f), each
application shall develop a comprehensive reentry
strategic plan that--
(A) contains a plan to assess inmate reentry
needs and measurable annual and 3-year
performance outcomes;
(B) uses, to the maximum extent possible,
randomly assigned and controlled studies, or
rigorous quasi-experimental studies with
matched comparison groups, to determine the
effectiveness of the program funded with a
grant under subsection (f); and
(C) includes as a goal of the plan to reduce
the rate of recidivism for offenders released
from prison, jail or a juvenile facility with
funds made available under subsection (f).
(2) Local evaluator.--A partnership with a local
evaluator described in subsection (d)(2) shall require
the local evaluator to use the baseline data and target
population characteristics developed under a subsection
(e) planning grant to derive a target goal for
recidivism reduction during the 3-year period beginning
on the date of implementation of the program.
(3) Coordination.--In developing a reentry plan under
this subsection, an applicant shall coordinate with
communities and stakeholders, including persons in the
fields of public safety, juvenile and adult
corrections, housing, health, education, substance
abuse, children and families, victims services,
employment, and business and members of nonprofit
organizations that can provide reentry services.
(4) Measurements of progress.--Each reentry plan
developed under this subsection shall measure the
progress of the applicant toward increasing public
safety by reducing rates of recidivism and enabling
released offenders to transition successfully back into
their communities.
(i) Reentry Task Force.--
(1) In general.--As a condition of receiving
financial assistance under subsection (f), each
applicant shall establish or empower a Reentry Task
Force, or other relevant convening authority, to--
(A) examine ways to pool resources and
funding streams to promote lower recidivism
rates for returning offenders and minimize the
harmful effects of offenders' time in prison,
jail, or a juvenile facility on families and
communities of offenders by collecting data and
best practices in offender reentry from
demonstration grantees and other agencies and
organizations; and
(B) provide the analysis described in
subsection (f)(2)(D).
(2) Membership.--The task force or other authority
under this subsection shall be comprised of--
(A) relevant State, Tribal, territorial, or
local leaders; and
(B) representatives of relevant--
(i) agencies;
(ii) service providers;
(iii) nonprofit organizations; and
(iv) stakeholders.
(j) Strategic Performance Outcomes.--
(1) In general.--Each applicant for an implementation
grant under subsection (f) shall identify in the
reentry strategic plan developed under subsection (h),
specific performance outcomes relating to the long-term
goals of increasing public safety and reducing
recidivism.
(2) Performance outcomes.--The performance outcomes
identified under paragraph (1) shall include, with
respect to offenders released back into the community--
(A) reduction in recidivism rates, which
shall be reported in accordance with the
measure selected by the Director of the Bureau
of Justice Statistics under section 234(c)(2)
of the Second Chance Act of 2007;
(B) reduction in crime;
(C) increased employment and education
opportunities;
(D) reduction in violations of conditions of
supervised release;
(E) increased payment of child support, where
appropriate;
(F) increased number of staff trained to
administer reentry services;
(G) increased proportion of individuals
served by the program among those eligible to
receive services;
(H) increased number of individuals receiving
risk screening needs assessment, and case
planning services;
(I) increased enrollment in, and completion
of treatment services, including substance
abuse and mental health services among those
assessed as needing such services;
(J) increased enrollment in and degrees
earned from educational programs, including
high school, GED, vocational training, and
college education;
(K) increased number of individuals obtaining
and retaining employment;
(L) increased number of individuals obtaining
and maintaining housing;
(M) increased self-reports of successful
community living, including stability of living
situation and positive family relationships;
(N) reduction in drug and alcohol use; and
(O) reduction in recidivism rates for
individuals receiving reentry services after
release, as compared to either baseline
recidivism rates in the jurisdiction of the
grantee or recidivism rates of the control or
comparison group.
(3) Other outcomes.--A grantee under this section may
include in the reentry strategic plan developed under
subsection (h) other performance outcomes that increase
the success rates of offenders who transition from
prison, jails, or juvenile facilities, including a
cost-benefit analysis to determine the cost
effectiveness of the reentry program.
(4) Coordination.--A grantee under subsection (f)
shall coordinate with communities and stakeholders
about the selection of performance outcomes identified
by the applicant, and shall consult with the Attorney
General for assistance with data collection and
measurement activities as provided for in the grant
application materials.
(5) Report.--Each grantee under subsection (f) shall
submit to the Attorney General an annual report that--
(A) identifies the progress of the grantee
toward achieving its strategic performance
outcomes; and
(B) describes other activities conducted by
the grantee to increase the success rates of
the reentry population, such as programs that
foster effective risk management and treatment
programming, offender accountability, and
community and victim participation.
(k) Performance Measurement.--
(1) In general.--The Attorney General, in
consultation with grantees under subsection (f),
shall--
(A) identify primary and secondary sources of
information to support the measurement of the
performance indicators identified under
subsection (f);
(B) identify sources and methods of data
collection in support of performance
measurement required under subsection (f);
(C) provide to all grantees technical
assistance and training on performance measures
and data collection for purposes of subsection
(f); and
(D) consult with the Substance Abuse and
Mental Health Services Administration and the
[National Institute on Drug Abuse] National
Institute on Drugs and Addiction on strategic
performance outcome measures and data
collection for purposes of subsection (f)
relating to substance abuse and mental health.
(2) Coordination.--The Attorney General shall
coordinate with other Federal agencies to identify
national and other sources of information to support
performance measurement of grantees.
(3) Standards for analysis.--Any statistical analysis
of population data conducted pursuant to this section
shall be conducted in accordance with the Federal
Register Notice dated October 30, 1997, relating to
classification standards.
(l) Future Eligibility.--To be eligible to receive a grant
under this section in any fiscal year after the fiscal year in
which a grantee receives a grant under this section, a grantee
shall submit to the Attorney General such information as is
necessary to demonstrate that--
(1) the grantee has adopted a reentry plan that
reflects input from nonprofit organizations, in any
case where relevant input is available and appropriate
to the grant application;
(2) the reentry plan of the grantee includes
performance measures to assess progress of the grantee
toward a 10 percent reduction in the rate of recidivism
over a 2-year period beginning on the date on which the
most recent implementation grant is made to the grantee
under subsection (f);
(3) the grantee will coordinate with the Attorney
General, nonprofit organizations (if relevant input
from nonprofit organizations is available and
appropriate), and other experts regarding the selection
and implementation of the performance measures
described in subsection (k); and
(4) the grantee has made adequate progress, as
determined by the Attorney General, toward reducing the
rate of recidivism by 10 percent during the 2-year
period described in paragraph (2).
(m) National Adult and Juvenile Offender Reentry Resource
Center.--
(1) Authority.--The Attorney General may, using
amounts made available to carry out this subsection,
make a grant to an eligible organization to provide for
the establishment of a National Adult and Juvenile
Offender Reentry Resource Center.
(2) Eligible organization.--An organization eligible
for the grant under paragraph (1) is any national
nonprofit organization approved by the Interagency Task
Force on Federal Programs and Activities Relating to
the Reentry of Offenders Into the Community, that
provides technical assistance and training to, and has
special expertise and broad, national-level experience
in, offender reentry programs, training, and research.
(3) Use of funds.--The organization receiving a grant
under paragraph (1) shall establish a National Adult
and Juvenile Offender Reentry Resource Center to--
(A) provide education, training, and
technical assistance for States, tribes,
territories, local governments, service
providers, nonprofit organizations, and
corrections institutions;
(B) collect data and best practices in
offender reentry from demonstration grantees
and others agencies and organizations;
(C) develop and disseminate evaluation tools,
mechanisms, and measures to better assess and
document coalition performance measures and
outcomes;
(D) disseminate information to States and
other relevant entities about best practices,
policy standards, and research findings;
(E) develop and implement procedures to
assist relevant authorities in determining when
release is appropriate and in the use of data
to inform the release decision;
(F) develop and implement procedures to
identify efficiently and effectively those
violators of probation, parole, or supervision
following release from prison, jail, or a
juvenile facility who should be returned to
prisons, jails, or juvenile facilities and
those who should receive other penalties based
on defined, graduated sanctions;
(G) collaborate with the Interagency Task
Force on Federal Programs and Activities
Relating to the Reentry of Offenders Into the
Community, and the Federal Resource Center for
Children of Prisoners;
(H) develop a national reentry research
agenda; and
(I) establish a database to enhance the
availability of information that will assist
offenders in areas including housing,
employment, counseling, mentoring, medical and
mental health services, substance abuse
treatment, transportation, and daily living
skills.
(4) Limit.--Of amounts made available to carry out
this section, not more than 4 percent of the authorized
level shall be available to carry out this subsection.
(n) Administration.--Of amounts made available to carry out
this section--
(1) not more than 2 percent of the authorized level
shall be available for administrative expenses in
carrying out this section; and
(2) not more than 2 percent of the authorized level
shall be made available to the National Institute of
Justice to evaluate the effectiveness of the
demonstration projects funded under this section, using
a methodology that--
(A) includes, to the maximum extent feasible,
random assignment of offenders (or entities
working with such persons) to program delivery
and control groups; and
(B) generates evidence on which reentry
approaches and strategies are most effective.
(o) Authorization of Appropriations.--
(1) In general.--To carry out this section, there are
authorized to be appropriated $35,000,000 for each of
fiscal years 2019 through 2023.
(2) Limitation; equitable distribution.--
(A) Limitation.--Of the amount made available
to carry out this section for any fiscal year,
not more than 3 percent or less than 2 percent
may be used for technical assistance and
training.
(B) Equitable distribution.--The Attorney
General shall ensure that grants awarded under
this section are equitably distributed among
the geographical regions and between urban and
rural populations, including Indian Tribes,
consistent with the objective of reducing
recidivism among criminal offenders.
(p) Definition.--In this section, the term ``reentry court''
means a program that--
(1) monitors juvenile and adult eligible offenders
reentering the community;
(2) provides continual judicial supervision;
(3) provides juvenile and adult eligible offenders
reentering the community with coordinated and
comprehensive reentry services and programs, such as--
(A) drug and alcohol testing and assessment
for treatment;
(B) assessment for substance abuse from a
substance abuse professional who is approved by
the State or Indian tribe and licensed by the
appropriate entity to provide alcohol and drug
addiction treatment, as appropriate;
(C) substance abuse treatment, including
medication-assisted treatment, from a provider
that is approved by the State or Indian tribe,
and licensed, if necessary, to provide medical
and other health services;
(D) health (including mental health) services
and assessment;
(E) aftercare and case management services
that--
(i) facilitate access to clinical
care and related health services; and
(ii) coordinate with such clinical
care and related health services; and
(F) any other services needed for reentry;
(4) convenes community impact panels, victim impact
panels, or victim impact educational classes;
(5) provides and coordinates the delivery of
community services to juvenile and adult eligible
offenders, including--
(A) housing assistance;
(B) education;
(C) job training;
(D) conflict resolution skills training;
(E) batterer intervention programs; and
(F) other appropriate social services; and
(6) establishes and implements graduated sanctions
and incentives.
* * * * * * *
----------
SECTION 7361 OF TITLE 5, UNITED STATES CODE
Sec. 7361. Drug abuse
(a) The Office of Personnel Management shall be responsible
for developing, in cooperation with the President, with the
Secretary of Health and Human Services (acting through the
[National Institute on Drug Abuse] National Institute on Drugs
and Addiction), and with other agencies, and in accordance with
applicable provisions of this subchapter, appropriate
prevention, treatment, and rehabilitation programs and services
for drug abuse among employees. Such agencies are encouraged to
extend, to the extent feasible, such programs and services to
the families of employees and to employees who have family
members who are drug abusers. Such programs and services shall
make optimal use of existing governmental facilities, services,
and skills.
(b) Section 527 of the Public Health Service Act (42 U.S.C.
290ee-3), relating to confidentiality of records, and any
regulations prescribed thereunder, shall apply with respect to
records maintained for the purpose of carrying out this
section.
(c) Each agency shall, with respect to any programs or
services provided by such agency, submit such written reports
as the Office may require in connection with any report
required under section 7363 of this title.
(d) For the purpose of this section, the term ``agency''
means an Executive agency.
----------
SECTION 303 OF CONTROLLED SUBSTANCES ACT
registration requirements
Sec. 303. (a) The Attorney General shall register an
applicant to manufacture controlled substances in schedule I or
II if he determines that such registration is consistent with
the public interest and with United States obligations under
international treaties, conventions, or protocols in effect on
the effective date of this part. In determining the public
interest, the following factors shall be considered:
(1) maintenance of effective controls against
diversion of particular controlled substances and any
controlled substance in schedule I or II compounded
therefrom into other than legitimate medical,
scientific, research, or industrial channels, by
limiting the importation and bulk manufacture of such
controlled substances to a number of establishments
which can produce an adequate and uninterrupted supply
of these substances under adequately competitive
conditions for legitimate medical, scientific,
research, and industrial purposes;
(2) compliance with applicable State and local law;
(3) promotion of technical advances in the art of
manufacturing these substances and the development of
new substances;
(4) prior conviction record of applicant under
Federal and State laws relating to the manufacture,
distribution, or dispensing of such substances;
(5) past experience in the manufacture of controlled
substances, and the existence in the establishment of
effective control against diversion; and
(6) such other factors as may be relevant to and
consistent with the public health and safety.
(b) The Attorney General shall register an applicant to
distribute a controlled substance in schedule I or II unless he
determines that the issuance of such registration is
inconsistent with the public interest. In determining the
public interest, the following factors shall be considered:
(1) maintenance of effective controls against
diversion of particular controlled substances into
other than legitimate medical, scientific, and
industrial channels;
(2) compliance with applicable State and local law;
(3) prior conviction record of applicant under
Federal or State laws relating to the manufacture,
distribution, or dispensing of such substances;
(4) past experience in the distribution of controlled
substances; and
(5) such other factors as may be relevant to and
consistent with the public health and safety.
(c) Registration granted under subsections (a) and (b) of
this section shall not entitle a registrant to (1) manufacture
or distribute controlled substances in schedule I or II other
than those specified in the registration, or (2) manufacture
any quantity of those controlled substances in excess of the
quota assigned pursuant to section 306.
(d) The Attorney General shall register an applicant to
manufacture controlled substances in schedule III, IV, or V,
unless he determines that the issuance of such registration is
inconsistent with the public interest. In determining the
public interest, the following factors shall be considered:
(1) maintenance of effective controls against
diversion of particular controlled substances and any
controlled substance in schedule III, IV, or V
compounded therefrom into other than legitimate
medical, scientific, or industrial channels;
(2) compliance with applicable State and local law;
(3) promotion of technical advances in the art of
manufacturing these substances and the development of
new substances;
(4) prior conviction record of applicant under
Federal or State laws relating to the manufacture,
distribution, or dispensing of such substances;
(5) past experience in the manufacture, distribution,
and dispensing of controlled substances, and the
existence in the establishment of effective controls
against diversion; and
(6) such other factors as may be relevant to and
consistent with the public health and safety.
(e) The Attorney General shall register an applicant to
distribute controlled substances in schedule III, IV, or V,
unless he determines that the issuance of such registration is
inconsistent with the public interest. In determining the
public interest, the following factors shall be considered:
(1) maintenance of effective controls against
diversion of particular controlled substances into
other than legitimate medical, scientific, and
industrial channels;
(2) compliance with applicable State and local law;
(3) prior conviction record of applicant under
Federal or State laws relating to the manufacture,
distribution, or dispensing of such substances;
(4) past experience in the distribution of controlled
substances; and
(5) such other factors as may be relevant to and
consistent with the public health and safety.
(f) The Attorney General shall register practitioners
(including pharmacies, as distinguished from pharmacists) to
dispense, or conduct research with, controlled substances in
schedule II, III, IV, or V and shall modify the registrations
of pharmacies so registered to authorize them to dispense
controlled substances by means of the Internet, if the
applicant is authorized to dispense, or conduct research with
respect to, controlled substances under the laws of the State
in which he practices. The Attorney General may deny an
application for such registration or such modification of
registration if the Attorney General determines that the
issuance of such registration or modification would be
inconsistent with the public interest. In determining the
public interest, the following factors shall be considered:
(1) The recommendation of the appropriate State
licensing board or professional disciplinary authority.
(2) The applicant's experience in dispensing, or
conducting research with respect to controlled
substances.
(3) The applicant's conviction record under Federal
or State laws relating to the manufacture,
distribution, or dispensing of controlled substances.
(4) Compliance with applicable State, Federal, or
local laws relating to controlled substances.
(5) Such other conduct which may threaten the public
health and safety.
Separate registration under this part for practitioners
engaging in research with controlled substances in schedule II,
III, IV, or V, who are already registered under this part in
another capacity, shall not be required. Registration
applications by practitioners wishing to conduct research with
controlled substances in schedule I shall be referred to the
Secretary, who shall determine the qualifications and
competency of each practitioner requesting registration, as
well as the merits of the research protocol. The Secretary, in
determining the merits of each research protocol, shall consult
with the Attorney General as to effective procedures to
adequately safeguard against diversion of such controlled
substances from legitimate medical or scientific use.
Registration for the purpose of bona fide research with
controlled substances in schedule I by a practitioner deemed
qualified by the Secretary may be denied by the Attorney
General only on a ground specified in section 304(a). Article 7
of the Convention on Psychotrophic Substances shall not be
construed to prohibit, or impose additional restrictions upon,
research involving drugs or other substances scheduled under
the convention which is conducted in conformity with this
subsection and other applicable provisions of this title.
(g)(1) Except as provided in paragraph (2), practitioners who
dispense narcotic drugs to individuals for maintenance
treatment or detoxification treatment shall obtain annually a
separate registration for that purpose. The Attorney General
shall register an applicant to dispense narcotic drugs to
individuals for maintenance treatment or detoxification
treatment (or both)--
(A) if the applicant is a practitioner who is
determined by the Secretary to be qualified (under
standards established by the Secretary) to engage in
the treatment with respect to which registration is
sought;
(B) if the Attorney General determines that the
applicant will comply with standards established by the
Attorney General respecting (i) security of stocks of
narcotic drugs for such treatment, and (ii) the
maintenance of records (in accordance with section 307)
on such drugs; and
(C) if the Secretary determines that the applicant
will comply with standards established by the Secretary
(after consultation with the Attorney General)
respecting the quantities of narcotic drugs which may
be provided for unsupervised use by individuals in such
treatment.
(2)(A) Subject to subparagraphs (D) and (J), the requirements
of paragraph (1) are waived in the case of the dispensing
(including the prescribing), by a practitioner, of narcotic
drugs in schedule III, IV, or V or combinations of such drugs
if the practitioner meets the conditions specified in
subparagraph (B) and the narcotic drugs or combinations of such
drugs meet the conditions specified in subparagraph (C).
(B) For purposes of subparagraph (A), the conditions
specified in this subparagraph with respect to a practitioner
are that, before the initial dispensing of narcotic drugs in
schedule III, IV, or V or combinations of such drugs to
patients for maintenance or detoxification treatment, the
practitioner submit to the Secretary a notification of the
intent of the practitioner to begin dispensing the drugs or
combinations for such purpose, and that the notification
contain the following certifications by the practitioner:
(i) The practitioner is a qualifying practitioner (as
defined in subparagraph (G)).
(ii) With respect to patients to whom the
practitioner will provide such drugs or combinations of
drugs, the practitioner has the capacity to provide
directly, by referral, or in such other manner as
determined by the Secretary--
(I) all drugs approved by the Food and Drug
Administration for the treatment of opioid use
disorder, including for maintenance,
detoxification, overdose reversal, and relapse
prevention; and
(II) appropriate counseling and other
appropriate ancillary services.
(iii)(I) The total number of such patients of the
practitioner at any one time will not exceed the
applicable number. Except as provided in subclause
(II), the applicable number is 30.
(II) The applicable number is--
(aa) 100 if, not sooner than 1 year after the
date on which the practitioner submitted the
initial notification, the practitioner submits
a second notification to the Secretary of the
need and intent of the practitioner to treat up
to 100 patients;
(bb) 100 if the practitioner holds additional
credentialing, as defined in section 8.2 of
title 42, Code of Federal Regulations (or
successor regulations);
(cc) 100 if the practitioner provides
medication-assisted treatment (MAT) using
covered medications (as such terms are defined
in section 8.2 of title 42, Code of Federal
Regulations (or successor regulations)) in a
qualified practice setting (as described in
section 8.615 of title 42, Code of Federal
Regulations (or successor regulations)); or
(dd) 275 if the practitioner meets the
requirements specified in sections 8.610
through 8.655 of title 42, Code of Federal
Regulations (or successor regulations).
(III) The Secretary may by regulation change such
applicable number.
(IV) The Secretary may exclude from the applicable
number patients to whom such drugs or combinations of
drugs are directly administered by the qualifying
practitioner in the office setting.
(C) For purposes of subparagraph (A), the conditions
specified in this subparagraph with respect to narcotic drugs
in schedule III, IV, or V or combinations of such drugs are as
follows:
(i) The drugs or combinations of drugs have, under
the Federal Food, Drug, and Cosmetic Act or section 351
of the Public Health Service Act, been approved for use
in maintenance or detoxification treatment.
(ii) The drugs or combinations of drugs have not been
the subject of an adverse determination. For purposes
of this clause, an adverse determination is a
determination published in the Federal Register and
made by the Secretary, after consultation with the
Attorney General, that the use of the drugs or
combinations of drugs for maintenance or detoxification
treatment requires additional standards respecting the
qualifications of practitioners to provide such
treatment, or requires standards respecting the
quantities of the drugs that may be provided for
unsupervised use.
(D)(i) A waiver under subparagraph (A) with respect to a
practitioner is not in effect unless (in addition to conditions
under subparagraphs (B) and (C)) the following conditions are
met:
(I) The notification under subparagraph (B) is in
writing and states the name of the practitioner.
(II) The notification identifies the registration
issued for the practitioner pursuant to subsection (f).
(III) If the practitioner is a member of a group
practice, the notification states the names of the
other practitioners in the practice and identifies the
registrations issued for the other practitioners
pursuant to subsection (f).
(ii) Upon receiving a determination from the Secretary under
clause (iii) finding that a practitioner meets all requirements
for a waiver under subparagraph (B), the Attorney General shall
assign the practitioner involved an identification number under
this paragraph for inclusion with the registration issued for
the practitioner pursuant to subsection (f). The identification
number so assigned shall be appropriate to preserve the
confidentiality of patients for whom the practitioner has
dispensed narcotic drugs under a waiver under subparagraph (A).
(iii) Not later than 45 days after the date on which the
Secretary receives a notification under subparagraph (B), the
Secretary shall make a determination of whether the
practitioner involved meets all requirements for a waiver under
subparagraph (B) and shall forward such determination to the
Attorney General. If the Secretary fails to make such
determination by the end of the such 45-day period, the
Attorney General shall assign the practitioner an
identification number described in clause (ii) at the end of
such period.
(E)(i) If a practitioner is not registered under paragraph
(1) and, in violation of the conditions specified in
subparagraphs (B) through (D), dispenses narcotic drugs in
schedule III, IV, or V or combinations of such drugs for
maintenance treatment or detoxification treatment, the Attorney
General may, for purposes of section 304(a)(4), consider the
practitioner to have committed an act that renders the
registration of the practitioner pursuant to subsection (f) to
be inconsistent with the public interest.
(ii)(I) Upon the expiration of 45 days from the date on which
the Secretary receives a notification under subparagraph (B), a
practitioner who in good faith submits a notification under
subparagraph (B) and reasonably believes that the conditions
specified in subparagraphs (B) through (D) have been met shall,
in dispensing narcotic drugs in schedule III, IV, or V or
combinations of such drugs for maintenance treatment or
detoxification treatment, be considered to have a waiver under
subparagraph (A) until notified otherwise by the Secretary,
except that such a practitioner may commence to prescribe or
dispense such narcotic drugs for such purposes prior to the
expiration of such 45-day period if it facilitates the
treatment of an individual patient and both the Secretary and
the Attorney General are notified by the practitioner of the
intent to commence prescribing or dispensing such narcotic
drugs.
(II) For purposes of subclause (I), the publication in the
Federal Register of an adverse determination by the Secretary
pursuant to subparagraph (C)(ii) shall (with respect to the
narcotic drug or combination involved) be considered to be a
notification provided by the Secretary to practitioners,
effective upon the expiration of the 30-day period beginning on
the date on which the adverse determination is so published.
(F)(i) With respect to the dispensing of narcotic drugs in
schedule III, IV, or V or combinations of such drugs to
patients for maintenance or detoxification treatment, a
practitioner may, in his or her discretion, dispense such drugs
or combinations for such treatment under a registration under
paragraph (1) or a waiver under subparagraph (A) (subject to
meeting the applicable conditions).
(ii) This paragraph may not be construed as having any legal
effect on the conditions for obtaining a registration under
paragraph (1), including with respect to the number of patients
who may be served under such a registration.
(G) For purposes of this paragraph:
(i) The term ``group practice'' has the meaning given
such term in section 1877(h)(4) of the Social Security
Act.
(ii) The term ``qualifying physician'' means a
physician who is licensed under State law and who meets
one or more of the following conditions:
(I) The physician holds a board certification
in addiction psychiatry or addiction medicine
from the American Board of Medical Specialties.
(II) The physician holds an addiction
certification or board certification from the
American Society of Addiction Medicine or the
American Board of Addiction Medicine.
(III) The physician holds a board
certification in addiction medicine from the
American Osteopathic Association.
(IV) The physician has, with respect to the
treatment and management of opiate-dependent
patients, completed not less than 8 hours of
training (through classroom situations,
seminars at professional society meetings,
electronic communications, or otherwise) that
is provided by the American Society of
Addiction Medicine, the American Academy of
Addiction Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Psychiatric
Association, or any other organization that the
Secretary determines is appropriate for
purposes of this subclause. Such training shall
include--
(aa) opioid maintenance and
detoxification;
(bb) appropriate clinical use of all
drugs approved by the Food and Drug
Administration for the treatment of
opioid use disorder;
(cc) initial and periodic patient
assessments (including substance use
monitoring);
(dd) individualized treatment
planning, overdose reversal, and
relapse prevention;
(ee) counseling and recovery support
services;
(ff) staffing roles and
considerations;
(gg) diversion control; and
(hh) other best practices, as
identified by the Secretary.
(V) The physician has participated as an
investigator in one or more clinical trials
leading to the approval of a narcotic drug in
schedule III, IV, or V for maintenance or
detoxification treatment, as demonstrated by a
statement submitted to the Secretary by the
sponsor of such approved drug.
(VI) The physician has such other training or
experience as the State medical licensing board
(of the State in which the physician will
provide maintenance or detoxification
treatment) considers to demonstrate the ability
of the physician to treat and manage opiate-
dependent patients.
(VII) The physician has such other training
or experience as the Secretary considers to
demonstrate the ability of the physician to
treat and manage opiate-dependent patients. Any
criteria of the Secretary under this subclause
shall be established by regulation. Any such
criteria are effective only for 3 years after
the date on which the criteria are promulgated,
but may be extended for such additional
discrete 3-year periods as the Secretary
considers appropriate for purposes of this
subclause. Such an extension of criteria may
only be effectuated through a statement
published in the Federal Register by the
Secretary during the 30-day period preceding
the end of the 3-year period involved.
(VIII) The physician graduated in good standing from
an accredited school of allopathic medicine or
osteopathic medicine in the United States during the 5-
year period immediately preceding the date on which the
physician submits to the Secretary a written
notification under subparagraph (B) and successfully
completed a comprehensive allopathic or osteopathic
medicine curriculum or accredited medical residency
that--
(aa) included not less than 8 hours of
training on treating and managing opioid-
dependent patients; and
(bb) included, at a minimum--
(AA) the training described in items
(aa) through (gg) of subclause (IV);
and
(BB) training with respect to any
other best practice the Secretary
determines should be included in the
curriculum, which may include training
on pain management, including
assessment and appropriate use of
opioid and non-opioid alternatives.
(iii) The term ``qualifying practitioner'' means--
(I) a qualifying physician, as defined in
clause (ii);
(II) a qualifying other practitioner, as
defined in clause (iv), who is a nurse
practitioner or physician assistant; or
(III) for the period beginning on October 1,
2018, and ending on October 1, 2023, a
qualifying other practitioner, as defined in
clause (iv), who is a clinical nurse
specialist, certified registered nurse
anesthetist, or certified nurse midwife.
(iv) The term ``qualifying other practitioner'' means
a nurse practitioner, clinical nurse specialist,
certified registered nurse anesthetist, certified nurse
midwife, or physician assistant who satisfies each of
the following:
(I) The nurse practitioner, clinical nurse
specialist, certified registered nurse
anesthetist, certified nurse midwife, or
physician assistant is licensed under State law
to prescribe schedule III, IV, or V medications
for the treatment of pain.
(II) The nurse practitioner, clinical nurse
specialist, certified registered nurse
anesthetist, certified nurse midwife, or
physician assistant has--
(aa) completed not fewer than 24
hours of initial training addressing
each of the topics listed in clause
(ii)(IV) (through classroom situations,
seminars at professional society
meetings, electronic communications, or
otherwise) provided by the American
Society of Addiction Medicine, the
American Academy of Addiction
Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Nurses
Credentialing Center, the American
Psychiatric Association, the American
Association of Nurse Practitioners, the
American Academy of Physician
Assistants, or any other organization
that the Secretary determines is
appropriate for purposes of this
subclause; or
(bb) has such other training or
experience as the Secretary determines
will demonstrate the ability of the
nurse practitioner, clinical nurse
specialist, certified registered nurse
anesthetist, certified nurse midwife,
or physician assistant to treat and
manage opiate-dependent patients.
(III) The nurse practitioner, clinical nurse
specialist, certified registered nurse
anesthetist, certified nurse midwife, or
physician assistant is supervised by, or works
in collaboration with, a qualifying physician,
if the nurse practitioner, clinical nurse
specialist, certified registered nurse
anesthetist, certified nurse midwife, or
physician assistant is required by State law to
prescribe medications for the treatment of
opioid use disorder in collaboration with or
under the supervision of a physician.
The Secretary may, by regulation, revise the requirements for
being a qualifying other practitioner under this clause.
(H)(i) In consultation with the Administrator of the Drug
Enforcement Administration, the Administrator of the Substance
Abuse and Mental Health Services Administration, the Director
of the [National Institute on Drug Abuse] National Institute on
Drugs and Addiction, and the Commissioner of Food and Drugs,
the Secretary shall issue regulations (through notice and
comment rulemaking) or issue practice guidelines to address the
following:
(I) Approval of additional credentialing bodies and
the responsibilities of additional credentialing
bodies.
(II) Additional exemptions from the requirements of
this paragraph and any regulations under this
paragraph.
(III) Such other elements of the requirements under
this paragraph as the Secretary determines necessary
for purposes of implementing such requirements.
Nothing in such regulations or practice guidelines may
authorize any Federal official or employee to exercise
supervision or control over the practice of medicine or the
manner in which medical services are provided.
(ii) Not later than 18 months after the date of enactment of
the Opioid Use Disorder Treatment Expansion and Modernization
Act, the Secretary shall update the treatment improvement
protocol containing best practice guidelines for the treatment
of opioid-dependent patients in office-based settings. The
Secretary shall update such protocol in consultation with
experts in opioid use disorder research and treatment.
(I) Notwithstanding section 708, nothing in this paragraph
shall be construed to preempt any State law that--
(i) permits a qualifying practitioner to dispense
narcotic drugs in schedule III, IV, or V, or
combinations of such drugs, for maintenance or
detoxification treatment in accordance with this
paragraph to a total number of patients that is more
than 30 or less than the total number applicable to the
qualifying practitioner under subparagraph (B)(iii)(II)
if a State enacts a law modifying such total number and
the Attorney General is notified by the State of such
modification; or
(ii) requires a qualifying practitioner to comply
with additional requirements relating to the dispensing
of narcotic drugs in schedule III, IV, or V, or
combinations of such drugs, including requirements
relating to the practice setting in which the
qualifying practitioner practices and education,
training, and reporting requirements.
(h) The Attorney General shall register an applicant to
distribute a list I chemical unless the Attorney General
determines that registration of the applicant is inconsistent
with the public interest. Registration under this subsection
shall not be required for the distribution of a drug product
that is exempted under clause (iv) or (v) of section
102(39)(A). In determining the public interest for the purposes
of this subsection, the Attorney General shall consider--
(1) maintenance by the applicant of effective
controls against diversion of listed chemicals into
other than legitimate channels;
(2) compliance by the applicant with applicable
Federal, State, and local law;
(3) any prior conviction record of the applicant
under Federal or State laws relating to controlled
substances or to chemicals controlled under Federal or
State law;
(4) any past experience of the applicant in the
manufacture and distribution of chemicals; and
(5) such other factors as are relevant to and
consistent with the public health and safety.
(i)(1) For purposes of registration to manufacture a
controlled substance under subsection (d) for use only in a
clinical trial, the Attorney General shall register the
applicant, or serve an order to show cause upon the applicant
in accordance with section 304(c), not later than 180 days
after the date on which the application is accepted for filing.
(2) For purposes of registration to manufacture a controlled
substance under subsection (a) for use only in a clinical
trial, the Attorney General shall, in accordance with the
regulations issued by the Attorney General, issue a notice of
application not later than 90 days after the application is
accepted for filing. Not later than 90 days after the date on
which the period for comment pursuant to such notice ends, the
Attorney General shall register the applicant, or serve an
order to show cause upon the applicant in accordance with
section 304(c), unless the Attorney General has granted a
hearing on the application under section 1008(i) of the
Controlled Substances Import and Export Act.
(j) Emergency Medical Services That Administer Controlled
Substances.--
(1) Registration.--For the purpose of enabling
emergency medical services professionals to administer
controlled substances in schedule II, III, IV, or V to
ultimate users receiving emergency medical services in
accordance with the requirements of this subsection,
the Attorney General--
(A) shall register an emergency medical
services agency if the agency submits an
application demonstrating it is authorized to
conduct such activity under the laws of each
State in which the agency practices; and
(B) may deny an application for such
registration if the Attorney General determines
that the issuance of such registration would be
inconsistent with the requirements of this
subsection or the public interest based on the
factors listed in subsection (f).
(2) Option for single registration.--In registering
an emergency medical services agency pursuant to
paragraph (1), the Attorney General shall allow such
agency the option of a single registration in each
State where the agency administers controlled
substances in lieu of requiring a separate registration
for each location of the emergency medical services
agency.
(3) Hospital-based agency.--If a hospital-based
emergency medical services agency is registered under
subsection (f), the agency may use the registration of
the hospital to administer controlled substances in
accordance with this subsection without being
registered under this subsection.
(4) Administration outside physical presence of
medical director or authorizing medical professional.--
Emergency medical services professionals of a
registered emergency medical services agency may
administer controlled substances in schedule II, III,
IV, or V outside the physical presence of a medical
director or authorizing medical professional in the
course of providing emergency medical services if the
administration is--
(A) authorized by the law of the State in
which it occurs; and
(B) pursuant to--
(i) a standing order that is issued
and adopted by one or more medical
directors of the agency, including any
such order that may be developed by a
specific State authority; or
(ii) a verbal order that is--
(I) issued in accordance with
a policy of the agency; and
(II) provided by a medical
director or authorizing medical
professional in response to a
request by the emergency
medical services professional
with respect to a specific
patient--
(aa) in the case of a
mass casualty incident;
or
(bb) to ensure the
proper care and
treatment of a specific
patient.
(5) Delivery.--A registered emergency medical
services agency may deliver controlled substances from
a registered location of the agency to an unregistered
location of the agency only if the agency--
(A) designates the unregistered location for
such delivery; and
(B) notifies the Attorney General at least 30
days prior to first delivering controlled
substances to the unregistered location.
(6) Storage.--A registered emergency medical services
agency may store controlled substances--
(A) at a registered location of the agency;
(B) at any designated location of the agency
or in an emergency services vehicle situated at
a registered or designated location of the
agency; or
(C) in an emergency medical services vehicle
used by the agency that is--
(i) traveling from, or returning to,
a registered or designated location of
the agency in the course of responding
to an emergency; or
(ii) otherwise actively in use by the
agency under circumstances that provide
for security of the controlled
substances consistent with the
requirements established by regulations
of the Attorney General.
(7) No treatment as distribution.--The delivery of
controlled substances by a registered emergency medical
services agency pursuant to this subsection shall not
be treated as distribution for purposes of section 308.
(8) Restocking of emergency medical services vehicles
at a hospital.--Notwithstanding paragraph (13)(J), a
registered emergency medical services agency may
receive controlled substances from a hospital for
purposes of restocking an emergency medical services
vehicle following an emergency response, and without
being subject to the requirements of section 308,
provided all of the following conditions are satisfied:
(A) The registered or designated location of
the agency where the vehicle is primarily
situated maintains a record of such receipt in
accordance with paragraph (9).
(B) The hospital maintains a record of such
delivery to the agency in accordance with
section 307.
(C) If the vehicle is primarily situated at a
designated location, such location notifies the
registered location of the agency within 72
hours of the vehicle receiving the controlled
substances.
(9) Maintenance of records.--
(A) In general.--A registered emergency
medical services agency shall maintain records
in accordance with subsections (a) and (b) of
section 307 of all controlled substances that
are received, administered, or otherwise
disposed of pursuant to the agency's
registration, without regard to subsection
307(c)(1)(B).
(B) Requirements.--Such records--
(i) shall include records of
deliveries of controlled substances
between all locations of the agency;
and
(ii) shall be maintained, whether
electronically or otherwise, at each
registered and designated location of
the agency where the controlled
substances involved are received,
administered, or otherwise disposed of.
(10) Other requirements.--A registered emergency
medical services agency, under the supervision of a
medical director, shall be responsible for ensuring
that--
(A) all emergency medical services
professionals who administer controlled
substances using the agency's registration act
in accordance with the requirements of this
subsection;
(B) the recordkeeping requirements of
paragraph (9) are met with respect to a
registered location and each designated
location of the agency;
(C) the applicable physical security
requirements established by regulation of the
Attorney General are complied with wherever
controlled substances are stored by the agency
in accordance with paragraph (6); and
(D) the agency maintains, at a registered
location of the agency, a record of the
standing orders issued or adopted in accordance
with paragraph (9).
(11) Regulations.--The Attorney General may issue
regulations--
(A) specifying, with regard to delivery of
controlled substances under paragraph (5)--
(i) the types of locations that may
be designated under such paragraph; and
(ii) the manner in which a
notification under paragraph (5)(B)
must be made;
(B) specifying, with regard to the storage of
controlled substances under paragraph (6), the
manner in which such substances must be stored
at registered and designated locations,
including in emergency medical service
vehicles; and
(C) addressing the ability of hospitals,
emergency medical services agencies, registered
locations, and designated locations to deliver
controlled substances to each other in the
event of--
(i) shortages of such substances;
(ii) a public health emergency; or
(iii) a mass casualty event.
(12) Rule of construction.--Nothing in this
subsection shall be construed--
(A) to limit the authority vested in the
Attorney General by other provisions of this
title to take measures to prevent diversion of
controlled substances; or
(B) to override the authority of any State to
regulate the provision of emergency medical
services consistent with this subsection.
(13) Definitions.--In this section:
(A) The term ``authorizing medical
professional'' means an emergency or other
physician, or another medical professional
(including an advanced practice registered
nurse or physician assistant)--
(i) who is registered under this Act;
(ii) who is acting within the scope
of the registration; and
(iii) whose scope of practice under a
State license or certification includes
the ability to provide verbal orders.
(B) The term ``designated location'' means a
location designated by an emergency medical
services agency under paragraph (5).
(C) The term ``emergency medical services''
means emergency medical response and emergency
mobile medical services provided outside of a
fixed medical facility.
(D) The term ``emergency medical services
agency'' means an organization providing
emergency medical services, including such an
organization that--
(i) is governmental (including fire-
based and hospital-based agencies),
nongovernmental (including hospital-
based agencies), private, or volunteer-
based;
(ii) provides emergency medical
services by ground, air, or otherwise;
and
(iii) is authorized by the State in
which the organization is providing
such services to provide emergency
medical care, including the
administering of controlled substances,
to members of the general public on an
emergency basis.
(E) The term ``emergency medical services
professional'' means a health care professional
(including a nurse, paramedic, or emergency
medical technician) licensed or certified by
the State in which the professional practices
and credentialed by a medical director of the
respective emergency medical services agency to
provide emergency medical services within the
scope of the professional's State license or
certification.
(F) The term ``emergency medical services
vehicle'' means an ambulance, fire apparatus,
supervisor truck, or other vehicle used by an
emergency medical services agency for the
purpose of providing or facilitating emergency
medical care and transport or transporting
controlled substances to and from the
registered and designated locations.
(G) The term ``hospital-based'' means, with
respect to an agency, owned or operated by a
hospital.
(H) The term ``medical director'' means a
physician who is registered under subsection
(f) and provides medical oversight for an
emergency medical services agency.
(I) The term ``medical oversight'' means
supervision of the provision of medical care by
an emergency medical services agency.
(J) The term ``registered emergency medical
services agency'' means--
(i) an emergency medical services
agency that is registered pursuant to
this subsection; or
(ii) a hospital-based emergency
medical services agency that is covered
by the registration of the hospital
under subsection (f).
(K) The term ``registered location'' means a
location that appears on the certificate of
registration issued to an emergency medical
services agency under this subsection or
subsection (f), which shall be where the agency
receives controlled substances from
distributors.
(L) The term ``specific State authority''
means a governmental agency or other such
authority, including a regional oversight and
coordinating body, that, pursuant to State law
or regulation, develops clinical protocols
regarding the delivery of emergency medical
services in the geographic jurisdiction of such
agency or authority within the State that may
be adopted by medical directors.
(M) The term ``standing order'' means a
written medical protocol in which a medical
director determines in advance the medical
criteria that must be met before administering
controlled substances to individuals in need of
emergency medical services.
(N) The term ``verbal order'' means an oral
directive that is given through any method of
communication including by radio or telephone,
directly to an emergency medical services
professional, to contemporaneously administer a
controlled substance to individuals in need of
emergency medical services outside the physical
presence of the medical director or authorizing
medical professional.
(k) In this section, the phrase ``factors as may be relevant
to and consistent with the public health and safety'' means
factors that are relevant to and consistent with the findings
contained in section 101.
----------
PUBLIC LAW 91-616
AN ACT To provide a comprehensive Federal program for the prevention
and treatment of alcohol abuse and alcoholism.
* * * * * * *
TITLE III--TECHNICAL ASSISTANCE AND FEDERAL GRANTS AND CONTRACTS
* * * * * * *
Part B--Projects Grants and Contracts
grants and contracts for the demonstration of new and more effective
alcohol abuse and alcoholism prevention, treatment, and rehabilitation
programs
Sec. 311. (a) The Secretary, acting through the Institute,
may make grants to public and nonprofit private entities and
may enter into contracts with public and private entities and
with individuals--
(1) to conduct demonstration and evaluation projects,
with a high priority on prevention and early
intervention projects in occupational and educational
settings and on modified community living and work-care
arrangements such as halfway houses, recovery homes,
and supervised home care, and with particular emphasis
on developing new and more effective alcohol abuse and
alcoholism prevention, treatment, and rehabilitation
programs,
(2) to support projects of a demonstration value in
developing methods for the effective coordination of
all alcoholism treatment, training, prevention, and
research resources available within a health service
area established under section 1511 of the Public
Health Service Act, and
(3) to provide education and training, which may
include additional training to enable treatment
personnel to meet certification requirements of public
or private accreditation or licensure, or requirements
of third-party payors,
for the prevention and treatment of alcohol abuse and
alcoholism and for the rehabilitation of alcohol abusers and
alcoholics.
(b) Projects and programs for which grants and contracts are
made under this section shall (1) be responsive to special
requirements of handicapped individuals in receiving such
services; (2) whenever possible, be community based, seek (in
the case of prevention and treatment services) to insure care
of good quality in general community care facilities and under
health insurance plans, and be integrated with, and provide for
the active participation of, a wide range of public and
nongovernmental agencies, organizations, institutions, and
individuals; (3) where a substantial number of the individuals
in the population served by the project or program are of
limited English-speaking ability, utilize the services of
outreach workers fluent in the language spoken by a predominant
number of such individuals and develop a plan and make
arrangements responsive to the needs of such population for
providing services to the extent practicable in the language
and cultural context most appropriate to such individuals, and
identify an individual employed by the project or program, or
who is available to the project or program on a full-time
basis, who is fluent both in that language and English and
whose responsibilities shall include providing guidance to the
individuals of limited English-speaking ability and to
appropriate staff members with respect to cultural
sensitivities and bridging linguistic and cultural differences;
and (4) where appropriate utilize existing community resources
(including community mental health centers).
(c)(1) In administering this section, the Secretary shall
require coordination of all applications for projects and
programs in a State.
(2)(A) Each applicant from within a State, upon filing its
application with the Secretary for a grant or contract under
this section, shall submit a copy of its application for review
by the State agency responsible for the administration of
alcohol abuse and alcoholism prevention, treatment, and
rehabilitation activities. Such State agency shall be given not
more than thirty days from the date of receipt of the
application to submit to the Secretary, in writing, an
evaluation of the project or program set forth in the
application. Such evaluation shall include comments on the
relationship of the project to other projects and programs
pending and approved and to any State comprehensive plan for
treatment and prevention of alcohol abuse and alcoholism. The
State shall furnish the applicant a copy of any such
evaluation.
(B)(i) Except as provided in clause (ii), each application
for a grant under this section shall be submitted by the
Secretary to the [National Advisory Council on Alcohol Abuse
and Alcoholism] National Advisory Council on Alcohol Effects
and Alcohol-Associated Disorders for its review. The Secretary
may approve an application for a grant under this section only
if it is recommended for approval by such Council.
(ii) Clause (i) shall not apply to an application for a grant
under this section for a project or program for any period of
12 consecutive months for which period payments under such
grant will be less than $250,000, if an application for a grant
under this section for such project or program and for a period
of time which includes such 12-month period has been submitted
to, and approved by, the Secretary.
(3) Approval of any application for a grant or contract by
the Secretary, including the earmarking or financial assistance
for a program or project, may be granted only if the
application substantially meets a set of criteria established
by the Secretary that--
(A) provides that the projects and programs for which
assistance under this section is sought will be
substantially administered by or under the supervision
of the applicant;
(B) provides for such methods of administration as
are necessary for the proper and efficient operation of
such programs and projects; and
(C) provides for such fiscal control and fund
accounting procedures as may be necessary to assure
proper disbursement of and accounting for Federal funds
paid to the applicant.
(4) The Secretary shall encourage the submission of and give
special consideration to applications under this section for
programs and projects aimed at underserved populations such as
racial and ethnic minorities, Native Americans (including
Native Hawaiians and Native American Pacific Islanders), youth,
the elderly, women, handicapped individuals, public inebriates,
and families of alcoholics.
(5)(A) No grant may be made under this section to a State or
to any entity within the government of a State unless the grant
application has been duly authorized by the chief executive
officer of such State.
(B) No grant or contract may be made under this section for a
period in excess of five years.
(C)(i) The amount of any grant or contract under this section
may not exceed 100 per centum of the cost of carrying out the
grant or contract in the first fiscal year for which the grant
or contract is made under this section, 80 per centum of such
cost in the second fiscal year for which the grant or contract
is made under this section, 70 per centum of such cost in the
third fiscal year for which the grant or contract is made under
this section, and 60 per centum of such cost in each of the
fourth and fifth fiscal years for which the grant or contract
is made under this section.
(ii) For purposes of this subparagraph, no grant or contract
shall be considered to have been made under this section for a
fiscal year ending before September 30, 1981.
(6) Each applicant, upon filing its application with the
Secretary for a grant or contract to provide prevention or
treatment services, shall provide a proposed performance
standard or standards to measure, or research protocol to
determine, the effectiveness of such services.
(7) Nothing shall prevent the use of funds provided under
this section for programs and projects aimed at the prevention,
treatment, or rehabilitation of drug abuse as well as alcohol
abuse and alcoholism.
* * * * * * *
----------
PUBLIC LAW 99-570
AN ACT To strengthen Federal efforts to encourage foreign cooperation
in eradicating illicit drug crops and in halting international drug
traffic, to improve enforcement of Federal drug laws and enhance
interdiction of illicit drug shipments, to provide strong Federal
leadership in establishing effective drug abuse prevention and
education programs, to expand Federal support for drug abuse treatment
and rehabilitation efforts, and for other purposes.
* * * * * * *
TITLE IV--DEMAND REDUCTION
* * * * * * *
Subtitle C--Indians and Alaska Natives
* * * * * * *
PART II--COORDINATION OF RESOURCES AND PROGRAMS
SEC. 4205. INTER-DEPARTMENTAL MEMORANDUM OF AGREEMENT.
(a) In General.--Not later than 1 year after the date of
enactment of the Tribal Law and Order Act of 2010, the
Secretary of the Interior, the Attorney General, and the
Secretary of Health and Human Services shall develop and enter
into a Memorandum of Agreement which shall, among other
things--
(1) determine and define the scope of the problem of
alcohol and substance abuse for Indian tribes and their
members and its financial and human costs, and
specifically identify such problems affecting Indian
youth,
(2) identify--
(A) the resources and programs of the Bureau
of Indian Affairs, Office of Justice Programs,
[Substance Abuse and Mental Health Services
Administration] Substance Use And Mental Health
Services Administration, and Indian Health
Service, and
(B) other Federal, tribal, State and local,
and private resources and programs,
which would be relevant to a coordinated effort to
combat alcohol and substance abuse among Indian people,
including those programs and resources made available
by this subtitle,
(3) develop and establish appropriate minimum
standards for each agency's program responsibilities
under the Memorandum of Agreement which may be--
(A) the existing Federal or State standards
in effect, or
(B) in the absence of such standards, new
standards which will be developed and
established in consultation with Indian tribes,
(4) coordinate the Bureau of Indian Affairs,
Department of Justice, [Substance Abuse and Mental
Health Services Administration] Substance Use And
Mental Health Services Administration, and Indian
Health Service alcohol and substance abuse programs
existing on the date of the enactment of this subtitle
with programs or efforts established by this subtitle,
(5) delineate the responsibilities of the Bureau of
Indian Affairs, Department of Justice, [Substance Abuse
and Mental Health Services Administration] Substance
Use And Mental Health Services Administration, and the
Indian Health Service to coordinate alcohol and
substance abuse-related services at the central, area,
agency, and service unit levels,
(6) direct Bureau of Indian Affairs agency and
education superintendents, where appropriate, and the
Indian Health Service service unit directors to
cooperate fully with tribal requests made pursuant to
section 4206, and
(7) provide for an annual review of such agreements
by the Secretary of the Interior, the Attorney General,
and the Secretary of Health and Human Services.
(b) Character of Activities.--To the extent that there are
new activities undertaken pursuant to this subtitle, those
activities shall supplement, not supplant, activities,
programs, and local actions that are ongoing on the date of the
enactment of this subtitle. Such activities shall be undertaken
in the manner least disruptive to tribal control, in accordance
with the Indian Self-Determination and Education Assistance Act
(25 U.S.C. 450 et seq.), and local control, in accordance with
section 1130 of the Education Amendments of 1978 (25 U.S.C.
2010).
(c) Consultation.--The Secretary of the Interior, the
Attorney General, and the Secretary of Health and Human
Services shall, in developing the Memorandum of Agreement under
subsection (a), consult with and solicit the comments of--
(1) interested Indian tribes,
(2) Indian individuals,
(3) Indian organizations, and
(4) professionals in the treatment of alcohol and
substance abuse.
(d) Publication.--The Memorandum of Agreement under
subsection (a) shall be submitted to Congress and published in
the Federal Register not later than 130 days after the date of
enactment of the Tribal Law and Order Act of 2010. At the same
time as publication in the Federal Register, the Secretary of
the Interior shall provide a copy of this subtitle and the
Memorandum of Agreement under subsection (a) to each Indian
tribe.
SEC. 4206. TRIBAL ACTION PLANS.
(a) In General.--The governing body of any Indian tribe may,
at its discretion, adopt a resolution for the establishment of
a Tribal Action Plan to coordinate available resources and
programs, including programs and resources made available by
this subtitle, in an effort to combat alcohol and substance
abuse among its members. Such resolution shall be the basis for
the implementation of this subtitle and of the Memorandum of
Agreement under section 4205.
(b) Cooperation.--At the request of any Indian tribe pursuant
to a resolution adopted under subsection (a), the Bureau of
Indian Affairs agency and education superintendents, where
appropriate,, the Office of Justice Programs, the [Substance
Abuse and Mental Health Services Administration] Substance Use
And Mental Health Services Administration, and the Indian
Health Service service unit director providing services to such
tribe shall cooperate with the tribe in the development of a
Tribal Action Plan to coordinate resources and programs
relevant to alcohol and substance abuse prevention and
treatment. Upon the development of such a plan, such
superintendents and director, as directed by the Memorandum of
Agreement established under section 4205, shall enter into an
agreement with the tribe for the implementation of the Tribal
Action Plan under subsection (a).
(c) Provisions.--
(1) Any Tribal Action Plan entered into under
subsection (b) shall provide for--
(A) the establishment of a Tribal
Coordinating Committee which shall--
(i) at a minimum, have as members a
tribal representative who shall serve
as Chairman and the Bureau of Indian
Affairs agency and education
superintendents, where appropriate,,
the Office of Justice Programs, the
[Substance Abuse and Mental Health
Services Administration] Substance Use
And Mental Health Services
Administration, and the Indian Health
Service service unit director, or their
representatives,
(ii) have primary responsibility for
the implementation of the Tribal Action
Plan,
(iii) have the responsibility for on-
going review and evaluation of, and the
making of recommendations to the tribe
relating to, the Tribal Action Plan,
and
(iv) have the responsibility for
scheduling Federal, tribal or other
personnel for training in the
prevention and treatment of alcohol and
substance abuse among Indians as
provided under section 4228, and
(B) the incorporation of the minimum
standards for those programs and services which
it encompasses which shall be--
(i) the Federal or State standards as
provided in section 4205(a)(3), or
(ii) applicable tribal standards, if
such standards are no less stringent
than the Federal or State standards.
(2) Any Tribal Action Plan may, among other things,
provide for--
(A) an assessment of the scope of the problem
of alcohol and substance abuse for the Indian
tribe which adopted the resolution for the
Plan,
(B) the identification and coordination of
available resources and programs relevant to a
program of alcohol and substance abuse
prevention and treatment,
(C) the establishment and prioritization of
goals and the efforts needed to meet those
goals,
(D) the identification of the community and
family roles in any of the efforts undertaken
as part of the Tribal Action Plan,
(E) the establishment of procedures for
amendment and revision of the plan as may be
determined necessary by the Tribal Coordinating
Committee, and
(F) an evaluation component to measure the
success of efforts made.
(3) All Tribal Action Plans shall be updated every 2
years.
(d) Grants.--(1) The Secretary of the Interior may make
grants to Indian tribes adopting a resolution pursuant to
subsection (a) to provide technical assistance in the
development of a Tribal Action Plan. The Secretary shall
allocate funds based on need.
(2) There are authorized to be appropriated for grants under
this subsection not more than $2,000,000 for the period of
fiscal years 2011 through 2015.
(e) Federal Action.--If any Indian tribe does not adopt a
resolution as provided in subsection (a) within 90 days after
the publication of the Memorandum of Agreement in the Federal
Register as provided in section 4205, the Secretary of the
Interior, the Attorney General, and the Secretary of Health and
Human Services shall require the Bureau of Indian Affairs
agency and education superintendents, where appropriate, and
the Indian Health Service service unit director serving such
tribe to enter into an agreement to identify and coordinate
available programs and resources to carry out the purposes of
this subtitle for such tribe. After such an agreement has been
entered into for a tribe such tribe may adopt a resolution
under subsection (a).
(f)(1) The Secretary of the Interior may make grants to
Indian tribes adopting a resolution pursuant to subsection (a)
to implement and develop community and in-school training,
education, and prevention programs on alcohol and substance
abuse, fetal alcohol syndrome and fetal alcohol effect.
(2) Funds provided under this section may be used for, but
are not limited to, the development and implementation of
tribal programs for--
(A) youth employment;
(B) youth recreation;
(C) youth cultural activities;
(D) community awareness programs; and
(E) community training and education programs.
(3) There are authorized to be appropriated to carry out the
provisions of this subsection $5,000,000 for fiscal years 2011
through 2015.
SEC. 4207. DEPARTMENTAL RESPONSIBILITY.
(a) Implementation.--The Secretary of the Interior, acting
through the Bureau of Indian Affairs, the Attorney General, and
the Secretary of Health and Human Services, acting through the
Indian Health Service, shall bear equal responsibility for the
implementation of this subtitle in cooperation with Indian
tribes.
(b) Office of Alcohol and Substance Abuse.--
(1) Establishment.--
(A) In general.--To improve coordination
among the Federal agencies and departments
carrying out this subtitle, there is
established within the [Substance Abuse and
Mental Health Services Administration]
Substance Use And Mental Health Services
Administration an office, to be known as the
``Office of Indian Alcohol and Substance
Abuse'' (referred to in this section as the
``Office'').
(B) Director.--The director of the Office
shall be appointed by the Administrator of the
[Substance Abuse and Mental Health Services
Administration] Substance Use And Mental Health
Services Administration--
(i) on a permanent basis; and
(ii) at a grade of not less than GS-
15 of the General Schedule.
(2) Responsibilities of office.--In addition to other
responsibilities which may be assigned to such Office,
it shall be responsible for--
(A) coordinating with other agencies to
monitor the performance and compliance of the
relevant Federal programs in achieving the
goals and purposes of this subtitle and the
Memorandum of Agreement entered into under
section 4205;
(B) serving as a point of contact for Indian
tribes and the Tribal Coordinating Committees
regarding the implementation of this subtitle,
the Memorandum of Agreement, and any Tribal
Action Plan established under section 4206; and
(C) not later than 1 year after the date of
enactment of the Tribal Law and Order Act of
2010, developing, in coordination and
consultation with tribal governments, a
framework for interagency and tribal
coordination that--
(i) establish the goals and other
desired outcomes of this Act;
(ii) prioritizes outcomes that are
aligned with the purposes of affected
agencies;
(iii) provides guidelines for
resource and information sharing;
(iv) provides technical assistance to
the affected agencies to establish
effective and permanent interagency
communication and coordination; and
(v) determines whether collaboration
is feasible, cost-effective, and within
agency capability.
(3) Appointment of employees.--The Administrator of
the [Substance Abuse and Mental Health Services
Administration] Substance Use And Mental Health
Services Administration shall appoint such employees to
work in the Office, and shall provide such funding,
services, and equipment, as may be necessary to enable
the Office to carry out the responsibilities under this
subsection.
(c) Indian Youth Programs Officer.--
(1) There is established in the Office the position
to be known as the Indian Youth Programs Officer. The
Administrator of the [Substance Abuse and Mental Health
Services Administration] Substance Use And Mental
Health Services Administration shall appoint the Indian
Youth Programs Officer.
(2) The position of Indian Youth Programs Officer
shall be established on a permanent basis at no less
than the grade of GS-14 of the General Schedule.
(3) In addition to other responsibilities which may
be assigned to the Indian Youth Programs Officer
relating to Indian youth, such Officer shall be
responsible for--
(A) monitoring the performance and compliance
of the applicable Federal programs in meeting
the goals and purposes of this subtitle and the
Memorandum of Agreement entered into under
section 4205 as they relate to Indian youth
efforts, and
(B) providing advice and recommendations,
including recommendations submitted by Indian
tribes and Tribal Coordinating Committees, to
the Director of the Office as they relate to
Indian youth.
* * * * * * *
----------
SOCIAL SECURITY ACT
* * * * * * *
TITLE XVIII--HEALTH INSURANCE FOR THE AGED AND DISABLED
* * * * * * *
Part E--Miscellaneous Provisions
definitions of services, institutions, etc.
Sec. 1861. For purposes of this title--
Spell of Illness
(a) The term ``spell of illness'' with respect to any
individual means a period of consecutive days--
(1) beginning with the first day (not included in a
previous spell of illness) (A) on which such individual
is furnished inpatient hospital services, inpatient
critical access hospital services or extended care
services, and (B) which occurs in a month for which he
is entitled to benefits under part A, and
(2) ending with the close of the first period of 60
consecutive days thereafter on each of which he is
neither an inpatient of a hospital or critical access
hospital nor an inpatient of a facility described in
section 1819(a)(1) or subsection (y)(1).
Inpatient Hospital Services
(b) The term ``inpatient hospital services'' means the
following items and services furnished to an inpatient of a
hospital and (except as provided in paragraph (3)) by the
hospital--
(1) bed and board;
(2) such nursing services and other related services,
such use of hospital facilities, and such medical
social services as are ordinarily furnished by the
hospital for the care and treatment of inpatients, and
such drugs, biologicals, supplies, appliances, and
equipment, for use in the hospital, as are ordinarily
furnished by such hospital for the care and treatment
of inpatients; and
(3) such other diagnostic or therapeutic items or
services, furnished by the hospital or by others under
arrangements with them made by the hospital, as are
ordinarily furnished to inpatients either by such
hospital or by others under such arrangements;
excluding, however--
(4) medical or surgical services provided by a
physician, resident, or intern, services described by
subsection (s)(2)(K), certified nurse-midwife services,
qualified psychologist services, and services of a
certified registered nurse anesthetist; and
(5) the services of a private-duty nurse or other
private-duty attendant.
Paragraph (4) shall not apply to services provided in a
hospital by--
(6) an intern or a resident-in-training under a
teaching program approved by the Council on Medical
Education of the American Medical Association or, in
the case of an osteopathic hospital, approved by the
Committee on Hospitals of the Bureau of Professional
Education of the American Osteopathic Association, or,
in the case of services in a hospital or osteopathic
hospital by an intern or resident-in-training in the
field of dentistry, approved by the Council on Dental
Education of the American Dental Association, or in the
case of services in a hospital or osteopathic hospital
by an intern or resident-in-training in the field of
podiatry, approved by the Council on Podiatric Medical
Education of the American Podiatric Medical
Association; or
(7) a physician where the hospital has a teaching
program approved as specified in paragraph (6), if (A)
the hospital elects to receive any payment due under
this title for reasonable costs of such services, and
(B) all physicians in such hospital agree not to bill
charges for professional services rendered in such
hospital to individuals covered under the insurance
program established by this title.
Inpatient Psychiatric Hospital Services
(c) The term ``inpatient psychiatric hospital services''
means inpatient hospital services furnished to an inpatient of
a psychiatric hospital.
Supplier
(d) The term ``supplier'' means, unless the context otherwise
requires, a physician or other practitioner, a facility, or
other entity (other than a provider of services) that furnishes
items or services under this title.
Hospital
(e) The term ``hospital'' (except for purposes of sections
1814(d), 1814(f), and 1835(b), subsection (a)(2) of this
section, paragraph (7) of this subsection, and subsection (i)
of this section) means an institution which--
(1) is primarily engaged in providing, by or under
the supervision of physicians, to inpatients (A)
diagnostic services and therapeutic services for
medical diagnosis, treatment, and care of injured,
disabled, or sick persons, or (B) rehabilitation
services for the rehabilitation of injured, disabled,
or sick persons;
(2) maintains clinical records on all patients;
(3) has bylaws in effect with respect to its staff of
physicians;
(4) has a requirement that every patient with respect
to whom payment may be made under this title must be
under the care of a physician, except that a patient
receiving qualified psychologist services (as defined
in subsection (ii)) may be under the care of a clinical
psychologist with respect to such services to the
extent permitted under State law;
(5) provides 24-hour nursing service rendered or
supervised by a registered professional nurse, and has
a licensed practical nurse or registered professional
nurse on duty at all times; except that until January
1, 1979, the Secretary is authorized to waive the
requirement of this paragraph for any one-year period
with respect to any institution, insofar as such
requirement relates to the provision of twenty-four-
hour nursing service rendered or supervised by a
registered professional nurse (except that in any event
a registered professional nurse must be present on the
premises to render or supervise the nursing service
provided, during at least the regular daytime shift),
where immediately preceding such one-year period he
finds that--
(A) such institution is located in a rural
area and the supply of hospital services in
such area is not sufficient to meet the needs
of individuals residing therein,
(B) the failure of such institution to
qualify as a hospital would seriously reduce
the availability of such services to such
individuals, and
(C) such institution has made and continues
to make a good faith effort to comply with this
paragraph, but such compliance is impeded by
the lack of qualified nursing personnel in such
area;
(6)(A) has in effect a hospital utilization review
plan which meets the requirements of subsection (k) and
(B) has in place a discharge planning process that
meets the requirements of subsection (ee);
(7) in the case of an institution in any State in
which State or applicable local law provides for the
licensing of hospitals, (A) is licensed pursuant to
such law or (B) is approved, by the agency of such
State or locality responsible for licensing hospitals,
as meeting the standards established for such
licensing;
(8) has in effect an overall plan and budget that
meets the requirements of subsection (z); and
(9) meets such other requirements as the Secretary
finds necessary in the interest of the health and
safety of individuals who are furnished services in the
institution.
For purposes of subsection (a)(2), such term includes any
institution which meets the requirements of paragraph (1) of
this subsection. For purposes of sections 1814(d) and 1835(b)
(including determination of whether an individual received
inpatient hospital services or diagnostic services for purposes
of such sections), section 1814(f)(2), and subsection (i) of
this section, such term includes any institution which (i)
meets the requirements of paragraphs (5) and (7) of this
subsection, (ii) is not primarily engaged in providing the
services described in section 1861(j)(1)(A) and (iii) is
primarily engaged in providing, by or under the supervision of
individuals referred to in paragraph (1) of section 1861(r), to
inpatients diagnostic services and therapeutic services for
medical diagnosis, treatment, and care of injured, disabled, or
sick persons, or rehabilitation services for the rehabilitation
of injured, disabled, or sick persons. For purposes of section
1814(f)(1), such term includes an institution which (i) is a
hospital for purposes of sections 1814(d), 1814(f)(2), and
1835(b) and (ii) is accredited by a national accreditation body
recognized by the Secretary under section 1865(a), or is
accredited by or approved by a program of the country in which
such institution is located if the Secretary finds the
accreditation or comparable approval standards of such program
to be essentially equivalent to those of such a national
accreditation body.. Notwithstanding the preceding provisions
of this subsection, such term shall not, except for purposes of
subsection (a)(2), include any institution which is primarily
for the care and treatment of mental diseases unless it is a
psychiatric hospital (as defined in subsection (f)). The term
``hospital'' also includes a religious nonmedical health care
institution (as defined in subsection (ss)(1)), but only with
respect to items and services ordinarily furnished by such
institution to inpatients, and payment may be made with respect
to services provided by or in such an institution only to such
extent and under such conditions, limitations, and requirements
(in addition to or in lieu of the conditions, limitations, and
requirements otherwise applicable) as may be provided in
regulations consistent with section 1821. For provisions
deeming certain requirements of this subsection to be met in
the case of accredited institutions, see section 1865. The term
``hospital'' also includes a facility of fifty beds or less
which is located in an area determined by the Secretary to meet
the definition relating to a rural area described in
subparagraph (A) of paragraph (5) of this subsection and which
meets the other requirements of this subsection, except that--
(A) with respect to the requirements for nursing
services applicable after December 31, 1978, such
requirements shall provide for temporary waiver of the
requirements, for such period as the Secretary deems
appropriate, where (i) the facility's failure to fully
comply with the requirements is attributable to a
temporary shortage of qualified nursing personnel in
the area in which the facility is located, (ii) a
registered professional nurse is present on the
premises to render or supervise the nursing service
provided during at least the regular daytime shift, and
(iii) the Secretary determines that the employment of
such nursing personnel as are available to the facility
during such temporary period will not adversely affect
the health and safety of patients;
(B) with respect to the health and safety
requirements promulgated under paragraph (9), such
requirements shall be applied by the Secretary to a
facility herein defined in such manner as to assure
that personnel requirements take into account the
availability of technical personnel and the educational
opportunities for technical personnel in the area in
which such facility is located, and the scope of
services rendered by such facility; and the Secretary,
by regulations, shall provide for the continued
participation of such a facility where such personnel
requirements are not fully met, for such period as the
Secretary determines that (i) the facility is making
good faith efforts to fully comply with the personnel
requirements, (ii) the employment by the facility of
such personnel as are available to the facility will
not adversely affect the health and safety of patients,
and (iii) if the Secretary has determined that because
of the facility's waiver under this subparagraph the
facility should limit its scope of services in order
not to adversely affect the health and safety of the
facility's patients, the facility is so limiting the
scope of services it provides; and
(C) with respect to the fire and safety requirements
promulgated under paragraph (9), the Secretary (i) may
waive, for such period as he deems appropriate,
specific provisions of such requirements which if
rigidly applied would result in unreasonable hardship
for such a facility and which, if not applied, would
not jeopardize the health and safety of patients, and
(ii) may accept a facility's compliance with all
applicable State codes relating to fire and safety in
lieu of compliance with the fire and safety
requirements promulgated under paragraph (9), if he
determines that such State has in effect fire and
safety codes, imposed by State law, which adequately
protect patients.
The term ``hospital'' does not include, unless the context
otherwise requires, a critical access hospital (as defined in
section 1861(mm)(1)) or a rural emergency hospital (as defined
in subsection (kkk)(2)).
Psychiatric Hospital
(f) The term ``psychiatric hospital'' means an institution
which--
(1) is primarily engaged in providing, by or under
the supervision of a physician, psychiatric services
for the diagnosis and treatment of mentally ill
persons;
(2) satisfies the requirements of paragraphs (3)
through (9) of subsection (e);
(3) maintains clinical records on all patients and
maintains such records as the Secretary finds to be
necessary to determine the degree and intensity of the
treatment provided to individuals entitled to hospital
insurance benefits under part A; and
(4) meets such staffing requirements as the Secretary
finds necessary for the institution to carry out an
active program of treatment for individuals who are
furnished services in the institution.
In the case of an institution which satisfies paragraphs (1)
and (2) of the preceding sentence and which contains a distinct
part which also satisfies paragraphs (3) and (4) of such
sentence, such distinct part shall be considered to be a
``psychiatric hospital''.
Outpatient Occupational Therapy Services
(g) The term ``outpatient occupational therapy services'' has
the meaning given the term ``outpatient physical therapy
services'' in subsection (p), except that ``occupational''
shall be substituted for ``physical'' each place it appears
therein.
Extended Care Services
(h) The term ``extended care services'' means the following
items and services furnished to an inpatient of a skilled
nursing facility and (except as provided in paragraphs (3), (6)
and (7)) by such skilled nursing facility--
(1) nursing care provided by or under the supervision
of a registered professional nurse;
(2) bed and board in connection with the furnishing
of such nursing care;
(3) physical or occupational therapy or speech-
language pathology services furnished by the skilled
nursing facility or by others under arrangements with
them made by the facility;
(4) medical social services;
(5) such drugs, biologicals, supplies, appliances,
and equipment, furnished for use in the skilled nursing
facility, as are ordinarily furnished by such facility
for the care and treatment of inpatients;
(6) medical services provided by an intern or
resident-in- training of a hospital with which the
facility has in effect a transfer agreement (meeting
the requirements of subsection (l)), under a teaching
program of such hospital approved as provided in the
last sentence of subsection (b), and other diagnostic
or therapeutic services provided by a hospital with
which the facility has such an agreement in effect; and
(7) such other services necessary to the health of
the patients as are generally provided by skilled
nursing facilities, or by others under arrangements
with them made by the facility;
excluding, however, any item or service if it would not be
included under subsection (b) if furnished to an inpatient of a
hospital.
Post-Hospital Extended Care Services
(i) The term ``post-hospital extended care services'' means
extended care services furnished an individual after transfer
from a hospital in which he was an inpatient for not less than
3 consecutive days before his discharge from the hospital in
connection with such transfer. For purposes of the preceding
sentence, items and services shall be deemed to have been
furnished to an individual after transfer from a hospital, and
he shall be deemed to have been an inpatient in the hospital
immediately before transfer therefrom, if he is admitted to the
skilled nursing facility (A) within 30 days after discharge
from such hospital, or (B) within such time as it would be
medically appropriate to begin an active course of treatment,
in the case of an individual whose condition is such that
skilled nursing facility care would not be medically
appropriate within 30 days after discharge from a hospital; and
an individual shall be deemed not to have been discharged from
a skilled nursing facility if, within 30 days after discharge
therefrom, he is admitted to such facility or any other skilled
nursing facility.
Skilled Nursing Facility
(j) The term ``skilled nursing facility'' has the meaning
given such term in section 1819(a).
Utilization Review
(k) A utilization review plan of a hospital or skilled
nursing facility shall be considered sufficient if it is
applicable to services furnished by the institution to
individuals entitled to insurance benefits under this title and
if it provides--
(1) for the review, on a sample or other basis, of
admissions to the institution, the duration of stays
therein, and the professional services (including drugs
and biologicals) furnished, (A) with respect to the
medical necessity of the services, and (B) for the
purpose of promoting the most efficient use of
available health facilities and services;
(2) for such review to be made by either (A) a staff
committee of the institution composed of two or more
physicians (of which at least two must be physicians
described in subsection (r)(1) of this section), with
or without participation of other professional
personnel, or (B) a group outside the institution which
is similarly composed and (i) which is established by
the local medical society and some or all of the
hospitals and skilled nursing facilities in the
locality, or (ii) if (and for as long as) there has not
been established such a group which serves such
institution, which is established in such other manner
as may be approved by the Secretary;
(3) for such review, in each case of inpatient
hospital services or extended care services furnished
to such an individual during a continuous period of
extended duration, as of such days of such period
(which may differ for different classes of cases) as
may be specified in regulations, with such review to be
made as promptly as possible, after each day so
specified, and in no event later than one week
following such day; and
(4) for prompt notification to the institution, the
individual, and his attending physician of any finding
(made after opportunity for consultation to such
attending physician) by the physician members of such
committee or group that any further stay in the
institution is not medically necessary.
The review committee must be composed as provided in clause (B)
of paragraph (2) rather than as provided in clause (A) of such
paragraph in the case of any hospital or skilled nursing
facility where, because of the small size of the institution,
or (in the case of a skilled nursing facility) because of lack
of an organized medical staff, or for such other reason or
reasons as may be included in regulations, it is impracticable
for the institution to have a properly functioning staff
committee for the purposes of this subsection. If the Secretary
determines that the utilization review procedures established
pursuant to title XIX are superior in their effectiveness to
the procedures required under this section, he may, to the
extent that he deems it appropriate, require for purposes of
this title that the procedures established pursuant to title
XIX be utilized instead of the procedures required by this
section.
Agreements for Transfer Between Skilled Nursing Facilities and
Hospitals
(l) A hospital and a skilled nursing facility shall be
considered to have a transfer agreement in effect if, by reason
of a written agreement between them or (in case the two
institutions are under common control) by reason of a written
undertaking by the person or body which controls them, there is
reasonable assurance that--
(1) transfer of patients will be effected between the
hospital and the skilled nursing facility whenever such
transfer is medically appropriate as determined by the
attending physician; and
(2) there will be interchange of medical and other
information necessary or useful in the care and
treatment of individuals transferred between the
institutions, or in determining whether such
individuals can be adequately cared for otherwise than
in either of such institutions.
Any skilled nursing facility which does not have such an
agreement in effect, but which is found by a State agency (of
the State in which such facility is situated) with which an
agreement under section 1864 is in effect (or, in the case of a
State in which no such agency has an agreement under section
1864, by the Secretary) to have attempted in good faith to
enter into such an agreement with a hospital sufficiently close
to the facility to make feasible the transfer between them of
patients and the information referred to in paragraph (2),
shall be considered to have such an agreement in effect if and
for so long as such agency (or the Secretary, as the case may
be) finds that to do so is in the public interest and essential
to assuring extended care services for persons in the community
who are eligible for payments with respect to such services
under this title.
Home Health Services
(m) The term ``home health services'' means the following
items and services furnished to an individual, who is under the
care of a physician, a nurse practitioner or a clinical nurse
specialist (as those terms are defined in subsection (aa)(5)),
or a physician assistant (as defined in subsection (aa)(5)), by
a home health agency or by others under arrangements with them
made by such agency, under a plan (for furnishing such items
and services to such individual) established and periodically
reviewed by a physician, a nurse practitioner, a clinical nurse
specialist, or a physician assistant, which items and services
are, except as provided in paragraph (7), provided on a
visiting basis in a place of residence used as such
individual's home--
(1) part-time or intermittent nursing care provided
by or under the supervision of a registered
professional nurse;
(2) physical or occupational therapy or speech-
language pathology services;
(3) medical social services under the direction of a
physician, a nurse practitioner, a clinical nurse
specialist, or a physician assistant;
(4) to the extent permitted in regulations, part-time
or intermittent services of a home health aide who has
successfully completed a training program approved by
the Secretary;
(5) medical supplies (including catheters, catheter
supplies, ostomy bags, and supplies related to ostomy
care, and a covered osteoporosis drug (as defined in
subsection (kk)), but excluding other drugs and
biologicals) and durable medical equipment and
applicable disposable devices (as defined in section
1834(s)(2)) while under such a plan;
(6) in the case of a home health agency which is
affiliated or under common control with a hospital,
medical services provided by an intern or resident-in-
training of such hospital, under a teaching program of
such hospital approved as provided in the last sentence
of subsection (b); and
(7) any of the foregoing items and services which are
provided on an outpatient basis, under arrangements
made by the home health agency, at a hospital or
skilled nursing facility, or at a rehabilitation center
which meets such standards as may be prescribed in
regulations, and--
(A) the furnishing of which involves the use
of equipment of such a nature that the items
and services cannot readily be made available
to the individual in such place of residence,
or
(B) which are furnished at such facility
while he is there to receive any such item or
service described in clause (A),
but not including transportation of the individual in
connection with any such item or service;
excluding, however, any item or service if it would not be
included under subsection (b) if furnished to an inpatient of a
hospital and home infusion therapy (as defined in subsection
(iii)(i)). For purposes of paragraphs (1) and (4), the term
``part-time or intermittent services'' means skilled nursing
and home health aide services furnished any number of days per
week as long as they are furnished (combined) less than 8 hours
each day and 28 or fewer hours each week (or, subject to review
on a case-by-case basis as to the need for care, less than 8
hours each day and 35 or fewer hours per week). For purposes of
sections 1814(a)(2)(C) and 1835(a)(2)(A), ``intermittent''
means skilled nursing care that is either provided or needed on
fewer than 7 days each week, or less than 8 hours of each day
for periods of 21 days or less (with extensions in exceptional
circumstances when the need for additional care is finite and
predictable).
Durable Medical Equipment
(n) The term ``durable medical equipment'' includes iron
lungs, oxygen tents, hospital beds, and wheelchairs (which may
include a power-operated vehicle that may be appropriately used
as a wheelchair, but only where the use of such a vehicle is
determined to be necessary on the basis of the individual's
medical and physical condition and the vehicle meets such
safety requirements as the Secretary may prescribe) used in the
patient's home (including an institution used as his home other
than an institution that meets the requirements of subsection
(e)(1) of this section or section 1819(a)(1)), whether
furnished on a rental basis or purchased, and includes blood-
testing strips and blood glucose monitors for individuals with
diabetes without regard to whether the individual has Type I or
Type II diabetes or to the individual's use of insulin (as
determined under standards established by the Secretary in
consultation with the appropriate organizations) and eye
tracking and gaze interaction accessories for speech generating
devices furnished to individuals with a demonstrated medical
need for such accessories; except that such term does not
include such equipment furnished by a supplier who has used,
for the demonstration and use of specific equipment, an
individual who has not met such minimum training standards as
the Secretary may establish with respect to the demonstration
and use of such specific equipment. With respect to a seat-lift
chair, such term includes only the seat-lift mechanism and does
not include the chair.
Home Health Agency
(o) The term ``home health agency'' means a public agency or
private organization, or a subdivision of such an agency or
organization, which--
(1) is primarily engaged in providing skilled nursing
services and other therapeutic services;
(2) has policies, established by a group of
professional personnel (associated with the agency or
organization), including one or more physicians, nurse
practitioners or clinical nurse specialists (as those
terms are defined in subsection (aa)(5)), certified
nurse-midwives (as defined in subsection (gg)), or
physician, nurse practitioner, clinical nurse
specialist, certified nurse-midwife, physician
assistant, assistants (as defined in subsection
(aa)(5)) and one or more registered professional
nurses, to govern the services (referred to in
paragraph (1)) which it provides, and provides for
supervision of such services by a physician, nurse
practitioner, clinical nurse specialist, certified
nurse-midwife, physician assistant, or registered
professional nurse;
(3) maintains clinical records on all patients;
(4) in the case of an agency or organization in any
State in which State or applicable local law provides
for the licensing of agencies or organizations of this
nature, (A) is licensed pursuant to such law, or (B) is
approved, by the agency of such State or locality
responsible for licensing agencies or organizations of
this nature, as meeting the standards established for
such licensing;
(5) has in effect an overall plan and budget that
meets the requirements of subsection (z);
(6) meets the conditions of participation specified
in section 1891(a) and such other conditions of
participation as the Secretary may find necessary in
the interest of the health and safety of individuals
who are furnished services by such agency or
organization;
(7) provides the Secretary with a surety bond--
(A) in a form specified by the Secretary and
in an amount that is not less than the minimum
of $50,000; and
(B) that the Secretary determines is
commensurate with the volume of payments to the
home health agency; and
(8) meets such additional requirements (including
conditions relating to bonding or establishing of
escrow accounts as the Secretary finds necessary for
the financial security of the program) as the Secretary
finds necessary for the effective and efficient
operation of the program;
except that for purposes of part A such term shall not include
any agency or organization which is primarily for the care and
treatment of mental diseases. The Secretary may waive the
requirement of a surety bond under paragraph (7) in the case of
an agency or organization that provides a comparable surety
bond under State law.
Outpatient Physical Therapy Services
(p) The term ``outpatient physical therapy services'' means
physical therapy services furnished by a provider of services,
a clinic, rehabilitation agency, or a public health agency, or
by others under an arrangement with, and under the supervision
of, such provider, clinic, rehabilitation agency, or public
health agency to an individual as an outpatient--
(1) who is under the care of a physician (as defined
in paragraph (1), (3), or (4) of section 1861(r)), and
(2) with respect to whom a plan prescribing the type,
amount, and duration of physical therapy services that
are to be furnished such individual has been
established by a physician (as so defined) or by a
qualified physical therapist and is periodically
reviewed by a physician (as so defined);
excluding, however--
(3) any item or service if it would not be included
under subsection (b) if furnished to an inpatient of a
hospital; and
(4) any such service--
(A) if furnished by a clinic or
rehabilitation agency, or by others under
arrangements with such clinic or agency, unless
such clinic or rehabilitation agency--
(i) provides an adequate program of
physical therapy services for
outpatients and has the facilities and
personnel required for such program or
required for the supervision of such a
program, in accordance with such
requirements as the Secretary may
specify,
(ii) has policies, established by a
group of professional personnel,
including one or more physicians
(associated with the clinic or
rehabilitation agency) and one or more
qualified physical therapists, to
govern the services (referred to in
clause (i)) it provides,
(iii) maintains clinical records on
all patients,
(iv) if such clinic or agency is
situated in a State in which State or
applicable local law provides for the
licensing of institutions of this
nature, (I) is licensed pursuant to
such law, or (II) is approved by the
agency of such State or locality
responsible for licensing institutions
of this nature, as meeting the
standards established for such
licensing; and
(v) meets such other conditions
relating to the health and safety of
individuals who are furnished services
by such clinic or agency on an
outpatient basis, as the Secretary may
find necessary, and provides the
Secretary on a continuing basis with a
surety bond in a form specified by the
Secretary and in an amount that is not
less than $50,000, or
(B) if furnished by a public health agency,
unless such agency meets such other conditions
relating to health and safety of individuals
who are furnished services by such agency on an
outpatient basis, as the Secretary may find
necessary.
The term ``outpatient physical therapy services'' also includes
physical therapy services furnished an individual by a physical
therapist (in his office or in such individual's home) who
meets licensing and other standards prescribed by the Secretary
in regulations, otherwise than under an arrangement with and
under the supervision of a provider of services, clinic,
rehabilitation agency, or public health agency, if the
furnishing of such services meets such conditions relating to
health and safety as the Secretary may find necessary. In
addition, such term includes physical therapy services which
meet the requirements of the first sentence of this subsection
except that they are furnished to an individual as an inpatient
of a hospital or extended care facility. Nothing in this
subsection shall be construed as requiring, with respect to
outpatients who are not entitled to benefits under this title,
a physical therapist to provide outpatient physical therapy
services only to outpatients who are under the care of a
physician or pursuant to a plan of care established by a
physician. The Secretary may waive the requirement of a surety
bond under paragraph (4)(A)(v) in the case of a clinic or
agency that provides a comparable surety bond under State law.
Physicians' Services
(q) The term ``physicians' services'' means professional
services performed by physicians, including surgery,
consultation, and home, office, and institutional calls (but
not including services described in subsection (b)(6)).
Physician
(r) The term ``physician'', when used in connection with the
performance of any function or action, means (1) a doctor of
medicine or osteopathy legally authorized to practice medicine
and surgery by the State in which he performs such function or
action (including a physician within the meaning of section
1101(a)(7)), (2) a doctor of dental surgery or of dental
medicine who is legally authorized to practice dentistry by the
State in which he performs such function and who is acting
within the scope of his license when he performs such
functions, (3) a doctor of podiatric medicine for the purposes
of subsections (k), (m), (p)(1), and (s) of this section and
sections 1814(a), 1832(a)(2)(F)(ii), and 1835 but only with
respect to functions which he is legally authorized to perform
as such by the State in which he performs them, (4) a doctor of
optometry, but only for purposes of subsection (p)(1) and with
respect to the provision of items or services described in
subsection (s) which he is legally authorized to perform as a
doctor of optometry by the State in which he performs them, or
(5) a chiropractor who is licensed as such by the State (or in
a State which does not license chiropractors as such, is
legally authorized to perform the services of a chiropractor in
the jurisdiction in which he performs such services), and who
meets uniform minimum standards promulgated by the Secretary,
but only for the purpose of sections 1861(s)(1) and
1861(s)(2)(A) and only with respect to treatment by means of
manual manipulation of the spine (to correct a subluxation)
which he is legally authorized to perform by the State or
jurisdiction in which such treatment is provided. For the
purposes of section 1862(a)(4) and subject to the limitations
and conditions provided in the previous sentence, such term
includes a doctor of one of the arts, specified in such
previous sentence, legally authorized to practice such art in
the country in which the inpatient hospital services (referred
to in such section 1862(a)(4)) are furnished.
Medical and Other Health Services
(s) The term ``medical and other health services'' means any
of the following items or services:
(1) physicians' services;
(2)(A) services and supplies (including drugs and
biologicals which are not usually self-administered by
the patient) furnished as an incident to a physician's
professional service, of kinds which are commonly
furnished in physicians' offices and are commonly
either rendered without charge or included in the
physicians' bills (or would have been so included but
for the application of section 1847B);
(B) hospital services (including drugs and
biologicals which are not usually self-administered by
the patient) incident to physicians' services rendered
to outpatients and partial hospitalization services
incident to such services;
(C) diagnostic services which are--
(i) furnished to an individual as an
outpatient by a hospital or by others under
arrangements with them made by a hospital, and
(ii) ordinarily furnished by such hospital
(or by others under such arrangements) to its
outpatients for the purpose of diagnostic
study;
(D) outpatient physical therapy services, outpatient
speech-language pathology services, and outpatient
occupational therapy services;
(E) rural health clinic services and Federally
qualified health center services;
(F) home dialysis supplies and equipment, self-care
home dialysis support services, and institutional
dialysis services and supplies, and, for items and
services furnished on or after January 1, 2011, renal
dialysis services (as defined in section
1881(b)(14)(B)), including such renal dialysis services
furnished on or after January 1, 2017, by a renal
dialysis facility or provider of services paid under
section 1881(b)(14) to an individual with acute kidney
injury (as defined in section 1834(r)(2));
(G) antigens (subject to quantity limitations
prescribed in regulations by the Secretary) prepared by
a physician, as defined in section 1861(r)(1), for a
particular patient, including antigens so prepared
which are forwarded to another qualified person
(including a rural health clinic) for administration to
such patient, from time to time, by or under the
supervision of another such physician;
(H)(i) services furnished pursuant to a contract
under section 1876 to a member of an eligible
organization by a physician assistant or by a nurse
practitioner (as defined in subsection (aa)(5)) and
such services and supplies furnished as an incident to
his service to such a member as would otherwise be
covered under this part if furnished by a physician or
as an incident to a physician's service; and
(ii) services furnished pursuant to a risk-sharing
contract under section 1876(g) to a member of an
eligible organization by a clinical psychologist (as
defined by the Secretary) or by a clinical social
worker (as defined in subsection (hh)(2)), and such
services and supplies furnished as an incident to such
clinical psychologist's services or clinical social
worker's services to such a member as would otherwise
be covered under this part if furnished by a physician
or as an incident to a physician's service;
(I) blood clotting factors, for hemophilia patients
competent to use such factors to control bleeding
without medical or other supervision, and items related
to the administration of such factors, subject to
utilization controls deemed necessary by the Secretary
for the efficient use of such factors;
(J) prescription drugs used in immunosuppressive
therapy furnished, to an individual who receives an
organ transplant for which payment is made under this
title;
(K)(i) services which would be physicians' services
and services described in subsections (ww)(1) and (hhh)
if furnished by a physician (as defined in subsection
(r)(1)) and which are performed by a physician
assistant (as defined in subsection (aa)(5)) under the
supervision of a physician (as so defined) and which
the physician assistant is legally authorized to
perform by the State in which the services are
performed, and such services and supplies furnished as
incident to such services as would be covered under
subparagraph (A) if furnished incident to a physician's
professional service, but only if no facility or other
provider charges or is paid any amounts with respect to
the furnishing of such services,
(ii) services which would be physicians' services and
services described in subsections (ww)(1) and (hhh) if
furnished by a physician (as defined in subsection
(r)(1)) and which are performed by a nurse practitioner
or clinical nurse specialist (as defined in subsection
(aa)(5)) working in collaboration (as defined in
subsection (aa)(6)) with a physician (as defined in
subsection (r)(1)) which the nurse practitioner or
clinical nurse specialist is legally authorized to
perform by the State in which the services are
performed, and such services and supplies furnished as
an incident to such services as would be covered under
subparagraph (A) if furnished incident to a physician's
professional service, but only if no facility or other
provider charges or is paid any amounts with respect to
the furnishing of such services;
(L) certified nurse-midwife services;
(M) qualified psychologist services;
(N) clinical social worker services (as defined in
subsection (hh)(2));
(O) erythropoietin for dialysis patients competent to
use such drug without medical or other supervision with
respect to the administration of such drug, subject to
methods and standards established by the Secretary by
regulation for the safe and effective use of such drug,
and items related to the administration of such drug;
(P) prostate cancer screening tests (as defined in
subsection (oo));
(Q) an oral drug (which is approved by the Federal
Food and Drug Administration) prescribed for use as an
anticancer chemotherapeutic agent for a given
indication, and containing an active ingredient (or
ingredients), which is the same indication and active
ingredient (or ingredients) as a drug which the carrier
determines would be covered pursuant to subparagraph
(A) or (B) if the drug could not be self-administered;
(R) colorectal cancer screening tests (as defined in
subsection (pp));
(S) diabetes outpatient self-management training
services (as defined in subsection (qq));
(T) an oral drug (which is approved by the Federal
Food and Drug Administration) prescribed for use as an
acute anti-emetic used as part of an anticancer
chemotherapeutic regimen if the drug is administered by
a physician (or as prescribed by a physician)--
(i) for use immediately before, at, or within
48 hours after the time of the administration
of the anticancer chemotherapeutic agent; and
(ii) as a full replacement for the anti-
emetic therapy which would otherwise be
administered intravenously;
(U) screening for glaucoma (as defined in subsection
(uu)) for individuals determined to be at high risk for
glaucoma, individuals with a family history of glaucoma
and individuals with diabetes;
(V) medical nutrition therapy services (as defined in
subsection (vv)(1)) in the case of a beneficiary with
diabetes or a renal disease who--
(i) has not received diabetes outpatient
self-management training services within a time
period determined by the Secretary;
(ii) is not receiving maintenance dialysis
for which payment is made under section 1881;
and
(iii) meets such other criteria determined by
the Secretary after consideration of protocols
established by dietitian or nutrition
professional organizations;
(W) an initial preventive physical examination (as
defined in subsection (ww));
(X) cardiovascular screening blood tests (as defined
in subsection (xx)(1));
(Y) diabetes screening tests (as defined in
subsection (yy));
(Z) intravenous immune globulin for the treatment of
primary immune deficiency diseases in the home (as
defined in subsection (zz));
(AA) ultrasound screening for abdominal aortic
aneurysm (as defined in subsection (bbb)) for an
individual--
(i) who receives a referral for such an
ultrasound screening as a result of an initial
preventive physical examination (as defined in
section 1861(ww)(1));
(ii) who has not been previously furnished
such an ultrasound screening under this title;
and
(iii) who--
(I) has a family history of abdominal
aortic aneurysm; or
(II) manifests risk factors included
in a beneficiary category recommended
for screening by the United States
Preventive Services Task Force
regarding abdominal aortic aneurysms;
(BB) additional preventive services (described in
subsection (ddd)(1));
(CC) items and services furnished under a
cardiac rehabilitation program (as defined in
subsection (eee)(1)) or under a pulmonary
rehabilitation program (as defined in
subsection (fff)(1));
(DD) items and services furnished under an
intensive cardiac rehabilitation program (as
defined in subsection (eee)(4));
(EE) kidney disease education services (as defined in
subsection (ggg));
(FF) personalized prevention plan services (as
defined in subsection (hhh));
(GG) home infusion therapy (as defined in subsection
(iii)(1)); and
(HH) opioid use disorder treatment services (as
defined in subsection (jjj)).
(3) diagnostic X-ray tests (including tests under the
supervision of a physician, furnished in a place of
residence used as the patient's home, if the
performance of such tests meets such conditions
relating to health and safety as the Secretary may find
necessary and including diagnostic mammography if
conducted by a facility that has a certificate (or
provisional certificate) issued under section 354 of
the Public Health Service Act), diagnostic laboratory
tests, and other diagnostic tests;
(4) X-ray, radium, and radioactive isotope therapy,
including materials and services of technicians;
(5) surgical dressings, and splints, casts, and other
devices used for reduction of fractures and
dislocations;
(6) durable medical equipment;
(7) ambulance service where the use of other methods
of transportation is contraindicated by the
individual's condition, but, subject to section
1834(l)(14), only to the extent provided in
regulations;
(8) prosthetic devices (other than dental) which
replace all or part of an internal body organ
(including colostomy bags and supplies directly related
to colostomy care), including replacement of such
devices, and including one pair of conventional
eyeglasses or contact lenses furnished subsequent to
each cataract surgery with insertion of an intraocular
lens;
(9) leg, arm, back, and neck braces, and artificial
legs, arms, and eyes, including replacements if
required because of a change in the patient's physical
condition;
(10)(A) pneumococcal vaccine and its administration
and, subject to section 4071(b) of the Omnibus Budget
Reconciliation Act of 1987, influenza vaccine and its
administration, and COVID-19 vaccine and its
administration; and
(B) hepatitis B vaccine and its administration,
furnished to an individual who is at high or
intermediate risk of contracting hepatitis B (as
determined by the Secretary under regulations);
(11) services of a certified registered nurse
anesthetist (as defined in subsection (bb));
(12) subject to section 4072(e) of the Omnibus Budget
Reconciliation Act of 1987, extra-depth shoes with
inserts or custom molded shoes with inserts for an
individual with diabetes, if--
(A) the physician who is managing the
individual's diabetic condition (i) documents
that the individual has peripheral neuropathy
with evidence of callus formation, a history of
pre-ulcerative calluses, a history of previous
ulceration, foot deformity, or previous
amputation, or poor circulation, and (ii)
certifies that the individual needs such shoes
under a comprehensive plan of care related to
the individual's diabetic condition;
(B) the particular type of shoes are
prescribed by a podiatrist or other qualified
physician (as established by the Secretary);
and
(C) the shoes are fitted and furnished by a
podiatrist or other qualified individual (such
as a pedorthist or orthotist, as established by
the Secretary) who is not the physician
described in subparagraph (A) (unless the
Secretary finds that the physician is the only
such qualified individual in the area);
(13) screening mammography (as defined in subsection
(jj));
(14) screening pap smear and screening pelvic exam;
and
(15) bone mass measurement (as defined in subsection
(rr)).
No diagnostic tests performed in any laboratory, including a
laboratory that is part of a rural health clinic, or a hospital
(which, for purposes of this sentence, means an institution
considered a hospital for purposes of section 1814(d)) shall be
included within paragraph (3) unless such laboratory--
(16) if situated in any State in which State or
applicable local law provides for licensing of
establishments of this nature, (A) is licensed pursuant
to such law, or (B) is approved, by the agency of such
State or locality responsible for licensing
establishments of this nature, as meeting the standards
established for such licensing; and
(17)(A) meets the certification requirements under
section 353 of the Public Health Service Act; and
(B) meets such other conditions relating to the
health and safety of individuals with respect to whom
such tests are performed as the Secretary may find
necessary.
There shall be excluded from the diagnostic services specified
in paragraph (2)(C) any item or service (except services
referred to in paragraph (1)) which would not be included under
subsection (b) if it were furnished to an inpatient of a
hospital. None of the items and services referred to in the
preceding paragraphs (other than paragraphs (1) and (2)(A)) of
this subsection which are furnished to a patient of an
institution which meets the definition of a hospital for
purposes of section 1814(d) shall be included unless such other
conditions are met as the Secretary may find necessary relating
to health and safety of individuals with respect to whom such
items and services are furnished.
Drugs and Biologicals
(t)(1) The term ``drugs'' and the term ``biologicals'',
except for purposes of subsection (m)(5) and paragraph (2),
include only such drugs (including contrast agents) and
biologicals, respectively, as are included (or approved for
inclusion) in the United States Pharmacopoeia, the National
Formulary, or the United States Homeopathic Pharmacopoeia, or
in New Drugs or Accepted Dental Remedies (except for any drugs
and biologicals unfavorably evaluated therein), or as are
approved by the pharmacy and drug therapeutics committee (or
equivalent committee) of the medical staff of the hospital
furnishing such drugs and biologicals for use in such hospital.
(2)(A) For purposes of paragraph (1), the term ``drugs'' also
includes any drugs or biologicals used in an anticancer
chemotherapeutic regimen for a medically accepted indication
(as described in subparagraph (B)).
(B) In subparagraph (A), the term ``medically accepted
indication'', with respect to the use of a drug, includes any
use which has been approved by the Food and Drug Administration
for the drug, and includes another use of the drug if--
(i) the drug has been approved by the Food and Drug
Administration; and
(ii)(I) such use is supported by one or more
citations which are included (or approved for
inclusion) in one or more of the following compendia:
the American Hospital Formulary Service-Drug
Information, the American Medical Association Drug
Evaluations, the United States Pharmacopoeia-Drug
Information (or its successor publications), and other
authoritative compendia as identified by the Secretary,
unless the Secretary has determined that the use is not
medically appropriate or the use is identified as not
indicated in one or more such compendia, or
(II) the carrier involved determines, based upon
guidance provided by the Secretary to carriers for
determining accepted uses of drugs, that such use is
medically accepted based on supportive clinical
evidence in peer reviewed medical literature appearing
in publications which have been identified for purposes
of this subclause by the Secretary.
The Secretary may revise the list of compendia in clause
(ii)(I) as is appropriate for identifying medically accepted
indications for drugs. On and after January 1, 2010, no
compendia may be included on the list of compendia under this
subparagraph unless the compendia has a publicly transparent
process for evaluating therapies and for identifying potential
conflicts of interests.
Provider of Services
(u) The term ``provider of services'' means a hospital,
critical access hospital, rural emergency hospital, skilled
nursing facility, comprehensive outpatient rehabilitation
facility, home health agency, hospice program, or, for purposes
of section 1814(g) and section 1835(e), a fund.
Reasonable Cost
(v)(1)(A) The reasonable cost of any services shall be the
cost actually incurred, excluding therefrom any part of
incurred cost found to be unnecessary in the efficient delivery
of needed health services, and shall be determined in
accordance with regulations establishing the method or methods
to be used, and the items to be included, in determining such
costs for various types or classes of institutions, agencies,
and services; except that in any case to which paragraph (2) or
(3) applies, the amount of the payment determined under such
paragraph with respect to the services involved shall be
considered the reasonable cost of such services. In prescribing
the regulations referred to in the preceding sentence, the
Secretary shall consider, among other things, the principles
generally applied by national organizations or established
prepayment organizations (which have developed such principles)
in computing the amount of payment, to be made by persons other
than the recipients of services, to providers of services on
account of services furnished to such recipients by such
providers. Such regulations may provide for determination of
the costs of services on a per diem, per unit, per capita, or
other basis, may provide for using different methods in
different circumstances, may provide for the use of estimates
of costs of particular items or services, may provide for the
establishment of limits on the direct or indirect overall
incurred costs or incurred costs of specific items or services
or groups of items or services to be recognized as reasonable
based on estimates of the costs necessary in the efficient
delivery of needed health services to individuals covered by
the insurance programs established under this title, and may
provide for the use of charges or a percentage of charges where
this method reasonably reflects the costs. Such regulations
shall (i) take into account both direct and indirect costs of
providers of services (excluding therefrom any such costs,
including standby costs, which are determined in accordance
with regulations to be unnecessary in the efficient delivery of
services covered by the insurance programs established under
this title) in order that, under the methods of determining
costs, the necessary costs of efficiently delivering covered
services to individuals covered by the insurance programs
established by this title will not be borne by individuals not
so covered, and the costs with respect to individuals not so
covered will not be borne by such insurance programs, and (ii)
provide for the making of suitable retroactive corrective
adjustments where, for a provider of services for any fiscal
period, the aggregate reimbursement produced by the methods of
determining costs proves to be either inadequate or excessive.
(B) In the case of extended care services, the regulations
under subparagraph (A) shall not include provision for specific
recognition of a return on equity capital.
(C) Where a hospital has an arrangement with a medical school
under which the faculty of such school provides services at
such hospital, an amount not in excess of the reasonable cost
of such services to the medical school shall be included in
determining the reasonable cost to the hospital of furnishing
services--
(i) for which payment may be made under part A, but
only if--
(I) payment for such services as furnished
under such arrangement would be made under part
A to the hospital had such services been
furnished by the hospital, and
(II) such hospital pays to the medical school
at least the reasonable cost of such services
to the medical school, or
(ii) for which payment may be made under part B, but
only if such hospital pays to the medical school at
least the reasonable cost of such services to the
medical school.
(D) Where (i) physicians furnish services which are either
inpatient hospital services (including services in conjunction
with the teaching programs of such hospital) by reason of
paragraph (7) of subsection (b) or for which entitlement exists
by reason of clause (II) of section 1832(a)(2)(B)(i), and (ii)
such hospital (or medical school under arrangement with such
hospital) incurs no actual cost in the furnishing of such
services, the reasonable cost of such services shall (under
regulations of the Secretary) be deemed to be the cost such
hospital or medical school would have incurred had it paid a
salary to such physicians rendering such services approximately
equivalent to the average salary paid to all physicians
employed by such hospital (or if such employment does not
exist, or is minimal in such hospital, by similar hospitals in
a geographic area of sufficient size to assure reasonable
inclusion of sufficient physicians in development of such
average salary).
(E) Such regulations may, in the case of skilled nursing
facilities in any State, provide for the use of rates,
developed by the State in which such facilities are located,
for the payment of the cost of skilled nursing facility
services furnished under the State's plan approved under title
XIX (and such rates may be increased by the Secretary on a
class or size of institution or on a geographical basis by a
percentage factor not in excess of 10 percent to take into
account determinable items or services or other requirements
under this title not otherwise included in the computation of
such State rates), if the Secretary finds that such rates are
reasonably related to (but not necessarily limited to) analyses
undertaken by such State of costs of care in comparable
facilities in such State. Notwithstanding the previous
sentence, such regulations with respect to skilled nursing
facilities shall take into account (in a manner consistent with
subparagraph (A) and based on patient-days of services
furnished) the costs (including the costs of services required
to attain or maintain the highest practicable physical, mental,
and psychosocial well-being of each resident eligible for
benefits under this title) of such facilities complying with
the requirements of subsections (b), (c), and (d) of section
1819 (including the costs of conducting nurse aide training and
competency evaluation programs and competency evaluation
programs).
(F) Such regulations shall require each provider of services
(other than a fund) to make reports to the Secretary of
information described in section 1121(a) in accordance with the
uniform reporting system (established under such section) for
that type of provider.
(G)(i) In any case in which a hospital provides inpatient
services to an individual that would constitute post-hospital
extended care services if provided by a skilled nursing
facility and a quality improvement organization (or, in the
absence of such a qualified organization, the Secretary or such
agent as the Secretary may designate) determines that inpatient
hospital services for the individual are not medically
necessary but post-hospital extended care services for the
individual are medically necessary and such extended care
services are not otherwise available to the individual (as
determined in accordance with criteria established by the
Secretary) at the time of such determination, payment for such
services provided to the individual shall continue to be made
under this title at the payment rate described in clause (ii)
during the period in which--
(I) such post-hospital extended care services for the
individual are medically necessary and not otherwise
available to the individual (as so determined),
(II) inpatient hospital services for the individual
are not medically necessary, and
(III) the individual is entitled to have payment made
for post-hospital extended care services under this
title,
except that if the Secretary determines that there is not an
excess of hospital beds in such hospital and (subject to clause
(iv)) there is not an excess of hospital beds in the area of
such hospital, such payment shall be made (during such period)
on the basis of the amount otherwise payable under part A with
respect to inpatient hospital services.
(ii)(I) Except as provided in subclause (II), the payment
rate referred to in clause (i) is a rate equal to the estimated
adjusted State-wide average rate per patient-day paid for
services provided in skilled nursing facilities under the State
plan approved under title XIX for the State in which such
hospital is located, or, if the State in which the hospital is
located does not have a State plan approved under title XIX,
the estimated adjusted State-wide average allowable costs per
patient-day for extended care services under this title in that
State.
(II) If a hospital has a unit which is a skilled nursing
facility, the payment rate referred to in clause (i) for the
hospital is a rate equal to the lesser of the rate described in
subclause (I) or the allowable costs in effect under this title
for extended care services provided to patients of such unit.
(iii) Any day on which an individual receives inpatient
services for which payment is made under this subparagraph
shall, for purposes of this Act (other than this subparagraph),
be deemed to be a day on which the individual received
inpatient hospital services.
(iv) In determining under clause (i), in the case of a public
hospital, whether or not there is an excess of hospital beds in
the area of such hospital, such determination shall be made on
the basis of only the public hospitals (including the hospital)
which are in the area of the hospital and which are under
common ownership with that hospital.
(H) In determining such reasonable cost with respect to home
health agencies, the Secretary may not include--
(i) any costs incurred in connection with bonding or
establishing an escrow account by any such agency as a
result of the surety bond requirement described in
subsection (o)(7) and the financial security
requirement described in subsection (o)(8);
(ii) in the case of home health agencies to which the
surety bond requirement described in subsection (o)(7)
and the financial security requirement described in
subsection (o)(8) apply, any costs attributed to
interest charged such an agency in connection with
amounts borrowed by the agency to repay overpayments
made under this title to the agency, except that such
costs may be included in reasonable cost if the
Secretary determines that the agency was acting in good
faith in borrowing the amounts;
(iii) in the case of contracts entered into by a home
health agency after the date of the enactment of this
subparagraph for the purpose of having services
furnished for or on behalf of such agency, any cost
incurred by such agency pursuant to any such contract
which is entered into for a period exceeding five
years; and
(iv) in the case of contracts entered into by a home
health agency before the date of the enactment of this
subparagraph for the purpose of having services
furnished for or on behalf of such agency, any cost
incurred by such agency pursuant to any such contract,
which determines the amount payable by the home health
agency on the basis of a percentage of the agency's
reimbursement or claim for reimbursement for services
furnished by the agency, to the extent that such cost
exceeds the reasonable value of the services furnished
on behalf of such agency.
(I) In determining such reasonable cost, the Secretary may
not include any costs incurred by a provider with respect to
any services furnished in connection with matters for which
payment may be made under this title and furnished pursuant to
a contract between the provider and any of its subcontractors
which is entered into after the date of the enactment of this
subparagraph and the value or cost of which is $10,000 or more
over a twelve-month period unless the contract contains a
clause to the effect that--
(i) until the expiration of four years after the
furnishing of such services pursuant to such contract,
the subcontractor shall make available, upon written
request by the Secretary, or upon request by the
Comptroller General, or any of their duly authorized
representatives, the contract, and books, documents and
records of such subcontractor that are necessary to
certify the nature and extent of such costs, and
(ii) if the subcontractor carries out any of the
duties of the contract through a subcontract, with a
value or cost of $10,000 or more over a twelve-month
period, with a related organization, such subcontract
shall contain a clause to the effect that until the
expiration of four years after the furnishing of such
services pursuant to such subcontract, the related
organization shall make available, upon written request
by the Secretary, or upon request by the Comptroller
General, or any of their duly authorized
representatives, the subcontract, and books, documents
and records of such organization that are necessary to
verify the nature and extent of such costs.
The Secretary shall prescribe in regulation criteria and
procedures which the Secretary shall use in obtaining access to
books, documents, and records under clauses required in
contracts and subcontracts under this subparagraph.
(J) Such regulations may not provide for any inpatient
routine salary cost differential as a reimbursable cost for
hospitals and skilled nursing facilities.
(K)(i) The Secretary shall issue regulations that provide, to
the extent feasible, for the establishment of limitations on
the amount of any costs or charges that shall be considered
reasonable with respect to services provided on an outpatient
basis by hospitals (other than bona fide emergency services as
defined in clause (ii)) or clinics (other than rural health
clinics), which are reimbursed on a cost basis or on the basis
of cost related charges, and by physicians utilizing such
outpatient facilities. Such limitations shall be reasonably
related to the charges in the same area for similar services
provided in physicians' offices. Such regulations shall provide
for exceptions to such limitations in cases where similar
services are not generally available in physicians' offices in
the area to individuals entitled to benefits under this title.
(ii) For purposes of clause (i), the term ``bona fide
emergency services'' means services provided in a hospital
emergency room after the sudden onset of a medical condition
manifesting itself by acute symptoms of sufficient severity
(including severe pain) such that the absence of immediate
medical attention could reasonably be expected to result in--
(I) placing the patient's health in serious jeopardy;
(II) serious impairment to bodily functions; or
(III) serious dysfunction of any bodily organ or
part.
(L)(i) The Secretary, in determining the amount of the
payments that may be made under this title with respect to
services furnished by home health agencies, may not recognize
as reasonable (in the efficient delivery of such services)
costs for the provision of such services by an agency to the
extent these costs exceed (on the aggregate for the agency) for
cost reporting periods beginning on or after--
(I) July 1, 1985, and before July 1, 1986, 120
percent of the mean of the labor-related and nonlabor
per visit costs for freestanding home health agencies,
(II) July 1, 1986, and before July 1, 1987, 115
percent of such mean,
(III) July 1, 1987, and before October 1, 1997, 112
percent of such mean,
(IV) October 1, 1997, and before October 1, 1998, 105
percent of the median of the labor-related and nonlabor
per visit costs for freestanding home health agencies,
or
(V) October 1, 1998, 106 percent of such median.
(ii) Effective for cost reporting periods beginning on or
after July 1, 1986, such limitations shall be applied on an
aggregate basis for the agency, rather than on a discipline
specific basis. The Secretary may provide for such exemptions
and exceptions to such limitation as he deems appropriate.
(iii) Not later than July 1, 1991, and annually thereafter
(but not for cost reporting periods beginning on or after July
1, 1994, and before July 1, 1996, or on or after July 1, 1997,
and before October 1, 1997), the Secretary shall establish
limits under this subparagraph for cost reporting periods
beginning on or after such date by utilizing the area wage
index applicable under section 1886(d)(3)(E) and determined
using the survey of the most recent available wages and wage-
related costs of hospitals located in the geographic area in
which the home health service is furnished (determined without
regard to whether such hospitals have been reclassified to a
new geographic area pursuant to section 1886(d)(8)(B), a
decision of the Medicare Geographic Classification Review Board
under section 1886(d)(10), or a decision of the Secretary).
(iv) In establishing limits under this subparagraph for cost
reporting periods beginning after September 30, 1997, the
Secretary shall not take into account any changes in the home
health market basket, as determined by the Secretary, with
respect to cost reporting periods which began on or after July
1, 1994, and before July 1, 1996.
(v) For services furnished by home health agencies for cost
reporting periods beginning on or after October 1, 1997,
subject to clause (viii)(I), the Secretary shall provide for an
interim system of limits. Payment shall not exceed the costs
determined under the preceding provisions of this subparagraph
or, if lower, the product of--
(I) an agency-specific per beneficiary annual
limitation calculated based 75 percent on 98 percent of
the reasonable costs (including nonroutine medical
supplies) for the agency's 12-month cost reporting
period ending during fiscal year 1994, and based 25
percent on 98 percent of the standardized regional
average of such costs for the agency's census division,
as applied to such agency, for cost reporting periods
ending during fiscal year 1994, such costs updated by
the home health market basket index; and
(II) the agency's unduplicated census count of
patients (entitled to benefits under this title) for
the cost reporting period subject to the limitation.
(vi) For services furnished by home health agencies for cost
reporting periods beginning on or after October 1, 1997, the
following rules apply:
(I) For new providers and those providers without a
12-month cost reporting period ending in fiscal year
1994 subject to clauses (viii)(II) and (viii)(III), the
per beneficiary limitation shall be equal to the median
of these limits (or the Secretary's best estimates
thereof) applied to other home health agencies as
determined by the Secretary. A home health agency that
has altered its corporate structure or name shall not
be considered a new provider for this purpose.
(II) For beneficiaries who use services furnished by
more than one home health agency, the per beneficiary
limitations shall be prorated among the agencies.
(vii)(I) Not later than January 1, 1998, the Secretary shall
establish per visit limits applicable for fiscal year 1998, and
not later than April 1, 1998, the Secretary shall establish per
beneficiary limits under clause (v)(I) for fiscal year 1998.
(II) Not later than August 1 of each year (beginning in 1998)
the Secretary shall establish the limits applicable under this
subparagraph for services furnished during the fiscal year
beginning October 1 of the year.
(viii)(I) In the case of a provider with a 12-month cost
reporting period ending in fiscal year 1994, if the limit
imposed under clause (v) (determined without regard to this
subclause) for a cost reporting period beginning during or
after fiscal year 1999 is less than the median described in
clause (vi)(I) (but determined as if any reference in clause
(v) to ``98 percent'' were a reference to ``100 percent''), the
limit otherwise imposed under clause (v) for such provider and
period shall be increased by \1/3\ of such difference.
(II) Subject to subclause (IV), for new providers and those
providers without a 12-month cost reporting period ending in
fiscal year 1994, but for which the first cost reporting period
begins before fiscal year 1999, for cost reporting periods
beginning during or after fiscal year 1999, the per beneficiary
limitation described in clause (vi)(I) shall be equal to the
median described in such clause (determined as if any reference
in clause (v) to ``98 percent'' were a reference to ``100
percent'').
(III) Subject to subclause (IV), in the case of a new
provider for which the first cost reporting period begins
during or after fiscal year 1999, the limitation applied under
clause (vi)(I) (but only with respect to such provider) shall
be equal to 75 percent of the median described in clause
(vi)(I).
(IV) In the case of a new provider or a provider without a
12-month cost reporting period ending in fiscal year 1994,
subclause (II) shall apply, instead of subclause (III), to a
home health agency which filed an application for home health
agency provider status under this title before September 15,
1998, or which was approved as a branch of its parent agency
before such date and becomes a subunit of the parent agency or
a separate agency on or after such date.
(V) Each of the amounts specified in subclauses (I) through
(III) are such amounts as adjusted under clause (iii) to
reflect variations in wages among different areas.
(ix) Notwithstanding the per beneficiary limit under clause
(viii), if the limit imposed under clause (v) (determined
without regard to this clause) for a cost reporting period
beginning during or after fiscal year 2000 is less than the
median described in clause (vi)(I) (but determined as if any
reference in clause (v) to ``98 percent'' were a reference to
``100 percent''), the limit otherwise imposed under clause (v)
for such provider and period shall be increased by 2 percent.
(x) Notwithstanding any other provision of this subparagraph,
in updating any limit under this subparagraph by a home health
market basket index for cost reporting periods beginning during
each of fiscal years 2000, 2002, and 2003, the update otherwise
provided shall be reduced by 1.1 percentage points. With
respect to cost reporting periods beginning during fiscal year
2001, the update to any limit under this subparagraph shall be
the home health market basket index.
(M) Such regulations shall provide that costs respecting care
provided by a provider of services, pursuant to an assurance
under title VI or XVI of the Public Health Service Act that the
provider will make available a reasonable volume of services to
persons unable to pay therefor, shall not be allowable as
reasonable costs.
(N) In determining such reasonable costs, costs incurred for
activities directly related to influencing employees respecting
unionization may not be included.
(O)(i) In establishing an appropriate allowance for
depreciation and for interest on capital indebtedness with
respect to an asset of a provider of services which has
undergone a change of ownership, such regulations shall
provide, except as provided in clause (iii), that the valuation
of the asset after such change of ownership shall be the
historical cost of the asset, as recognized under this title,
less depreciation allowed, to the owner of record as of the
date of enactment of the Balanced Budget Act of 1997 (or, in
the case of an asset not in existence as of that date, the
first owner of record of the asset after that date).
(ii) Such regulations shall not recognize, as reasonable in
the provision of health care services, costs (including legal
fees, accounting and administrative costs, travel costs, and
the costs of feasibility studies) attributable to the
negotiation or settlement of the sale or purchase of any
capital asset (by acquisition or merger) for which any payment
has previously been made under this title.
(iii) In the case of the transfer of a hospital from
ownership by a State to ownership by a nonprofit corporation
without monetary consideration, the basis for capital
allowances to the new owner shall be the book value of the
hospital to the State at the time of the transfer.
(P) If such regulations provide for the payment for a return
on equity capital (other than with respect to costs of
inpatient hospital services), the rate of return to be
recognized, for determining the reasonable cost of services
furnished in a cost reporting period, shall be equal to the
average of the rates of interest, for each of the months any
part of which is included in the period, on obligations issued
for purchase by the Federal Hospital Insurance Trust Fund.
(Q) Except as otherwise explicitly authorized, the Secretary
is not authorized to limit the rate of increase on allowable
costs of approved medical educational activities.
(R) In determining such reasonable cost, costs incurred by a
provider of services representing a beneficiary in an
unsuccessful appeal of a determination described in section
1869(b) shall not be allowable as reasonable costs.
(S)(i) Such regulations shall not include provision for
specific recognition of any return on equity capital with
respect to hospital outpatient departments.
(ii)(I) Such regulations shall provide that, in determining
the amount of the payments that may be made under this title
with respect to all the capital-related costs of outpatient
hospital services, the Secretary shall reduce the amounts of
such payments otherwise established under this title by 15
percent for payments attributable to portions of cost reporting
periods occurring during fiscal year 1990, by 15 percent for
payments attributable to portions of cost reporting periods
occurring during fiscal year 1991, and by 10 percent for
payments attributable to portions of cost reporting periods
occurring during fiscal years 1992 through 1999 and until the
first date that the prospective payment system under section
1833(t) is implemented.
(II) The Secretary shall reduce the reasonable cost of
outpatient hospital services (other than the capital-related
costs of such services) otherwise determined pursuant to
section 1833(a)(2)(B)(i)(I) by 5.8 percent for payments
attributable to portions of cost reporting periods occurring
during fiscal years 1991 through 1999 and until the first date
that the prospective payment system under section 1833(t) is
implemented.
(III) Subclauses (I) and (II) shall not apply to payments
with respect to the costs of hospital outpatient services
provided by any hospital that is a sole community hospital (as
defined in section 1886(d)(5)(D)(iii)) or a critical access
hospital (as defined in section 1861(mm)(1)).
(IV) In applying subclauses (I) and (II) to services for
which payment is made on the basis of a blend amount under
section 1833(i)(3)(A)(ii) or 1833(n)(1)(A)(ii), the costs
reflected in the amounts described in sections
1833(i)(3)(B)(i)(I) and 1833(n)(1)(B)(i)(I), respectively,
shall be reduced in accordance with such subclause.
(T) In determining such reasonable costs for hospitals, no
reduction in copayments under section 1833(t)(8)(B) shall be
treated as a bad debt and the amount of bad debts otherwise
treated as allowable costs which are attributable to the
deductibles and coinsurance amounts under this title shall be
reduced--
(i) for cost reporting periods beginning during
fiscal year 1998, by 25 percent of such amount
otherwise allowable,
(ii) for cost reporting periods beginning during
fiscal year 1999, by 40 percent of such amount
otherwise allowable,
(iii) for cost reporting periods beginning during
fiscal year 2000, by 45 percent of such amount
otherwise allowable,
(iv) for cost reporting periods beginning during
fiscal years 2001 through 2012, by 30 percent of such
amount otherwise allowable, and
(v) for cost reporting periods beginning during
fiscal year 2013 or a subsequent fiscal year, by 35
percent of such amount otherwise allowable.
(U) In determining the reasonable cost of ambulance services
(as described in subsection (s)(7)) provided during fiscal year
1998, during fiscal year 1999, and during so much of fiscal
year 2000 as precedes January 1, 2000, the Secretary shall not
recognize the costs per trip in excess of costs recognized as
reasonable for ambulance services provided on a per trip basis
during the previous fiscal year (after application of this
subparagraph), increased by the percentage increase in the
consumer price index for all urban consumers (U.S. city
average) as estimated by the Secretary for the 12-month period
ending with the midpoint of the fiscal year involved reduced by
1.0 percentage point. For ambulance services provided after
June 30, 1998, the Secretary may provide that claims for such
services must include a code (or codes) under a uniform coding
system specified by the Secretary that identifies the services
furnished.
(V) In determining such reasonable costs for skilled nursing
facilities and (beginning with respect to cost reporting
periods beginning during fiscal year 2013) for covered skilled
nursing services described in section 1888(e)(2)(A) furnished
by hospital providers of extended care services (as described
in section 1883), the amount of bad debts otherwise treated as
allowed costs which are attributable to the coinsurance amounts
under this title for individuals who are entitled to benefits
under part A and--
(i) are not described in section 1935(c)(6)(A)(ii)
shall be reduced by--
(I) for cost reporting periods beginning on or after
October 1, 2005, but before fiscal year 2013, 30
percent of such amount otherwise allowable; and
(II) for cost reporting periods beginning during
fiscal year 2013 or a subsequent fiscal year, by 35
percent of such amount otherwise allowable.
(ii) are described in such section--
(I) for cost reporting periods beginning on or after
October 1, 2005, but before fiscal year 2013, shall not
be reduced;
(II) for cost reporting periods beginning during
fiscal year 2013, shall be reduced by 12 percent of
such amount otherwise allowable;
(III) for cost reporting periods beginning during
fiscal year 2014, shall be reduced by 24 percent of
such amount otherwise allowable; and
(IV) for cost reporting periods beginning during a
subsequent fiscal year, shall be reduced by 35 percent
of such amount otherwise allowable.
(W)(i) In determining such reasonable costs for providers
described in clause (ii), the amount of bad debts otherwise
treated as allowable costs which are attributable to
deductibles and coinsurance amounts under this title shall be
reduced--
(I) for cost reporting periods beginning during
fiscal year 2013, by 12 percent of such amount
otherwise allowable;
(II) for cost reporting periods beginning during
fiscal year 2014, by 24 percent of such amount
otherwise allowable; and
(III) for cost reporting periods beginning during a
subsequent fiscal year, by 35 percent of such amount
otherwise allowable.
(ii) A provider described in this clause is a provider of
services not described in subparagraph (T) or (V), a supplier,
or any other type of entity that receives payment for bad debts
under the authority under subparagraph (A).
(2)(A) If the bed and board furnished as part of inpatient
hospital services (including inpatient tuberculosis hospital
services and inpatient psychiatric hospital services) or post-
hospital extended care services is in accommodations more
expensive than semi-private accommodations, the amount taken
into account for purposes of payment under this title with
respect to such services may not exceed the amount that would
be taken into account with respect to such services if
furnished in such semi-private accommodations unless the more
expensive accommodations were required for medical reasons.
(B) Where a provider of services which has an agreement in
effect under this title furnishes to an individual items or
services which are in excess of or more expensive than the
items or services with respect to which payment may be made
under part A or part B, as the case may be, the Secretary shall
take into account for purposes of payment to such provider of
services only the items or services with respect to which such
payment may be made.
(3) If the bed and board furnished as part of inpatient
hospital services (including inpatient tuberculosis hospital
services and inpatient psychiatric hospital services) or post-
hospital extended care services is in accommodations other
than, but not more expensive than, semi-private accommodations
and the use of such other accommodations rather than semi-
private accommodations was neither at the request of the
patient nor for a reason which the Secretary determines is
consistent with the purposes of this title, the amount of the
payment with respect to such bed and board under part A shall
be the amount otherwise payable under this title for such bed
and board furnished in semi-private accommodations minus the
difference between the charge customarily made by the hospital
or skilled nursing facility for bed and board in semi-private
accommodations and the charge customarily made by it for bed
and board in the accommodations furnished.
(4) If a provider of services furnishes items or services to
an individual which are in excess of or more expensive than the
items or services determined to be necessary in the efficient
delivery of needed health services and charges are imposed for
such more expensive items or services under the authority
granted in section 1866(a)(2)(B)(ii), the amount of payment
with respect to such items or services otherwise due such
provider in any fiscal period shall be reduced to the extent
that such payment plus such charges exceed the cost actually
incurred for such items or services in the fiscal period in
which such charges are imposed.
(5)(A) Where physical therapy services, occupational therapy
services, speech therapy services, or other therapy services or
services of other health-related personnel (other than
physicians) are furnished under an arrangement with a provider
of services or other organization, specified in the first
sentence of subsection (p) (including through the operation of
subsection (g)) the amount included in any payment to such
provider or other organization under this title as the
reasonable cost of such services (as furnished under such
arrangements) shall not exceed an amount equal to the salary
which would reasonably have been paid for such services
(together with any additional costs that would have been
incurred by the provider or other organization) to the person
performing them if they had been performed in an employment
relationship with such provider or other organization (rather
than under such arrangement) plus the cost of such other
expenses (including a reasonable allowance for traveltime and
other reasonable types of expense related to any differences in
acceptable methods of organization for the provision of such
therapy) incurred by such person, as the Secretary may in
regulations determine to be appropriate.
(B) Notwithstanding the provisions of subparagraph (A), if a
provider of services or other organization specified in the
first sentence of section 1861(p) requires the services of a
therapist on a limited part-time basis, or only to perform
intermittent services, the Secretary may make payment on the
basis of a reasonable rate per unit of service, even though
such rate is greater per unit of time than salary related
amounts, where he finds that such greater payment is, in the
aggregate, less than the amount that would have been paid if
such organization had employed a therapist on a full- or part-
time salary basis.
(6) For purposes of this subsection, the term ``semi-private
accommodations'' means two-bed, three-bed, or four-bed
accommodations.
(7)(A) For limitation on Federal participation for capital
expenditures which are out of conformity with a comprehensive
plan of a State or areawide planning agency, see section 1122.
(B) For further limitations on reasonable cost and
determination of payment amounts for operating costs of
inpatient hospital services and waivers for certain States, see
section 1886.
(C) For provisions restricting payment for provider-based
physicians' services and for payments under certain percentage
arrangements, see section 1887.
(D) For further limitations on reasonable cost and
determination of payment amounts for routine service costs of
skilled nursing facilities, see subsections (a) through (c) of
section 1888.
(8) Items unrelated to patient care.--Reasonable costs do not
include costs for the following--
(i) entertainment, including tickets to sporting and
other entertainment events;
(ii) gifts or donations;
(iii) personal use of motor vehicles;
(iv) costs for fines and penalties resulting from
violations of Federal, State, or local laws; and
(v) education expenses for spouses or other
dependents of providers of services, their employees or
contractors.
Arrangements for Certain Services
(w)(1) The term ``arrangements'' is limited to arrangements
under which receipt of payment by the hospital, critical access
hospital, skilled nursing facility, home health agency, or
hospice program (whether in its own right or as agent), with
respect to services for which an individual is entitled to have
payment made under this title, discharges the liability of such
individual or any other person to pay for the services.
(2) Utilization review activities conducted, in accordance
with the requirements of the program established under part B
of title XI of the Social Security Act with respect to services
furnished by a hospital or critical access hospital to patients
insured under part A of this title or entitled to have payment
made for such services under part B of this title or under a
State plan approved under title XIX, by a quality improvement
organization designated for the area in which such hospital or
critical access hospital is located shall be deemed to have
been conducted pursuant to arrangements between such hospital
or critical access hospital and such organization under which
such hospital or critical access hospital is obligated to pay
to such organization, as a condition of receiving payment for
hospital or critical access hospital services so furnished
under this part or under such a State plan, such amount as is
reasonably incurred and requested (as determined under
regulations of the Secretary) by such organization in
conducting such review activities with respect to services
furnished by such hospital or critical access hospital to such
patients.
State and United States
(x) The terms ``State'' and ``United States'' have the
meaning given to them by subsections (h) and (i), respectively,
of section 210.
Extended Care in Religious Nonmedical Health Care Institutions
(y)(1) The term ``skilled nursing facility'' also includes a
religious nonmedical health care institution (as defined in
subsection (ss)(1)), but only (except for purposes of
subsection (a)(2)) with respect to items and services
ordinarily furnished by such an institution to inpatients, and
payment may be made with respect to services provided by or in
such an institution only to such extent and under such
conditions, limitations, and requirements (in addition to or in
lieu of the conditions, limitations, and requirements otherwise
applicable) as may be provided in regulations consistent with
section 1821.
(2) Notwithstanding any other provision of this title,
payment under part A may not be made for services furnished an
individual in a skilled nursing facility to which paragraph (1)
applies unless such individual elects, in accordance with
regulations, for a spell of illness to have such services
treated as post-hospital extended care services for purposes of
such part; and payment under part A may not be made for post-
hospital extended care services--
(A) furnished an individual during such spell of
illness in a skilled nursing facility to which
paragraph (1) applies after--
(i) such services have been furnished to him
in such a facility for 30 days during such
spell, or
(ii) such services have been furnished to him
during such spell in a skilled nursing facility
to which such paragraph does not apply; or
(B) furnished an individual during such spell of
illness in a skilled nursing facility to which
paragraph (1) does not apply after such services have
been furnished to him during such spell in a skilled
nursing facility to which such paragraph applies.
(3) The amount payable under part A for post-hospital
extended care services furnished an individual during any spell
of illness in a skilled nursing facility to which paragraph (1)
applies shall be reduced by a coinsurance amount equal to one-
eighth of the inpatient hospital deductible for each day before
the 31st day on which he is furnished such services in such a
facility during such spell (and the reduction under this
paragraph shall be in lieu of any reduction under section
1813(a)(3)).
(4) For purposes of subsection (i), the determination of
whether services furnished by or in an institution described in
paragraph (1) constitute post-hospital extended care services
shall be made in accordance with and subject to such
conditions, limitations, and requirements as may be provided in
regulations.
Institutional Planning
(z) An overall plan and budget of a hospital, skilled nursing
facility, comprehensive outpatient rehabilitation facility, or
home health agency shall be considered sufficient if it--
(1) provides for an annual operating budget which
includes all anticipated income and expenses related to
items which would, under generally accepted accounting
principles, be considered income and expense items
(except that nothing in this paragraph shall require
that there be prepared, in connection with any budget,
an item-by-item identification of the components of
each type of anticipated expenditure or income);
(2)(A) provides for a capital expenditures plan for
at least a 3-year period (including the year to which
the operating budget described in paragraph (1) is
applicable) which includes and identifies in detail the
anticipated sources of financing for, and the
objectives of, each anticipated expenditure in excess
of $600,000 (or such lesser amount as may be
established by the State under section 1122(g)(1) in
which the hospital is located) related to the
acquisition of land, the improvement of land,
buildings, and equipment, and the replacement,
modernization, and expansion of the buildings and
equipment which would, under generally accepted
accounting principles, be considered capital items;
(B) provides that such plan is submitted to the
agency designated under section 1122(b), or if no such
agency is designated, to the appropriate health
planning agency in the State (but this subparagraph
shall not apply in the case of a facility exempt from
review under section 1122 by reason of section
1122(j));
(3) provides for review and updating at least
annually; and
(4) is prepared, under the direction of the governing
body of the institution or agency, by a committee
consisting of representatives of the governing body,
the administrative staff, and the medical staff (if
any) of the institution or agency.
Rural Health Clinic Services and Federally Qualified Health Center
Services
(aa)(1) The term ``rural health clinic services'' means --
(A) physicians' services and such services and
supplies as are covered under section 1861(s)(2)(A) if
furnished as an incident to a physician's professional
service and items and services described in section
1861(s)(10),
(B) such services furnished by a physician assistant
or a nurse practitioner (as defined in paragraph (5)),
by a clinical psychologist (as defined by the
Secretary) or by a clinical social worker (as defined
in subsection (hh)(1)), and such services and supplies
furnished as an incident to his service as would
otherwise be covered if furnished by a physician or as
an incident to a physician's service, and
(C) in the case of a rural health clinic located in
an area in which there exists a shortage of home health
agencies, part-time or intermittent nursing care and
related medical supplies (other than drugs and
biologicals) furnished by a registered professional
nurse or licensed practical nurse to a homebound
individual under a written plan of treatment (i)
established and periodically reviewed by a physician
described in paragraph (2)(B), or (ii) established by a
nurse practitioner or physician assistant and
periodically reviewed and approved by a physician
described in paragraph (2)(B),
when furnished to an individual as an outpatient of a rural
health clinic.
(2) The term ``rural health clinic'' means a facility which
--
(A) is primarily engaged in furnishing to outpatients
services described in subparagraphs (A) and (B) of
paragraph (1);
(B) in the case of a facility which is not a
physician-directed clinic, has an arrangement
(consistent with the provisions of State and local law
relative to the practice, performance, and delivery of
health services) with one or more physicians (as
defined in subsection (r)(1)) under which provision is
made for the periodic review by such physicians of
covered services furnished by physician assistants and
nurse practitioners, the supervision and guidance by
such physicians of physician assistants and nurse
practitioners, the preparation by such physicians of
such medical orders for care and treatment of clinic
patients as may be necessary, and the availability of
such physicians for such referral of and consultation
for patients as is necessary and for advice and
assistance in the management of medical emergencies;
and, in the case of a physician-directed clinic, has
one or more of its staff physicians perform the
activities accomplished through such an arrangement;
(C) maintains clinical records on all patients;
(D) has arrangements with one or more hospitals,
having agreements in effect under section 1866, for the
referral and admission of patients requiring inpatient
services or such diagnostic or other specialized
services as are not available at the clinic;
(E) has written policies, which are developed with
the advice of (and with provision for review of such
policies from time to time by) a group of professional
personnel, including one or more physicians and one or
more physician assistants or nurse practitioners, to
govern those services described in paragraph (1) which
it furnishes;
(F) has a physician, physician assistant, or nurse
practitioner responsible for the execution of policies
described in subparagraph (E) and relating to the
provision of the clinic's services;
(G) directly provides routine diagnostic services,
including clinical laboratory services, as prescribed
in regulations by the Secretary, and has prompt access
to additional diagnostic services from facilities
meeting requirements under this title;
(H) in compliance with State and Federal law, has
available for administering to patients of the clinic
at least such drugs and biologicals as are determined
by the Secretary to be necessary for the treatment of
emergency cases (as defined in regulations) and has
appropriate procedures or arrangements for storing,
administering, and dispensing any drugs and
biologicals;
(I) has a quality assessment and performance
improvement program, and appropriate procedures for
review of utilization of clinic services, as the
Secretary may specify;
(J) has a nurse practitioner, a physician assistant,
or a certified nurse-midwife (as defined in subsection
(gg)) available to furnish patient care services not
less than 50 percent of the time the clinic operates;
and
(K) meets such other requirements as the Secretary
may find necessary in the interest of the health and
safety of the individuals who are furnished services by
the clinic.
For the purposes of this title, such term includes only a
facility which (i) is located in an area that is not an
urbanized area (as defined by the Bureau of the Census) and in
which there are insufficient numbers of needed health care
practitioners (as determined by the Secretary), and that,
within the previous 4-year period, has been designated by the
chief executive officer of the State and certified by the
Secretary as an area with a shortage of personal health
services or designated by the Secretary either (I) as an area
with a shortage of personal health services under section
330(b)(3) or 1302(7) of the Public Health Service Act, (II) as
a health professional shortage area described in section
332(a)(1)(A) of that Act because of its shortage of primary
medical care manpower, (III) as a high impact area described in
section 329(a)(5) of that Act, of (IV) as an area which
includes a population group which the Secretary determines has
a health manpower shortage under section 332(a)(1)(B) of that
Act, (ii) has filed an agreement with the Secretary by which it
agrees not to charge any individual or other person for items
or services for which such individual is entitled to have
payment made under this title, except for the amount of any
deductible or coinsurance amount imposed with respect to such
items or services (not in excess of the amount customarily
charged for such items and services by such clinic), pursuant
to subsections (a) and (b) of section 1833, (iii) employs a
physician assistant or nurse practitioner, and (iv) is not a
rehabilitation agency or a facility which is primarily for the
care and treatment of mental diseases. A facility that is in
operation and qualifies as a rural health clinic under this
title or title XIX and that subsequently fails to satisfy the
requirement of clause (i) shall be considered, for purposes of
this title and title XIX, as still satisfying the requirement
of such clause if it is determined, in accordance with criteria
established by the Secretary in regulations, to be essential to
the delivery of primary care services that would otherwise be
unavailable in the geographic area served by the clinic. If a
State agency has determined under section 1864(a) that a
facility is a rural health clinic and the facility has applied
to the Secretary for approval as such a clinic, the Secretary
shall notify the facility of the Secretary's approval or
disapproval not later than 60 days after the date of the State
agency determination or the application (whichever is later).
(3) The term ``Federally qualified health center services''
means--
(A) services of the type described in subparagraphs
(A) through (C) of paragraph (1) and preventive
services (as defined in section 1861(ddd)(3)); and
(B) preventive primary health services that a center
is required to provide under section 330 of the Public
Health Service Act,
when furnished to an individual as an outpatient of a Federally
qualified health center by the center or by a health care
professional under contract with the center and, for this
purpose, any reference to a rural health clinic or a physician
described in paragraph (2)(B) is deemed a reference to a
Federally qualified health center or a physician at the center,
respectively.
(4) The term ``Federally qualified health center'' means an
entity which--
(A)(i) is receiving a grant under section 330 of the
Public Health Service Act, or
(ii)(I) is receiving funding from such a grant under
a contract with the recipient of such a grant, and (II)
meets the requirements to receive a grant under section
330 of such Act;
(B) based on the recommendation of the Health
Resources and Services Administration within the Public
Health Service, is determined by the Secretary to meet
the requirements for receiving such a grant;
(C) was treated by the Secretary, for purposes of
part B, as a comprehensive Federally funded health
center as of January 1, 1990; or
(D) is an outpatient health program or facility
operated by a tribe or tribal organization under the
Indian Self-Determination Act or by an urban Indian
organization receiving funds under title V of the
Indian Health Care Improvement Act.
(5)(A) The term ``physician assistant'' and the term ``nurse
practitioner'' mean, for purposes of this title, a physician
assistant or nurse practitioner who performs such services as
such individual is legally authorized to perform (in the State
in which the individual performs such services) in accordance
with State law (or the State regulatory mechanism provided by
State law), and who meets such training, education, and
experience requirements (or any combination thereof) as the
Secretary may prescribe in regulations.
(B) The term ``clinical nurse specialist'' means, for
purposes of this title, an individual who--
(i) is a registered nurse and is licensed to practice
nursing in the State in which the clinical nurse
specialist services are performed; and
(ii) holds a master's degree in a defined clinical
area of nursing from an accredited educational
institution.
(6) The term ``collaboration'' means a process in which a
nurse practitioner works with a physician to deliver health
care services within the scope of the practitioner's
professional expertise, with medical direction and appropriate
supervision as provided for in jointly developed guidelines or
other mechanisms as defined by the law of the State in which
the services are performed.
(7)(A) The Secretary shall waive for a 1-year period the
requirements of paragraph (2) that a rural health clinic employ
a physician assistant, nurse practitioner or certified nurse
midwife or that such clinic require such providers to furnish
services at least 50 percent of the time that the clinic
operates for any facility that requests such waiver if the
facility demonstrates that the facility has been unable,
despite reasonable efforts, to hire a physician assistant,
nurse practitioner, or certified nurse-midwife in the previous
90-day period.
(B) The Secretary may not grant such a waiver under
subparagraph (A) to a facility if the request for the waiver is
made less than 6 months after the date of the expiration of any
previous such waiver for the facility, or if the facility has
not yet been determined to meet the requirements (including
subparagraph (J) of the first sentence of paragraph (2)) of a
rural health clinic.
(C) A waiver which is requested under this paragraph shall be
deemed granted unless such request is denied by the Secretary
within 60 days after the date such request is received.
Services of a Certified Registered Nurse Anesthetist
(bb)(1) The term ``services of a certified registered nurse
anesthetist'' means anesthesia services and related care
furnished by a certified registered nurse anesthetist (as
defined in paragraph (2)) which the nurse anesthetist is
legally authorized to perform as such by the State in which the
services are furnished.
(2) The term ``certified registered nurse anesthetist'' means
a certified registered nurse anesthetist licensed by the State
who meets such education, training, and other requirements
relating to anesthesia services and related care as the
Secretary may prescribe. In prescribing such requirements the
Secretary may use the same requirements as those established by
a national organization for the certification of nurse
anesthetists. Such term also includes, as prescribed by the
Secretary, an anesthesiologist assistant.
Comprehensive Outpatient Rehabilitation Facility Services
(cc)(1) The term ``comprehensive outpatient rehabilitation
facility services'' means the following items and services
furnished by a physician or other qualified professional
personnel (as defined in regulations by the Secretary) to an
individual who is an outpatient of a comprehensive outpatient
rehabilitation facility under a plan (for furnishing such items
and services to such individual) established and periodically
reviewed by a physician--
(A) physicians' services;
(B) physical therapy, occupational therapy, speech-
language pathology services, and respiratory therapy;
(C) prosthetic and orthotic devices, including
testing, fitting, or training in the use of prosthetic
and orthotic devices;
(D) social and psychological services;
(E) nursing care provided by or under the supervision
of a registered professional nurse;
(F) drugs and biologicals which cannot, as determined
in accordance with regulations, be self-administered;
(G) supplies and durable medical equipment; and
(H) such other items and services as are medically
necessary for the rehabilitation of the patient and are
ordinarily furnished by comprehensive outpatient
rehabilitation facilities,
excluding, however, any item or service if it would not be
included under subsection (b) if furnished to an inpatient of a
hospital. In the case of physical therapy, occupational
therapy, and speech pathology services, there shall be no
requirement that the item or service be furnished at any single
fixed location if the item or service is furnished pursuant to
such plan and payments are not otherwise made for the item or
service under this title.
(2) The term ``comprehensive outpatient rehabilitation
facility'' means a facility which--
(A) is primarily engaged in providing (by or under
the supervision of physicians) diagnostic, therapeutic,
and restorative services to outpatients for the
rehabilitation of injured, disabled, or sick persons;
(B) provides at least the following comprehensive
outpatient rehabilitation services: (i) physicians'
services (rendered by physicians, as defined in section
1861(r)(1), who are available at the facility on a
full- or part-time basis); (ii) physical therapy; and
(iii) social or psychological services;
(C) maintains clinical records on all patients;
(D) has policies established by a group of
professional personnel (associated with the facility),
including one or more physicians defined in subsection
(r)(1) to govern the comprehensive outpatient
rehabilitation services it furnishes, and provides for
the carrying out of such policies by a full- or part-
time physician referred to in subparagraph (B)(i);
(E) has a requirement that every patient must be
under the care of a physician;
(F) in the case of a facility in any State in which
State or applicable local law provides for the
licensing of facilities of this nature (i) is licensed
pursuant to such law, or (ii) is approved by the agency
of such State or locality, responsible for licensing
facilities of this nature, as meeting the standards
established for such licensing;
(G) has in effect a utilization review plan in
accordance with regulations prescribed by the
Secretary;
(H) has in effect an overall plan and budget that
meets the requirements of subsection (z);
(I) provides the Secretary on a continuing basis with
a surety bond in a form specified by the Secretary and
in an amount that is not less than $50,000; and
(J) meets such other conditions of participation as
the Secretary may find necessary in the interest of the
health and safety of individuals who are furnished
services by such facility, including conditions
concerning qualifications of personnel in these
facilities.
The Secretary may waive the requirement of a surety bond under
subparagraph (I) in the case of a facility that provides a
comparable surety bond under State law.
Hospice Care; Hospice Program
(dd)(1) The term ``hospice care'' means the following items
and services provided to a terminally ill individual by, or by
others under arrangements made by, a hospice program under a
written plan (for providing such care to such individual)
established and periodically reviewed by the individual's
attending physician and by the medical director (and by the
interdisciplinary group described in paragraph (2)(B)) of the
program--
(A) nursing care provided by or under the supervision
of a registered professional nurse,
(B) physical or occupational therapy, or speech-
language pathology services,
(C) medical social services under the direction of a
physician,
(D)(i) services of a home health aide who has
successfully completed a training program approved by
the Secretary and (ii) homemaker services,
(E) medical supplies (including drugs and
biologicals) and the use of medical appliances, while
under such a plan,
(F) physicians' services,
(G) short-term inpatient care (including both respite
care and procedures necessary for pain control and
acute and chronic symptom management) in an inpatient
facility meeting such conditions as the Secretary
determines to be appropriate to provide such care, but
such respite care may be provided only on an
intermittent, nonroutine, and occasional basis and may
not be provided consecutively over longer than five
days,
(H) counseling (including dietary counseling) with
respect to care of the terminally ill individual and
adjustment to his death, and
(I) any other item or service which is specified in
the plan and for which payment may otherwise be made
under this title.
The care and services described in subparagraphs (A) and (D)
may be provided on a 24-hour, continuous basis only during
periods of crisis (meeting criteria established by the
Secretary) and only as necessary to maintain the terminally ill
individual at home.
(2) The term ``hospice program'' means a public agency or
private organization (or a subdivision thereof) which--
(A)(i) is primarily engaged in providing the care and
services described in paragraph (1) and makes such
services available (as needed) on a 24-hour basis and
which also provides bereavement counseling for the
immediate family of terminally ill individuals and
services described in section 1812(a)(5),
(ii) provides for such care and services in
individuals' homes, on an outpatient basis, and on a
short-term inpatient basis, directly or under
arrangements made by the agency or organization, except
that--
(I) the agency or organization must routinely
provide directly substantially all of each of
the services described in subparagraphs (A),
(C), and (H) of paragraph (1), except as
otherwise provided in paragraph (5), and
(II) in the case of other services described
in paragraph (1) which are not provided
directly by the agency or organization, the
agency or organization must maintain
professional management responsibility for all
such services furnished to an individual,
regardless of the location or facility in which
such services are furnished; and
(iii) provides assurances satisfactory to the
Secretary that the aggregate number of days of
inpatient care described in paragraph (1)(G) provided
in any 12-month period to individuals who have an
election in effect under section 1812(d) with respect
to that agency or organization does not exceed 20
percent of the aggregate number of days during that
period on which such elections for such individuals are
in effect;
(B) has an interdisciplinary group of personnel
which--
(i) includes at least--
(I) one physician (as defined in
subsection (r)(1)),
(II) one registered professional
nurse, and
(III) one social worker,
employed by or, in the case of a physician described in
subclause (I), under contract with the agency or
organization, and also includes at least one pastoral
or other counselor,
(ii) provides (or supervises the provision
of) the care and services described in
paragraph (1), and
(iii) establishes the policies governing the
provision of such care and services;
(C) maintains central clinical records on all
patients;
(D) does not discontinue the hospice care it provides
with respect to a patient because of the inability of
the patient to pay for such care;
(E)(i) utilizes volunteers in its provision of care
and services in accordance with standards set by the
Secretary, which standards shall ensure a continuing
level of effort to utilize such volunteers, and (ii)
maintains records on the use of these volunteers and
the cost savings and expansion of care and services
achieved through the use of these volunteers;
(F) in the case of an agency or organization in any
State in which State or applicable local law provides
for the licensing of agencies or organizations of this
nature, is licensed pursuant to such law; and
(G) meets such other requirements as the Secretary
may find necessary in the interest of the health and
safety of the individuals who are provided care and
services by such agency or organization.
(3)(A) An individual is considered to be ``terminally ill''
if the individual has a medical prognosis that the individual's
life expectancy is 6 months or less.
(B) The term ``attending physician'' means, with respect to
an individual, the physician (as defined in subsection (r)(1)),
the nurse practitioner (as defined in subsection (aa)(5)), or
the physician assistant (as defined in such subsection), who
may be employed by a hospice program, whom the individual
identifies as having the most significant role in the
determination and delivery of medical care to the individual at
the time the individual makes an election to receive hospice
care.
(4)(A) An entity which is certified as a provider of services
other than a hospice program shall be considered, for purposes
of certification as a hospice program, to have met any
requirements under paragraph (2) which are also the same
requirements for certification as such other type of provider.
The Secretary shall coordinate surveys for determining
certification under this title so as to provide, to the extent
feasible, for simultaneous surveys of an entity which seeks to
be certified as a hospice program and as a provider of services
of another type.
(B) Any entity which is certified as a hospice program and as
a provider of another type shall have separate provider
agreements under section 1866 and shall file separate cost
reports with respect to costs incurred in providing hospice
care and in providing other services and items under this
title.
(5)(A) The Secretary may waive the requirements of paragraph
(2)(A)(ii)(I) for an agency or organization with respect to all
or part of the nursing care described in paragraph (1)(A) if
such agency or organization--
(i) is located in an area which is not an urbanized
area (as defined by the Bureau of the Census);
(ii) was in operation on or before January 1, 1983;
and
(iii) has demonstrated a good faith effort (as
determined by the Secretary) to hire a sufficient
number of nurses to provide such nursing care directly.
(B) Any waiver, which is in such form and containing such
information as the Secretary may require and which is requested
by an agency or organization under subparagraph (A) or (C),
shall be deemed to be granted unless such request is denied by
the Secretary within 60 days after the date such request is
received by the Secretary. The granting of a waiver under
subparagraph (A) or (C) shall not preclude the granting of any
subsequent waiver request should such a waiver again become
necessary.
(C) The Secretary may waive the requirements of paragraph
(2)(A)(i) and (2)(A)(ii) for an agency or organization with
respect to the services described in paragraph (1)(B) and, with
respect to dietary counseling, paragraph (1)(H), if such agency
or organization--
(i) is located in an area which is not an urbanized
area (as defined by the Bureau of Census), and
(ii) demonstrates to the satisfaction of the
Secretary that the agency or organization has been
unable, despite diligent efforts, to recruit
appropriate personnel.
(D) In extraordinary, exigent, or other non-routine
circumstances, such as unanticipated periods of high patient
loads, staffing shortages due to illness or other events, or
temporary travel of a patient outside a hospice program's
service area, a hospice program may enter into arrangements
with another hospice program for the provision by that other
program of services described in paragraph (2)(A)(ii)(I). The
provisions of paragraph (2)(A)(ii)(II) shall apply with respect
to the services provided under such arrangements.
(E) A hospice program may provide services described in
paragraph (1)(A) other than directly by the program if the
services are highly specialized services of a registered
professional nurse and are provided non-routinely and so
infrequently so that the provision of such services directly
would be impracticable and prohibitively expensive.
Discharge Planning Process
(ee)(1) A discharge planning process of a hospital shall be
considered sufficient if it is applicable to services furnished
by the hospital to individuals entitled to benefits under this
title and if it meets the guidelines and standards established
by the Secretary under paragraph (2).
(2) The Secretary shall develop guidelines and standards for
the discharge planning process in order to ensure a timely and
smooth transition to the most appropriate type of and setting
for post-hospital or rehabilitative care. The guidelines and
standards shall include the following:
(A) The hospital must identify, at an early stage of
hospitalization, those patients who are likely to
suffer adverse health consequences upon discharge in
the absence of adequate discharge planning.
(B) Hospitals must provide a discharge planning
evaluation for patients identified under subparagraph
(A) and for other patients upon the request of the
patient, patient's representative, or patient's
physician.
(C) Any discharge planning evaluation must be made on
a timely basis to ensure that appropriate arrangements
for post-hospital care will be made before discharge
and to avoid unnecessary delays in discharge.
(D) A discharge planning evaluation must include an
evaluation of a patient's likely need for appropriate
post-hospital services, including hospice care and
post-hospital extended care services, and the
availability of those services, including the
availability of home health services through
individuals and entities that participate in the
program under this title and that serve the area in
which the patient resides and that request to be listed
by the hospital as available and, in the case of
individuals who are likely to need post-hospital
extended care services, the availability of such
services through facilities that participate in the
program under this title and that serve the area in
which the patient resides.
(E) The discharge planning evaluation must be
included in the patient's medical record for use in
establishing an appropriate discharge plan and the
results of the evaluation must be discussed with the
patient (or the patient's representative).
(F) Upon the request of a patient's physician, the
hospital must arrange for the development and initial
implementation of a discharge plan for the patient.
(G) Any discharge planning evaluation or discharge
plan required under this paragraph must be developed
by, or under the supervision of, a registered
professional nurse, social worker, or other
appropriately qualified personnel.
(H) Consistent with section 1802, the discharge plan
shall--
(i) not specify or otherwise limit the
qualified provider which may provide post-
hospital home health services, and
(ii) identify (in a form and manner specified
by the Secretary) any entity to whom the
individual is referred in which the hospital
has a disclosable financial interest (as
specified by the Secretary consistent with
section 1866(a)(1)(S)) or which has such an
interest in the hospital.
(3) With respect to a discharge plan for an individual who is
enrolled with a Medicare+Choice organization under a
Medicare+Choice plan and is furnished inpatient hospital
services by a hospital under a contract with the organization--
(A) the discharge planning evaluation under paragraph
(2)(D) is not required to include information on the
availability of home health services through
individuals and entities which do not have a contract
with the organization; and
(B) notwithstanding subparagraph (H)(i), the plan may
specify or limit the provider (or providers) of post-
hospital home health services or other post-hospital
services under the plan.
Partial Hospitalization Services
(ff)(1) The term ``partial hospitalization services'' means
the items and services described in paragraph (2) prescribed by
a physician and provided under a program described in paragraph
(3) under the supervision of a physician pursuant to an
individualized, written plan of treatment established and
periodically reviewed by a physician (in consultation with
appropriate staff participating in such program), which plan
sets forth the physician's diagnosis, the type, amount,
frequency, and duration of the items and services provided
under the plan, and the goals for treatment under the plan.
(2) The items and services described in this paragraph are--
(A) individual and group therapy with physicians or
psychologists (or other mental health professionals to
the extent authorized under State law),
(B) occupational therapy requiring the skills of a
qualified occupational therapist,
(C) services of social workers, trained psychiatric
nurses, and other staff trained to work with
psychiatric patients,
(D) drugs and biologicals furnished for therapeutic
purposes (which cannot, as determined in accordance
with regulations, be self-administered),
(E) individualized activity therapies that are not
primarily recreational or diversionary,
(F) family counseling (the primary purpose of which
is treatment of the individual's condition),
(G) patient training and education (to the extent
that training and educational activities are closely
and clearly related to individual's care and
treatment),
(H) diagnostic services, and
(I) such other items and services as the Secretary
may provide (but in no event to include meals and
transportation);
that are reasonable and necessary for the diagnosis or active
treatment of the individual's condition, reasonably expected to
improve or maintain the individual's condition and functional
level and to prevent relapse or hospitalization, and furnished
pursuant to such guidelines relating to frequency and duration
of services as the Secretary shall by regulation establish
(taking into account accepted norms of medical practice and the
reasonable expectation of patient improvement).
(3)(A) A program described in this paragraph is a program
which is furnished by a hospital to its outpatients or by a
community mental health center (as defined in subparagraph
(B)), and which is a distinct and organized intensive
ambulatory treatment service offering less than 24-hour-daily
care other than in an individual's home or in an inpatient or
residential setting.
(B) For purposes of subparagraph (A), the term ``community
mental health center'' means an entity that--
(i)(I) provides the mental health services described
in section 1913(c)(1) of the Public Health Service Act;
or
(II) in the case of an entity operating in a State
that by law precludes the entity from providing itself
the service described in subparagraph (E) of such
section, provides for such service by contract with an
approved organization or entity (as determined by the
Secretary);
(ii) meets applicable licensing or certification
requirements for community mental health centers in the
State in which it is located;
(iii) provides at least 40 percent of its services to
individuals who are not eligible for benefits under
this title; and
(iv) meets such additional conditions as the
Secretary shall specify to ensure (I) the health and
safety of individuals being furnished such services,
(II) the effective and efficient furnishing of such
services, and (III) the compliance of such entity with
the criteria described in section 1931(c)(1) of the
Public Health Service Act.
Certified Nurse-Midwife Services
(gg)(1) The term ``certified nurse-midwife services'' means
such services furnished by a certified nurse-midwife (as
defined in paragraph (2)) and such services and supplies
furnished as an incident to the nurse-midwife's service which
the certified nurse-midwife is legally authorized to perform
under State law (or the State regulatory mechanism provided by
State law) as would otherwise be covered if furnished by a
physician or as an incident to a physicians' service.
(2) The term ``certified nurse-midwife'' means a registered
nurse who has successfully completed a program of study and
clinical experience meeting guidelines prescribed by the
Secretary, or has been certified by an organization recognized
by the Secretary.
Clinical Social Worker; Clinical Social Worker Services
(hh)(1) The term ``clinical social worker'' means an
individual who--
(A) possesses a master's or doctor's degree in social
work;
(B) after obtaining such degree has performed at
least 2 years of supervised clinical social work; and
(C)(i) is licensed or certified as a clinical social
worker by the State in which the services are
performed, or
(ii) in the case of an individual in a State which
does not provide for licensure or certification--
(I) has completed at least 2 years or 3,000
hours of post-master's degree supervised
clinical social work practice under the
supervision of a master's level social worker
in an appropriate setting (as determined by the
Secretary), and
(II) meets such other criteria as the
Secretary establishes.
(2) The term ``clinical social worker services'' means
services performed by a clinical social worker (as defined in
paragraph (1)) for the diagnosis and treatment of mental
illnesses (other than services furnished to an inpatient of a
hospital and other than services furnished to an inpatient of a
skilled nursing facility which the facility is required to
provide as a requirement for participation) which the clinical
social worker is legally authorized to perform under State law
(or the State regulatory mechanism provided by State law) of
the State in which such services are performed as would
otherwise be covered if furnished by a physician or as an
incident to a physician's professional service.
Qualified Psychologist Services
(ii) The term ``qualified psychologist services'' means such
services and such services and supplies furnished as an
incident to his service furnished by a clinical psychologist
(as defined by the Secretary) which the psychologist is legally
authorized to perform under State law (or the State regulatory
mechanism provided by State law) as would otherwise be covered
if furnished by a physician or as an incident to a physician's
service.
Screening Mammography
(jj) The term ``screening mammography'' means a radiologic
procedure provided to a woman for the purpose of early
detection of breast cancer and includes a physician's
interpretation of the results of the procedure.
Covered Osteoporosis Drug
(kk) The term ``covered osteoporosis drug'' means an
injectable drug approved for the treatment of post-menopausal
osteoporosis provided to an individual by a home health agency
if, in accordance with regulations promulgated by the
Secretary--
(1) the individual's attending physician, nurse
practitioner or clinical nurse specialist (as those
terms are defined in subsection (aa)(5)), certified
nurse-midwife (as defined in subsection (gg)), or
physician assistant (as defined in subsection (aa)(5))
certifies that the individual has suffered a bone
fracture related to post-menopausal osteoporosis and
that the individual is unable to learn the skills
needed to self-administer such drug or is otherwise
physically or mentally incapable of self-administering
such drug; and
(2) the individual is confined to the individual's
home (except when receiving items and services referred
to in subsection (m)(7)).
Speech-Language Pathology Services; Audiology Services
(ll)(1) The term ``speech-language pathology services'' means
such speech, language, and related function assessment and
rehabilitation services furnished by a qualified speech-
language pathologist as the speech-language pathologist is
legally authorized to perform under State law (or the State
regulatory mechanism provided by State law) as would otherwise
be covered if furnished by a physician.
(2) The term ``outpatient speech-language pathology
services'' has the meaning given the term ``outpatient physical
therapy services'' in subsection (p), except that in applying
such subsection--
(A) ``speech-language pathology'' shall be
substituted for ``physical therapy'' each place it
appears; and
(B) ``speech-language pathologist'' shall be
substituted for ``physical therapist'' each place it
appears.
(3) The term ``audiology services'' means such hearing and
balance assessment services furnished by a qualified
audiologist as the audiologist is legally authorized to perform
under State law (or the State regulatory mechanism provided by
State law), as would otherwise be covered if furnished by a
physician.
(4) In this subsection:
(A) The term ``qualified speech-language
pathologist'' means an individual with a master's or
doctoral degree in speech-language pathology who--
(i) is licensed as a speech-language
pathologist by the State in which the
individual furnishes such services, or
(ii) in the case of an individual who
furnishes services in a State which does not
license speech-language pathologists, has
successfully completed 350 clock hours of
supervised clinical practicum (or is in the
process of accumulating such supervised
clinical experience), performed not less than 9
months of supervised full-time speech-language
pathology services after obtaining a master's
or doctoral degree in speech-language pathology
or a related field, and successfully completed
a national examination in speech-language
pathology approved by the Secretary.
(B) The term ``qualified audiologist'' means an
individual with a master's or doctoral degree in
audiology who--
(i) is licensed as an audiologist by the
State in which the individual furnishes such
services, or
(ii) in the case of an individual who
furnishes services in a State which does not
license audiologists, has successfully
completed 350 clock hours of supervised
clinical practicum (or is in the process of
accumulating such supervised clinical
experience), performed not less than 9 months
of supervised full-time audiology services
after obtaining a master's or doctoral degree
in audiology or a related field, and
successfully completed a national examination
in audiology approved by the Secretary.
Critical Access Hospital; Critical Access Hospital Services
(mm)(1) The term ``critical access hospital'' means a
facility certified by the Secretary as a critical access
hospital under section 1820(e).
(2) The term ``inpatient critical access hospital services''
means items and services, furnished to an inpatient of a
critical access hospital by such facility, that would be
inpatient hospital services if furnished to an inpatient of a
hospital by a hospital.
(3) The term ``outpatient critical access hospital services''
means medical and other health services furnished by a critical
access hospital on an outpatient basis.
Screening Pap Smear; Screening Pelvic Exam
(nn)(1) The term ``screening pap smear'' means a diagnostic
laboratory test consisting of a routine exfoliative cytology
test (Papanicolaou test) provided to a woman for the purpose of
early detection of cervical or vaginal cancer and includes a
physician's interpretation of the results of the test, if the
individual involved has not had such a test during the
preceding 2 years, or during the preceding year in the case of
a woman described in paragraph (3).
(2) The term ``screening pelvic exam'' means a pelvic
examination provided to a woman if the woman involved has not
had such an examination during the preceding 2 years, or during
the preceding year in the case of a woman described in
paragraph (3), and includes a clinical breast examination.
(3) A woman described in this paragraph is a woman who--
(A) is of childbearing age and has had a test
described in this subsection during any of the
preceding 3 years that indicated the presence of
cervical or vaginal cancer or other abnormality; or
(B) is at high risk of developing cervical or vaginal
cancer (as determined pursuant to factors identified by
the Secretary).
Prostate Cancer Screening Tests
(oo)(1) The term ``prostate cancer screening test'' means a
test that consists of any (or all) of the procedures described
in paragraph (2) provided for the purpose of early detection of
prostate cancer to a man over 50 years of age who has not had
such a test during the preceding year.
(2) The procedures described in this paragraph are as
follows:
(A) A digital rectal examination.
(B) A prostate-specific antigen blood test.
(C) For years beginning after 2002, such other
procedures as the Secretary finds appropriate for the
purpose of early detection of prostate cancer, taking
into account changes in technology and standards of
medical practice, availability, effectiveness, costs,
and such other factors as the Secretary considers
appropriate.
Colorectal Cancer Screening Tests
(pp)(1) The term ``colorectal cancer screening test'' means
any of the following procedures furnished to an individual for
the purpose of early detection of colorectal cancer:
(A) Screening fecal-occult blood test.
(B) Screening flexible sigmoidoscopy.
(C) Screening colonoscopy.
(D) Such other tests or procedures, and modifications
to tests and procedures under this subsection, with
such frequency and payment limits, as the Secretary
determines appropriate, in consultation with
appropriate organizations.
(2) An ``individual at high risk for colorectal cancer'' is
an individual who, because of family history, prior experience
of cancer or precursor neoplastic polyps, a history of chronic
digestive disease condition (including inflammatory bowel
disease, Crohn's Disease, or ulcerative colitis), the presence
of any appropriate recognized gene markers for colorectal
cancer, or other predisposing factors, faces a high risk for
colorectal cancer.
Diabetes Outpatient Self-Management Training Services
(qq)(1) The term ``diabetes outpatient self-management
training services'' means educational and training services
furnished (at such times as the Secretary determines
appropriate) to an individual with diabetes by a certified
provider (as described in paragraph (2)(A)) in an outpatient
setting by an individual or entity who meets the quality
standards described in paragraph (2)(B), but only if the
physician who is managing the individual's diabetic condition
certifies that such services are needed under a comprehensive
plan of care related to the individual's diabetic condition to
ensure therapy compliance or to provide the individual with
necessary skills and knowledge (including skills related to the
self-administration of injectable drugs) to participate in the
management of the individual's condition.
(2) In paragraph (1)--
(A) a ``certified provider'' is a physician, or other
individual or entity designated by the Secretary, that,
in addition to providing diabetes outpatient self-
management training services, provides other items or
services for which payment may be made under this
title; and
(B) a physician, or such other individual or entity,
meets the quality standards described in this paragraph
if the physician, or individual or entity, meets
quality standards established by the Secretary, except
that the physician or other individual or entity shall
be deemed to have met such standards if the physician
or other individual or entity meets applicable
standards originally established by the National
Diabetes Advisory Board and subsequently revised by
organizations who participated in the establishment of
standards by such Board, or is recognized by an
organization that represents individuals (including
individuals under this title) with diabetes as meeting
standards for furnishing the services.
Bone Mass Measurement
(rr)(1) The term ``bone mass measurement'' means a radiologic
or radioisotopic procedure or other procedure approved by the
Food and Drug Administration performed on a qualified
individual (as defined in paragraph (2)) for the purpose of
identifying bone mass or detecting bone loss or determining
bone quality, and includes a physician's interpretation of the
results of the procedure.
(2) For purposes of this subsection, the term ``qualified
individual'' means an individual who is (in accordance with
regulations prescribed by the Secretary)--
(A) an estrogen-deficient woman at clinical risk for
osteoporosis;
(B) an individual with vertebral abnormalities;
(C) an individual receiving long-term glucocorticoid
steroid therapy;
(D) an individual with primary hyperparathyroidism;
or
(E) an individual being monitored to assess the
response to or efficacy of an approved osteoporosis
drug therapy.
(3) The Secretary shall establish such standards regarding
the frequency with which a qualified individual shall be
eligible to be provided benefits for bone mass measurement
under this title.
Religious Nonmedical Health Care Institution
(ss)(1) The term ``religious nonmedical health care
institution'' means an institution that--
(A) is described in subsection (c)(3) of
section 501 of the Internal Revenue Code of
1986 and is exempt from taxes under subsection
(a) of such section;
(B) is lawfully operated under all applicable
Federal, State, and local laws and regulations;
(C) provides only nonmedical nursing items
and services exclusively to patients who choose
to rely solely upon a religious method of
healing and for whom the acceptance of medical
health services would be inconsistent with
their religious beliefs;
(D) provides such nonmedical items and
services exclusively through nonmedical nursing
personnel who are experienced in caring for the
physical needs of such patients;
(E) provides such nonmedical items and
services to inpatients on a 24-hour basis;
(F) on the basis of its religious beliefs,
does not provide through its personnel or
otherwise medical items and services (including
any medical screening, examination, diagnosis,
prognosis, treatment, or the administration of
drugs) for its patients;
(G)(i) is not owned by, under common
ownership with, or has an ownership interest
in, a provider of medical treatment or
services;
(ii) is not affiliated with--
(I) a provider of medical treatment
or services, or
(II) an individual who has an
ownership interest in a provider of
medical treatment or services;
(H) has in effect a utilization review plan
which--
(i) provides for the review of
admissions to the institution, of the
duration of stays therein, of cases of
continuous extended duration, and of
the items and services furnished by the
institution,
(ii) requires that such reviews be
made by an appropriate committee of the
institution that includes the
individuals responsible for overall
administration and for supervision of
nursing personnel at the institution,
(iii) provides that records be
maintained of the meetings, decisions,
and actions of such committee, and
(iv) meets such other requirements as
the Secretary finds necessary to
establish an effective utilization
review plan;
(I) provides the Secretary with such
information as the Secretary may require to
implement section 1821, including information
relating to quality of care and coverage
determinations; and
(J) meets such other requirements as the
Secretary finds necessary in the interest of
the health and safety of individuals who are
furnished services in the institution.
(2) To the extent that the Secretary finds that the
accreditation of an institution by a State, regional, or
national agency or association provides reasonable assurances
that any or all of the requirements of paragraph (1) are met or
exceeded, the Secretary may treat such institution as meeting
the condition or conditions with respect to which the Secretary
made such finding.
(3)(A)(i) In administering this subsection and section 1821,
the Secretary shall not require any patient of a religious
nonmedical health care institution to undergo medical
screening, examination, diagnosis, prognosis, or treatment or
to accept any other medical health care service, if such
patient (or legal representative of the patient) objects
thereto on religious grounds.
(ii) Clause (i) shall not be construed as preventing the
Secretary from requiring under section 1821(a)(2) the provision
of sufficient information regarding an individual's condition
as a condition for receipt of benefits under part A for
services provided in such an institution.
(B)(i) In administering this subsection and section 1821, the
Secretary shall not subject a religious nonmedical health care
institution or its personnel to any medical supervision,
regulation, or control, insofar as such supervision,
regulation, or control would be contrary to the religious
beliefs observed by the institution or such personnel.
(ii) Clause (i) shall not be construed as preventing the
Secretary from reviewing items and services billed by the
institution to the extent the Secretary determines such review
to be necessary to determine whether such items and services
were not covered under part A, are excessive, or are
fraudulent.
(4)(A) For purposes of paragraph (1)(G)(i), an ownership
interest of less than 5 percent shall not be taken into
account.
(B) For purposes of paragraph (1)(G)(ii), none of the
following shall be considered to create an affiliation:
(i) An individual serving as an uncompensated
director, trustee, officer, or other member of the
governing body of a religious nonmedical health care
institution.
(ii) An individual who is a director, trustee,
officer, employee, or staff member of a religious
nonmedical health care institution having a family
relationship with an individual who is affiliated with
(or has an ownership interest in) a provider of medical
treatment or services.
(iii) An individual or entity furnishing goods or
services as a vendor to both providers of medical
treatment or services and religious nonmedical health
care institutions.
Post-Institutional Home Health Services; Home Health Spell of Illness
(tt)(1) The term ``post-institutional home health services''
means home health services furnished to an individual--
(A) after discharge from a hospital or critical
access hospital in which the individual was an
inpatient for not less than 3 consecutive days before
such discharge if such home health services were
initiated within 14 days after the date of such
discharge; or
(B) after discharge from a skilled nursing facility
in which the individual was provided post-hospital
extended care services if such home health services
were initiated within 14 days after the date of such
discharge.
(2) The term ``home health spell of illness'' with respect to
any individual means a period of consecutive days--
(A) beginning with the first day (not included in a
previous home health spell of illness) (i) on which
such individual is furnished post-institutional home
health services, and (ii) which occurs in a month for
which the individual is entitled to benefits under part
A, and
(B) ending with the close of the first period of 60
consecutive days thereafter on each of which the
individual is neither an inpatient of a hospital or
critical access hospital nor an inpatient of a facility
described in section 1819(a)(1) or subsection (y)(1)
nor provided home health services.
Screening for Glaucoma
(uu) The term ``screening for glaucoma'' means a dilated eye
examination with an intraocular pressure measurement, and a
direct ophthalmoscopy or a slit-lamp biomicroscopic examination
for the early detection of glaucoma which is furnished by or
under the direct supervision of an optometrist or
ophthalmologist who is legally authorized to furnish such
services under State law (or the State regulatory mechanism
provided by State law) of the State in which the services are
furnished, as would otherwise be covered if furnished by a
physician or as an incident to a physician's professional
service, if the individual involved has not had such an
examination in the preceding year.
Medical Nutrition Therapy Services; Registered Dietitian or Nutrition
Professional
(vv)(1) The term ``medical nutrition therapy services'' means
nutritional diagnostic, therapy, and counseling services for
the purpose of disease management which are furnished by a
registered dietitian or nutrition professional (as defined in
paragraph (2)) pursuant to a referral by a physician (as
defined in subsection (r)(1)).
(2) Subject to paragraph (3), the term ``registered dietitian
or nutrition professional'' means an individual who--
(A) holds a baccalaureate or higher degree granted by
a regionally accredited college or university in the
United States (or an equivalent foreign degree) with
completion of the academic requirements of a program in
nutrition or dietetics, as accredited by an appropriate
national accreditation organization recognized by the
Secretary for this purpose;
(B) has completed at least 900 hours of supervised
dietetics practice under the supervision of a
registered dietitian or nutrition professional; and
(C)(i) is licensed or certified as a dietitian or
nutrition professional by the State in which the
services are performed; or
(ii) in the case of an individual in a State that
does not provide for such licensure or certification,
meets such other criteria as the Secretary establishes.
(3) Subparagraphs (A) and (B) of paragraph (2) shall not
apply in the case of an individual who, as of the date of the
enactment of this subsection, is licensed or certified as a
dietitian or nutrition professional by the State in which
medical nutrition therapy services are performed.
Initial Preventive Physical Examination
(ww)(1) The term ``initial preventive physical examination''
means physicians' services consisting of a physical examination
(including measurement of height, weight body mass index,, and
blood pressure) with the goal of health promotion and disease
detection and includes education, counseling, and referral with
respect to screening and other preventive services described in
paragraph (2), end-of-life planning (as defined in paragraph
(3)) upon the agreement with the individual, and the furnishing
of a review of any current opioid prescriptions (as defined in
paragraph (4)), but does not include clinical laboratory tests.
(2) The screening and other preventive services described in
this paragraph include the following:
(A) Pneumococcal, influenza, and hepatitis B vaccine
and administration under subsection (s)(10).
(B) Screening mammography as defined in subsection
(jj).
(C) Screening pap smear and screening pelvic exam as
defined in subsection (nn).
(D) Prostate cancer screening tests as defined in
subsection (oo).
(E) Colorectal cancer screening tests as defined in
subsection (pp).
(F) Diabetes outpatient self-management training
services as defined in subsection (qq)(1).
(G) Bone mass measurement as defined in subsection
(rr).
(H) Screening for glaucoma as defined in subsection
(uu).
(I) Medical nutrition therapy services as defined in
subsection (vv).
(J) Cardiovascular screening blood tests as defined
in subsection (xx)(1).
(K) Diabetes screening tests as defined in subsection
(yy).
(L) Ultrasound screening for abdominal aortic
aneurysm as defined in section 1861(bbb).
(M) An electrocardiogram.
(N) Screening for potential substance use disorders.
(O) Additional preventive services (as defined in
subsection (ddd)(1)).
(3) For purposes of paragraph (1), the term ``end-of-life
planning'' means verbal or written information regarding--
(A) an individual's ability to prepare an advance
directive in the case that an injury or illness causes
the individual to be unable to make health care
decisions; and
(B) whether or not the physician is willing to follow
the individual's wishes as expressed in an advance
directive.
(4) For purposes of paragraph (1), the term ``a review of any
current opioid prescriptions'' means, with respect to an
individual determined to have a current prescription for
opioids--
(A) a review of the potential risk factors to the
individual for opioid use disorder;
(B) an evaluation of the individual's severity of
pain and current treatment plan;
(C) the provision of information on non-opioid
treatment options; and
(D) a referral to a specialist, as appropriate.
Cardiovascular Screening Blood Test
(xx)(1) The term ``cardiovascular screening blood test''
means a blood test for the early detection of cardiovascular
disease (or abnormalities associated with an elevated risk of
cardiovascular disease) that tests for the following:
(A) Cholesterol levels and other lipid or
triglyceride levels.
(B) Such other indications associated with the
presence of, or an elevated risk for, cardiovascular
disease as the Secretary may approve for all
individuals (or for some individuals determined by the
Secretary to be at risk for cardiovascular disease),
including indications measured by noninvasive testing.
The Secretary may not approve an indication under subparagraph
(B) for any individual unless a blood test for such is
recommended by the United States Preventive Services Task
Force.
(2) The Secretary shall establish standards, in consultation
with appropriate organizations, regarding the frequency for
each type of cardiovascular screening blood tests, except that
such frequency may not be more often than once every 2 years.
Diabetes Screening Tests
(yy)(1) The term ``diabetes screening tests'' means testing
furnished to an individual at risk for diabetes (as defined in
paragraph (2)) for the purpose of early detection of diabetes,
including--
(A) a fasting plasma glucose test; and
(B) such other tests, and modifications to tests, as
the Secretary determines appropriate, in consultation
with appropriate organizations.
(2) For purposes of paragraph (1), the term ``individual at
risk for diabetes'' means an individual who has any of the
following risk factors for diabetes:
(A) Hypertension.
(B) Dyslipidemia.
(C) Obesity, defined as a body mass index greater
than or equal to 30 kg/m2.
(D) Previous identification of an elevated impaired
fasting glucose.
(E) Previous identification of impaired glucose
tolerance.
(F) A risk factor consisting of at least 2 of the
following characteristics:
(i) Overweight, defined as a body mass index
greater than 25, but less than 30, kg/
m2.
(ii) A family history of diabetes.
(iii) A history of gestational diabetes
mellitus or delivery of a baby weighing greater
than 9 pounds.
(iv) 65 years of age or older.
(3) The Secretary shall establish standards, in consultation
with appropriate organizations, regarding the frequency of
diabetes screening tests, except that such frequency may not be
more often than twice within the 12-month period following the
date of the most recent diabetes screening test of that
individual.
Intravenous Immune Globulin
(zz) The term ``intravenous immune globulin'' means an
approved pooled plasma derivative for the treatment in the
patient's home of a patient with a diagnosed primary immune
deficiency disease, but not including items or services related
to the administration of the derivative, if a physician
determines administration of the derivative in the patient's
home is medically appropriate.
Extended Care in Religious Nonmedical Health Care Institutions
(aaa)(1) The term ``home health agency'' also includes a
religious nonmedical health care institution (as defined in
subsection (ss)(1)), but only with respect to items and
services ordinarily furnished by such an institution to
individuals in their homes, and that are comparable to items
and services furnished to individuals by a home health agency
that is not religious nonmedical health care institution.
(2)(A) Subject to subparagraphs (B), payment may be made with
respect to services provided by such an institution only to
such extent and under such conditions, limitations, and
requirements (in addition to or in lieu of the conditions,
limitations, and requirements otherwise applicable) as may be
provided in regulations consistent with section 1821.
(B) Notwithstanding any other provision of this title,
payment may not be made under subparagraph (A)--
(i) in a year insofar as such payments exceed
$700,000; and
(ii) after December 31, 2006.
Ultrasound Screening for Abdominal Aortic Aneurysm
(bbb) The term ``ultrasound screening for abdominal aortic
aneurysm'' means--
(1) a procedure using sound waves (or such other
procedures using alternative technologies, of
commensurate accuracy and cost, that the Secretary may
specify) provided for the early detection of abdominal
aortic aneurysm; and
(2) includes a physician's interpretation of the
results of the procedure.
Long-Term Care Hospital
(ccc) The term ``long-term care hospital'' means a hospital
which--
(1) is primarily engaged in providing inpatient
services, by or under the supervision of a physician,
to Medicare beneficiaries whose medically complex
conditions require a long hospital stay and programs of
care provided by a long-term care hospital;
(2) has an average inpatient length of stay (as
determined by the Secretary) of greater than 25 days,
or meets the requirements of clause (II) of section
1886(d)(1)(B)(iv);
(3) satisfies the requirements of subsection (e); and
(4) meets the following facility criteria:
(A) the institution has a patient review
process, documented in the patient medical
record, that screens patients prior to
admission for appropriateness of admission to a
long-term care hospital, validates within 48
hours of admission that patients meet admission
criteria for long-term care hospitals,
regularly evaluates patients throughout their
stay for continuation of care in a long-term
care hospital, and assesses the available
discharge options when patients no longer meet
such continued stay criteria;
(B) the institution has active physician
involvement with patients during their
treatment through an organized medical staff,
physician-directed treatment with physician on-
site availability on a daily basis to review
patient progress, and consulting physicians on
call and capable of being at the patient's side
within a moderate period of time, as determined
by the Secretary; and
(C) the institution has interdisciplinary
team treatment for patients, requiring
interdisciplinary teams of health care
professionals, including physicians, to prepare
and carry out an individualized treatment plan
for each patient.
Additional Preventive Services; Preventive Services
(ddd)(1) The term ``additional preventive services'' means
services not described in subparagraph (A) or (C) of paragraph
(3) that identify medical conditions or risk factors and that
the Secretary determines are--
(A) reasonable and necessary for the prevention or
early detection of an illness or disability;
(B) recommended with a grade of A or B by the United
States Preventive Services Task Force; and
(C) appropriate for individuals entitled to benefits
under part A or enrolled under part B.
(2) In making determinations under paragraph (1) regarding
the coverage of a new service, the Secretary shall use the
process for making national coverage determinations (as defined
in section 1869(f)(1)(B)) under this title. As part of the use
of such process, the Secretary may conduct an assessment of the
relation between predicted outcomes and the expenditures for
such service and may take into account the results of such
assessment in making such determination.
(3) The term ``preventive services'' means the following:
(A) The screening and preventive services described
in subsection (ww)(2) (other than the service described
in subparagraph (M) of such subsection).
(B) An initial preventive physical examination (as
defined in subsection (ww)).
(C) Personalized prevention plan services (as defined
in subsection (hhh)(1)).
Cardiac Rehabilitation Program; Intensive Cardiac Rehabilitation
Program
(eee)(1) The term ``cardiac rehabilitation program'' means a
program (as described in paragraph (2)) that furnishes the
items and services described in paragraph (3) under the
supervision of a physician (as defined in subsection (r)(1)) or
a physician assistant, nurse practitioner, or clinical nurse
specialist (as those terms are defined in subsection (aa)(5)).
(2) A program described in this paragraph is a program under
which--
(A) items and services under the program are
delivered--
(i) in a physician's office;
(ii) in a hospital on an outpatient basis; or
(iii) in other settings determined
appropriate by the Secretary;
(B) a physician (as defined in subsection (r)(1)) or
a physician assistant, nurse practitioner, or clinical
nurse specialist (as those terms are defined in
subsection (aa)(5)) is immediately available and
accessible for medical consultation and medical
emergencies at all times items and services are being
furnished under the program, except that, in the case
of items and services furnished under such a program in
a hospital, such availability shall be presumed; and
(C) individualized treatment is furnished under a
written plan established, reviewed, and signed by a
physician every 30 days that describes--
(i) the individual's diagnosis;
(ii) the type, amount, frequency, and
duration of the items and services furnished
under the plan; and
(iii) the goals set for the individual under
the plan.
(3) The items and services described in this paragraph are--
(A) physician-prescribed exercise;
(B) cardiac risk factor modification, including
education, counseling, and behavioral intervention (to
the extent such education, counseling, and behavioral
intervention is closely related to the individual's
care and treatment and is tailored to the individual's
needs);
(C) psychosocial assessment;
(D) outcomes assessment; and
(E) such other items and services as the Secretary
may determine, but only if such items and services
are--
(i) reasonable and necessary for the
diagnosis or active treatment of the
individual's condition;
(ii) reasonably expected to improve or
maintain the individual's condition and
functional level; and
(iii) furnished under such guidelines
relating to the frequency and duration of such
items and services as the Secretary shall
establish, taking into account accepted norms
of medical practice and the reasonable
expectation of improvement of the individual.
(4)(A) The term ``intensive cardiac rehabilitation program''
means a program (as described in paragraph (2)) that furnishes
the items and services described in paragraph (3) under the
supervision of a physician (as defined in subsection (r)(1)) or
a physician assistant, nurse practitioner, or clinical nurse
specialist (as those terms are defined in subsection (aa)(5))
and has shown, in peer-reviewed published research, that it
accomplished--
(i) one or more of the following:
(I) positively affected the progression of
coronary heart disease; or
(II) reduced the need for coronary bypass
surgery; or
(III) reduced the need for percutaneous
coronary interventions; and
(ii) a statistically significant reduction in 5 or
more of the following measures from their level before
receipt of cardiac rehabilitation services to their
level after receipt of such services:
(I) low density lipoprotein;
(II) triglycerides;
(III) body mass index;
(IV) systolic blood pressure;
(V) diastolic blood pressure; or
(VI) the need for cholesterol, blood
pressure, and diabetes medications.
(B) To be eligible for an intensive cardiac rehabilitation
program, an individual must have--
(i) had an acute myocardial infarction within the
preceding 12 months;
(ii) had coronary bypass surgery;
(iii) stable angina pectoris;
(iv) had heart valve repair or replacement;
(v) had percutaneous transluminal coronary
angioplasty (PTCA) or coronary stenting;
(vi) had a heart or heart-lung transplant;
(vii) stable, chronic heart failure (defined
as patients with left ventricular ejection
fraction of 35 percent or less and New York
Heart Association (NYHA) class II to IV
symptoms despite being on optimal heart failure
therapy for at least 6 weeks); or
(viii) any additional condition for which the
Secretary has determined that a cardiac
rehabilitation program shall be covered, unless
the Secretary determines, using the same
process used to determine that the condition is
covered for a cardiac rehabilitation program,
that such coverage is not supported by the
clinical evidence.
(C) An intensive cardiac rehabilitation program may be
provided in a series of 72 one-hour sessions (as defined in
section 1848(b)(5)), up to 6 sessions per day, over a period of
up to 18 weeks.
(5) The Secretary shall establish standards to ensure that a
physician with expertise in the management of individuals with
cardiac pathophysiology who is licensed to practice medicine in
the State in which a cardiac rehabilitation program (or the
intensive cardiac rehabilitation program, as the case may be)
is offered--
(A) is responsible for such program; and
(B) in consultation with appropriate staff, is
involved substantially in directing the progress of
individual in the program.
Pulmonary Rehabilitation Program
(fff)(1) The term ``pulmonary rehabilitation program'' means
a program (as described in subsection (eee)(2) with respect to
a program under this subsection) that furnishes the items and
services described in paragraph (2) under the supervision of a
physician (as defined in subsection (r)(1)) or a physician
assistant, nurse practitioner, or clinical nurse specialist (as
those terms are defined in subsection (aa)(5)).
(2) The items and services described in this paragraph are--
(A) physician-prescribed exercise;
(B) education or training (to the extent the
education or training is closely and clearly related to
the individual's care and treatment and is tailored to
such individual's needs);
(C) psychosocial assessment;
(D) outcomes assessment; and
(E) such other items and services as the Secretary
may determine, but only if such items and services
are--
(i) reasonable and necessary for the
diagnosis or active treatment of the
individual's condition;
(ii) reasonably expected to improve or
maintain the individual's condition and
functional level; and
(iii) furnished under such guidelines
relating to the frequency and duration of such
items and services as the Secretary shall
establish, taking into account accepted norms
of medical practice and the reasonable
expectation of improvement of the individual.
(3) The Secretary shall establish standards to ensure that a
physician with expertise in the management of individuals with
respiratory pathophysiology who is licensed to practice
medicine in the State in which a pulmonary rehabilitation
program is offered--
(A) is responsible for such program; and
(B) in consultation with appropriate staff, is
involved substantially in directing the progress of
individual in the program.
Kidney Disease Education Services
(ggg)(1) The term ``kidney disease education services'' means
educational services that are--
(A) furnished to an individual with stage IV chronic
kidney disease who, according to accepted clinical
guidelines identified by the Secretary, will require
dialysis or a kidney transplant;
(B) furnished, upon the referral of the physician
managing the individual's kidney condition, by a
qualified person (as defined in paragraph (2)); and
(C) designed--
(i) to provide comprehensive information
(consistent with the standards set under
paragraph (3)) regarding--
(I) the management of comorbidities,
including for purposes of delaying the
need for dialysis;
(II) the prevention of uremic
complications; and
(III) each option for renal
replacement therapy (including
hemodialysis and peritoneal dialysis at
home and in-center as well as vascular
access options and transplantation);
(ii) to ensure that the individual has the
opportunity to actively participate in the
choice of therapy; and
(iii) to be tailored to meet the needs of the
individual involved.
(2)(A) The term ``qualified person'' means--
(i) a physician (as defined in section 1861(r)(1)) or
a physician assistant, nurse practitioner, or clinical
nurse specialist (as defined in section 1861(aa)(5)),
who furnishes services for which payment may be made
under the fee schedule established under section 1848;
and
(ii) a provider of services located in a rural area
(as defined in section 1886(d)(2)(D)).
(B) Such term does not include a provider of services (other
than a provider of services described in subparagraph (A)(ii))
or a renal dialysis facility.
(3) The Secretary shall set standards for the content of such
information to be provided under paragraph (1)(C)(i) after
consulting with physicians, other health professionals, health
educators, professional organizations, accrediting
organizations, kidney patient organizations, dialysis
facilities, transplant centers, network organizations described
in section 1881(c)(2), and other knowledgeable persons. To the
extent possible the Secretary shall consult with persons or
entities described in the previous sentence, other than a
dialysis facility, that has not received industry funding from
a drug or biological manufacturer or dialysis facility.
(4) No individual shall be furnished more than 6 sessions of
kidney disease education services under this title.
Annual Wellness Visit
(hhh)(1) The term ``personalized prevention plan services''
means the creation of a plan for an individual--
(A) that includes a health risk assessment (that
meets the guidelines established by the Secretary under
paragraph (4)(A)) of the individual that is completed
prior to or as part of the same visit with a health
professional described in paragraph (3); and
(B) that--
(i) takes into account the results of the
health risk assessment; and
(ii) may contain the elements described in
paragraph (2).
(2) Subject to paragraph (4)(H), the elements described in
this paragraph are the following:
(A) The establishment of, or an update to, the
individual's medical and family history.
(B) A list of current providers and suppliers that
are regularly involved in providing medical care to the
individual (including a list of all prescribed
medications).
(C) A measurement of height, weight, body mass index
(or waist circumference, if appropriate), blood
pressure, and other routine measurements.
(D) Detection of any cognitive impairment.
(E) The establishment of, or an update to, the
following:
(i) A screening schedule for the next 5 to 10
years, as appropriate, based on recommendations
of the United States Preventive Services Task
Force and the Advisory Committee on
Immunization Practices, and the individual's
health status, screening history, and age-
appropriate preventive services covered under
this title.
(ii) A list of risk factors and conditions
for which primary, secondary, or tertiary
prevention interventions are recommended or are
underway, including any mental health
conditions or any such risk factors or
conditions that have been identified through an
initial preventive physical examination (as
described under subsection (ww)(1)), and a list
of treatment options and their associated risks
and benefits.
(F) The furnishing of personalized health advice and
a referral, as appropriate, to health education or
preventive counseling services or programs aimed at
reducing identified risk factors and improving self-
management, or community-based lifestyle interventions
to reduce health risks and promote self-management and
wellness, including weight loss, physical activity,
smoking cessation, fall prevention, and nutrition.
(G) Screening for potential substance use disorders
and referral for treatment as appropriate.
(H) The furnishing of a review of any current opioid
prescriptions (as defined in subsection (ww)(4)).
(I) Any other element determined appropriate by the
Secretary.
(3) A health professional described in this paragraph is--
(A) a physician;
(B) a practitioner described in clause (i) of section
1842(b)(18)(C); or
(C) a medical professional (including a health
educator, registered dietitian, or nutrition
professional) or a team of medical professionals, as
determined appropriate by the Secretary, under the
supervision of a physician.
(4)(A) For purposes of paragraph (1)(A), the Secretary, not
later than 1 year after the date of enactment of this
subsection, shall establish publicly available guidelines for
health risk assessments. Such guidelines shall be developed in
consultation with relevant groups and entities and shall
provide that a health risk assessment--
(i) identify chronic diseases, injury risks,
modifiable risk factors, and urgent health needs of the
individual; and
(ii) may be furnished--
(I) through an interactive telephonic or web-
based program that meets the standards
established under subparagraph (B);
(II) during an encounter with a health care
professional;
(III) through community-based prevention
programs; or
(IV) through any other means the Secretary
determines appropriate to maximize
accessibility and ease of use by beneficiaries,
while ensuring the privacy of such
beneficiaries.
(B) Not later than 1 year after the date of enactment of this
subsection, the Secretary shall establish standards for
interactive telephonic or web-based programs used to furnish
health risk assessments under subparagraph (A)(ii)(I). The
Secretary may utilize any health risk assessment developed
under section 4004(f) of the Patient Protection and Affordable
Care Act as part of the requirement to develop a personalized
prevention plan to comply with this subparagraph.
(C)(i) Not later than 18 months after the date of enactment
of this subsection, the Secretary shall develop and make
available to the public a health risk assessment model. Such
model shall meet the guidelines under subparagraph (A) and may
be used to meet the requirement under paragraph (1)(A).
(ii) Any health risk assessment that meets the guidelines
under subparagraph (A) and is approved by the Secretary may be
used to meet the requirement under paragraph (1)(A).
(D) The Secretary may coordinate with community-based
entities (including State Health Insurance Programs, Area
Agencies on Aging, Aging and Disability Resource Centers, and
the Administration on Aging) to--
(i) ensure that health risk assessments are
accessible to beneficiaries; and
(ii) provide appropriate support for the completion
of health risk assessments by beneficiaries.
(E) The Secretary shall establish procedures to make
beneficiaries and providers aware of the requirement that a
beneficiary complete a health risk assessment prior to or at
the same time as receiving personalized prevention plan
services.
(F) To the extent practicable, the Secretary shall encourage
the use of, integration with, and coordination of health
information technology (including use of technology that is
compatible with electronic medical records and personal health
records) and may experiment with the use of personalized
technology to aid in the development of self-management skills
and management of and adherence to provider recommendations in
order to improve the health status of beneficiaries.
(G) A beneficiary shall be eligible to receive only an
initial preventive physical examination (as defined under
subsection (ww)(1)) during the 12-month period after the date
that the beneficiary's coverage begins under part B and shall
be eligible to receive personalized prevention plan services
under this subsection each year thereafter provided that the
beneficiary has not received either an initial preventive
physical examination or personalized prevention plan services
within the preceding 12-month period.
(H) The Secretary shall issue guidance that--
(i) identifies elements under paragraph (2) that are
required to be provided to a beneficiary as part of
their first visit for personalized prevention plan
services; and
(ii) establishes a yearly schedule for appropriate
provision of such elements thereafter.
(iii) Home Infusion Therapy.--(1) The term ``home infusion
therapy'' means the items and services described in paragraph
(2) furnished by a qualified home infusion therapy supplier (as
defined in paragraph (3)(D)) which are furnished in the
individual's home (as defined in paragraph (3)(B)) to an
individual--
(A) who is under the care of an applicable provider
(as defined in paragraph (3)(A)); and
(B) with respect to whom a plan prescribing the type,
amount, and duration of infusion therapy services that
are to be furnished such individual has been
established by a physician (as defined in subsection
(r)(1)) and is periodically reviewed by a physician (as
so defined) in coordination with the furnishing of home
infusion drugs (as defined in paragraph (3)(C)) under
part B.
(2) The items and services described in this paragraph are
the following:
(A) Professional services, including nursing
services, furnished in accordance with the plan.
(B) Training and education (not otherwise paid for as
durable medical equipment (as defined in subsection
(n)), remote monitoring, and monitoring services for
the provision of home infusion therapy and home
infusion drugs furnished by a qualified home infusion
therapy supplier.
(3) For purposes of this subsection:
(A) The term ``applicable provider'' means--
(i) a physician;
(ii) a nurse practitioner; and
(iii) a physician assistant.
(B) The term ``home'' means a place of residence used
as the home of an individual (as defined for purposes
of subsection (n)).
(C) The term ``home infusion drug'' means a
parenteral drug or biological administered
intravenously, or subcutaneously for an administration
period of 15 minutes or more, in the home of an
individual through a pump that is an item of durable
medical equipment (as defined in subsection (n)). Such
term does not include the following:
(i) Insulin pump systems.
(ii) A self-administered drug or biological
on a self-administered drug exclusion list.
Clause (ii) shall not apply to a self-administered drug
or biological on a self-administered drug exclusion
list if such drug or biological was included as a
transitional home infusion drug under subparagraph
(A)(iii) of section 1834(u)(7) and was identified by a
HCPCS code described in subparagraph (C)(ii) of such
section.
(D)(i) The term ``qualified home infusion therapy
supplier'' means a pharmacy, physician, or other
provider of services or supplier licensed by the State
in which the pharmacy, physician, or provider or
services or supplier furnishes items or services and
that--
(I) furnishes infusion therapy to individuals
with acute or chronic conditions requiring
administration of home infusion drugs;
(II) ensures the safe and effective provision
and administration of home infusion therapy on
a 7-day-a-week, 24-hour-a-day basis;
(III) is accredited by an organization
designated by the Secretary pursuant to section
1834(u)(5); and
(IV) meets such other requirements as the
Secretary determines appropriate, taking into
account the standards of care for home infusion
therapy established by Medicare Advantage plans
under part C and in the private sector.
(ii) A qualified home infusion therapy supplier may
subcontract with a pharmacy, physician, provider of
services, or supplier to meet the requirements of this
subparagraph.
(jjj) Opioid Use Disorder Treatment Services; Opioid
Treatment Program.--
(1) Opioid use disorder treatment services.--The term
``opioid use disorder treatment services'' means items
and services that are furnished by an opioid treatment
program for the treatment of opioid use disorder,
including--
(A) opioid agonist and antagonist treatment
medications (including oral, injected, or
implanted versions) that are approved by the
Food and Drug Administration under section 505
of the Federal Food, Drug, and Cosmetic Act for
use in the treatment of opioid use disorder;
(B) dispensing and administration of such
medications, if applicable;
(C) substance use counseling by a
professional to the extent authorized under
State law to furnish such services;
(D) individual and group therapy with a
physician or psychologist (or other mental
health professional to the extent authorized
under State law);
(E) toxicology testing, and
(F) other items and services that the
Secretary determines are appropriate (but in no
event to include meals or transportation).
(2) Opioid treatment program.--The term ``opioid
treatment program'' means an entity that is an opioid
treatment program (as defined in section 8.2 of title
42 of the Code of Federal Regulations, or any successor
regulation) that--
(A) is enrolled under section 1866(j);
(B) has in effect a certification by the
[Substance Abuse and Mental Health Services
Administration] Substance Use And Mental Health
Services Administration for such a program;
(C) is accredited by an accrediting body
approved by the [Substance Abuse and Mental
Health Services Administration] Substance Use
And Mental Health Services Administration; and
(D) meets such additional conditions as the
Secretary may find necessary to ensure--
(i) the health and safety of
individuals being furnished services
under such program; and
(ii) the effective and efficient
furnishing of such services.
Rural Emergency Hospital Services; Rural Emergency Hospital
(kkk)(1) Rural emergency hospital services.--
(A) In general.--The term ``rural emergency hospital
services'' means the following services furnished by a
rural emergency hospital (as defined in paragraph (2))
that do not exceed an annual per patient average of 24
hours in such rural emergency hospital:
(i) Emergency department services and
observation care.
(ii) At the election of the rural emergency
hospital, with respect to services furnished on
an outpatient basis, other medical and health
services as specified by the Secretary through
rulemaking.
(B) Staffed emergency department.--For purposes of
subparagraph (A)(i), an emergency department of a rural
emergency hospital shall be considered a staffed
emergency department if it meets the following
requirements:
(i) The emergency department is staffed 24
hours a day, 7 days a week.
(ii) A physician (as defined in section
1861(r)(1)), nurse practitioner, clinical nurse
specialist, or physician assistant (as those
terms are defined in section 1861(aa)(5)) is
available to furnish rural emergency hospital
services in the facility 24 hours a day.
(iii) Applicable staffing and staffing
responsibilities under section 485.631 of title
42, Code of Federal Regulations (or any
successor regulation).
(2) Rural emergency hospital.--The term ``rural emergency
hospital'' means a facility described in paragraph (3) that--
(A) is enrolled under section 1866(j), submits the
additional information described in paragraph (4)(A)
for purposes of such enrollment, and makes the detailed
transition plan described in clause (i) of such
paragraph available to the public, in a form and manner
determined appropriate by the Secretary;
(B) does not provide any acute care inpatient
services, other than those described in paragraph
(6)(A);
(C) has in effect a transfer agreement with a level I
or level II trauma center;
(D) meets--
(i) licensure requirements as described in
paragraph (5);
(ii) the requirements of a staffed emergency
department as described in paragraph (1)(B);
(iii) such staff training and certification
requirements as the Secretary may require;
(iv) conditions of participation applicable
to--
(I) critical access hospitals, with
respect to emergency services under
section 485.618 of title 42, Code of
Federal Regulations (or any successor
regulation); and
(II) hospital emergency departments
under this title, as determined
applicable by the Secretary;
(v) such other requirements as the Secretary
finds necessary in the interest of the health
and safety of individuals who are furnished
rural emergency hospital services; and
(vi) in the case where the rural emergency
hospital includes a distinct part unit of the
facility that is licensed as a skilled nursing
facility, such distinct part meets the
requirements applicable to skilled nursing
facilities under this title.
(3) Facility described.--A facility described in this
paragraph is a facility that as of the date of the enactment of
this subsection--
(A) was a critical access hospital; or
(B) was a subsection (d) hospital (as defined in
section 1886(d)(1)(B)) with not more than 50 beds
located in a county (or equivalent unit of local
government) in a rural area (as defined in section
1886(d)(2)(D)), or was a subsection (d) hospital (as so
defined) with not more than 50 beds that was treated as
being located in a rural area pursuant to section
1886(d)(8)(E).
(4) Additional information.--
(A) Information.--For purposes of paragraph (2)(A), a
facility that submits an application for enrollment
under section 1866(j) as a rural emergency hospital
shall submit the following information at such time and
in such form as the Secretary may require:
(i) An action plan for initiating rural
emergency hospital services (as defined in
paragraph (1)), including a detailed transition
plan that lists the specific services that the
facility will--
(I) retain;
(II) modify
(III) add; and
(IV) discontinue.
(ii) A description of services that the
facility intends to furnish on an outpatient
basis pursuant to paragraph (1)(A)(ii).
(iii) Information regarding how the facility
intends to use the additional facility payment
provided under section 1834(x)(2), including a
description of the services covered under this
title that the additional facility payment
would be supporting, such as furnishing
telehealth services and ambulance services,
including operating the facility and
maintaining the emergency department to provide
such services covered under this title.
(iv) Such other information as the Secretary
determines appropriate.
(B) Effect of enrollment.--Such enrollment shall
remain effective with respect to a facility until such
time as--
(i) the facility elects to convert back to
its prior designation as a critical access
hospital or a subsection (d) hospital (as
defined in section 1886(d)(1)(B)), subject to
requirements applicable under this title for
such designation and in accordance with
procedures established by the Secretary; or
(ii) the Secretary determines the facility
does not meet the requirements applicable to a
rural emergency hospital under this subsection.
(5) Licensure.--A facility may not operate as a rural
emergency hospital in a State unless the facility--
(A) is located in a State that provides for the
licensing of such hospitals under State or applicable
local law; and
(B)(i) is licensed pursuant to such law; or
(ii) is approved by the agency of such State or
locality responsible for licensing hospitals, as
meeting the standards established for such licensing.
(6) Discretionary authority.--A rural emergency hospital
may--
(A) include a unit of the facility that is a distinct
part licensed as a skilled nursing facility to furnish
post-hospital extended care services; and
(B) be considered a hospital with less than 50 beds
for purposes of the exception to the payment limit for
rural health clinics under section 1833(f).
(7) Quality measurement.--
(A) In general.--The Secretary shall establish
quality measurement reporting requirements for rural
emergency hospitals, which may include the use of a
small number of claims-based outcomes measures or
surveys of patients with respect to their experience in
the rural emergency hospital, in accordance with the
succeeding provisions of this paragraph.
(B) Quality reporting by rural emergency hospitals.--
(i) In general.--With respect to each year
beginning with 2023, (or each year beginning on
or after the date that is one year after one or
more measures are first specified under
subparagraph (C)), a rural emergency hospital
shall submit data to the Secretary in
accordance with clause (ii).
(ii) Submission of quality data.--With
respect to each such year, a rural emergency
hospital shall submit to the Secretary data on
quality measures specified under subparagraph
(C). Such data shall be submitted in a form and
manner, and at a time, specified by the
Secretary for purposes of this subparagraph.
(C) Quality measures.--
(i) In general.--Subject to clause (ii), any
measure specified by the Secretary under this
subparagraph must have been endorsed by the
entity with a contract under section 1890(a).
(ii) Exception.--In the case of a specified
area or medical topic determined appropriate by
the Secretary for which a feasible and
practical measure has not been endorsed by the
entity with a contract under section 1890(a),
the Secretary may specify a measure that is not
so endorsed as long as due consideration is
given to measures that have been endorsed or
adopted by a consensus organization identified
by the Secretary.
(iii) Consideration of low case volume when
specifying performance measures.--The Secretary
shall, in the selection of measures specified
under this subparagraph, take into
consideration ways to account for rural
emergency hospitals that lack sufficient case
volume to ensure that the performance rates for
such measures are reliable.
(D) Public availability of data submitted.--The
Secretary shall establish procedures for making data
submitted under subparagraph (B) available to the
public regarding the performance of individual rural
emergency hospitals. Such procedures shall ensure that
a rural emergency hospital has the opportunity to
review, and submit corrections for, the data that is to
be made public with respect to the rural emergency
hospital prior to such data being made public. Such
information shall be posted on the Internet website of
the Centers for Medicare & Medicaid Services in an
easily understandable format as determined appropriate
by the Secretary.
(8) Clarification regarding application of provisions
relating to off-campus outpatient department of a provider.--
Nothing in this subsection, section 1833(a)(10), or section
1834(x) shall affect the application of paragraph (1)(B)(v) of
section 1833(t), relating to applicable items and services (as
defined in subparagraph (A) of paragraph (21) of such section)
that are furnished by an off-campus outpatient department of a
provider (as defined in subparagraph (B) of such paragraph).
(9) Implementation.--There shall be no administrative or
judicial review under section 1869, 1878, or otherwise of the
following:
(A) The determination of whether a rural emergency
hospital meets the requirements of this subsection.
(B) The establishment of requirements under this
subsection by the Secretary, including requirements
described in paragraphs (2)(D), (4), and (7).
(C) The determination of payment amounts under
section 1834(x), including the additional facility
payment described in paragraph (2) of such section.
* * * * * * *
SEC. 1866F. OPIOID USE DISORDER TREATMENT DEMONSTRATION PROGRAM.
(a) Implementation of 4-Year Demonstration Program.--
(1) In general.--Not later than January 1, 2021, the
Secretary shall implement a 4-year demonstration
program under this title (in this section referred to
as the ``Program'') to increase access of applicable
beneficiaries to opioid use disorder treatment
services, improve physical and mental health outcomes
for such beneficiaries, and to the extent possible,
reduce expenditures under this title. Under the
Program, the Secretary shall make payments under
subsection (e) to participants (as defined in
subsection (c)(1)(A)) for furnishing opioid use
disorder treatment services delivered through opioid
use disorder care teams, or arranging for such services
to be furnished, to applicable beneficiaries
participating in the Program.
(2) Opioid use disorder treatment services.--For
purposes of this section, the term ``opioid use
disorder treatment services''--
(A) means, with respect to an applicable
beneficiary, services that are furnished for
the treatment of opioid use disorders and that
utilize drugs approved under section 505 of the
Federal Food, Drug, and Cosmetic Act for the
treatment of opioid use disorders in an
outpatient setting; and
(B) includes--
(i) medication-assisted treatment;
(ii) treatment planning;
(iii) psychiatric, psychological, or
counseling services (or any combination
of such services), as appropriate;
(iv) social support services, as
appropriate; and
(v) care management and care
coordination services, including
coordination with other providers of
services and suppliers not on an opioid
use disorder care team.
(b) Program Design.--
(1) In general.--The Secretary shall design the
Program in such a manner to allow for the evaluation of
the extent to which the Program accomplishes the
following purposes:
(A) Reduces hospitalizations and emergency
department visits.
(B) Increases use of medication-assisted
treatment for opioid use disorders.
(C) Improves health outcomes of individuals
with opioid use disorders, including by
reducing the incidence of infectious diseases
(such as hepatitis C and HIV).
(D) Does not increase the total spending on
items and services under this title.
(E) Reduces deaths from opioid overdose.
(F) Reduces the utilization of inpatient
residential treatment.
(2) Consultation.--In designing the Program,
including the criteria under subsection (e)(2)(A), the
Secretary shall, not later than 3 months after the date
of the enactment of this section, consult with
specialists in the field of addiction, clinicians in
the primary care community, and beneficiary groups.
(c) Participants; Opioid Use Disorder Care Teams.--
(1) Participants.--
(A) Definition.--In this section, the term
``participant'' means an entity or individual--
(i) that is otherwise enrolled under
this title and that is--
(I) a physician (as defined
in section 1861(r)(1));
(II) a group practice
comprised of at least one
physician described in
subclause (I);
(III) a hospital outpatient
department;
(IV) a federally qualified
health center (as defined in
section 1861(aa)(4));
(V) a rural health clinic (as
defined in section
1861(aa)(2));
(VI) a community mental
health center (as defined in
section 1861(ff)(3)(B));
(VII) a clinic certified as a
certified community behavioral
health clinic pursuant to
section 223 of the Protecting
Access to Medicare Act of 2014;
or
(VIII) any other individual
or entity specified by the
Secretary;
(ii) that applied for and was
selected to participate in the Program
pursuant to an application and
selection process established by the
Secretary; and
(iii) that establishes an opioid use
disorder care team (as defined in
paragraph (2)) through employing or
contracting with health care
practitioners described in paragraph
(2)(A), and uses such team to furnish
or arrange for opioid use disorder
treatment services in the outpatient
setting under the Program.
(B) Preference.--In selecting participants
for the Program, the Secretary shall give
preference to individuals and entities that are
located in areas with a prevalence of opioid
use disorders that is higher than the national
average prevalence.
(2) Opioid use disorder care teams.--
(A) In general.--For purposes of this
section, the term ``opioid use disorder care
team'' means a team of health care
practitioners established by a participant
described in paragraph (1)(A) that--
(i) shall include--
(I) at least one physician
(as defined in section
1861(r)(1)) furnishing primary
care services or addiction
treatment services to an
applicable beneficiary; and
(II) at least one eligible
practitioner (as defined in
paragraph (3)), who may be a
physician who meets the
criterion in subclause (I); and
(ii) may include other practitioners
licensed under State law to furnish
psychiatric, psychological, counseling,
and social services to applicable
beneficiaries.
(B) Requirements for receipt of payment under
program.--In order to receive payments under
subsection (e), each participant in the Program
shall--
(i) furnish opioid use disorder
treatment services through opioid use
disorder care teams to applicable
beneficiaries who agree to receive the
services;
(ii) meet minimum criteria, as
established by the Secretary; and
(iii) submit to the Secretary, in
such form, manner, and frequency as
specified by the Secretary, with
respect to each applicable beneficiary
for whom opioid use disorder treatment
services are furnished by the opioid
use disorder care team, data and such
other information as the Secretary
determines appropriate to--
(I) monitor and evaluate the
Program;
(II) determine if minimum
criteria are met under clause
(ii); and
(III) determine the incentive
payment under subsection (e).
(3) Eligible practitioner defined.--For purposes of
this section, the term ``eligible practitioner'' means
a physician or other health care practitioner, such as
a nurse practitioner, that--
(A) is enrolled under section 1866(j)(1);
(B) is authorized to prescribe or dispense
narcotic drugs to individuals for maintenance
treatment or detoxification treatment; and
(C) has in effect a waiver in accordance with
section 303(g) of the Controlled Substances Act
for such purpose and is otherwise in compliance
with regulations promulgated by the [Substance
Abuse and Mental Health Services
Administration] Substance Use And Mental Health
Services Administration to carry out such
section.
(d) Participation of Applicable Beneficiaries.--
(1) Applicable beneficiary defined.--In this section,
the term ``applicable beneficiary'' means an individual
who--
(A) is entitled to, or enrolled for, benefits
under part A and enrolled for benefits under
part B;
(B) is not enrolled in a Medicare Advantage
plan under part C;
(C) has a current diagnosis for an opioid use
disorder; and
(D) meets such other criteria as the
Secretary determines appropriate.
Such term shall include an individual who is dually
eligible for benefits under this title and title XIX if
such individual satisfies the criteria described in
subparagraphs (A) through (D).
(2) Voluntary beneficiary participation; limitation
on number of beneficiaries.--An applicable beneficiary
may participate in the Program on a voluntary basis and
may terminate participation in the Program at any time.
Not more than 20,000 applicable beneficiaries may
participate in the Program at any time.
(3) Services.--In order to participate in the
Program, an applicable beneficiary shall agree to
receive opioid use disorder treatment services from a
participant. Participation under the Program shall not
affect coverage of or payment for any other item or
service under this title for the applicable
beneficiary.
(4) Beneficiary access to services.--Nothing in this
section shall be construed as encouraging providers to
limit applicable beneficiary access to services covered
under this title, and applicable beneficiaries shall
not be required to relinquish access to any benefit
under this title as a condition of receiving services
from a participant in the Program.
(e) Payments.--
(1) Per applicable beneficiary per month care
management fee.--
(A) In general.--The Secretary shall
establish a schedule of per applicable
beneficiary per month care management fees.
Such a per applicable beneficiary per month
care management fee shall be paid to a
participant in addition to any other amount
otherwise payable under this title to the
health care practitioners in the participant's
opioid use disorder care team or, if
applicable, to the participant. A participant
may use such per applicable beneficiary per
month care management fee to deliver additional
services to applicable beneficiaries, including
services not otherwise eligible for payment
under this title.
(B) Payment amounts.--In carrying out
subparagraph (A), the Secretary may--
(i) consider payments otherwise
payable under this title for opioid use
disorder treatment services and the
needs of applicable beneficiaries;
(ii) pay a higher per applicable
beneficiary per month care management
fee for an applicable beneficiary who
receives more intensive treatment
services from a participant and for
whom those services are appropriate
based on clinical guidelines for opioid
use disorder care;
(iii) pay a higher per applicable
beneficiary per month care management
fee for the month in which the
applicable beneficiary begins treatment
with a participant than in subsequent
months, to reflect the greater time and
costs required for the planning and
initiation of treatment, as compared to
maintenance of treatment; and
(iv) take into account whether a
participant's opioid use disorder care
team refers applicable beneficiaries to
other suppliers or providers for any
opioid use disorder treatment services.
(C) No duplicate payment.--The Secretary
shall make payments under this paragraph to
only one participant for services furnished to
an applicable beneficiary during a calendar
month.
(2) Incentive payments.--
(A) In general.--Under the Program, the
Secretary shall establish a performance-based
incentive payment, which shall be paid (using a
methodology established and at a time
determined appropriate by the Secretary) to
participants based on the performance of
participants with respect to criteria, as
determined appropriate by the Secretary, in
accordance with subparagraph (B).
(B) Criteria.--
(i) In general.--Criteria described
in subparagraph (A) may include
consideration of the following:
(I) Patient engagement and
retention in treatment.
(II) Evidence-based
medication-assisted treatment.
(III) Other criteria
established by the Secretary.
(ii) Required consultation and
consideration.--In determining criteria
described in subparagraph (A), the
Secretary shall--
(I) consult with
stakeholders, including
clinicians in the primary care
community and in the field of
addiction medicine; and
(II) consider existing
clinical guidelines for the
treatment of opioid use
disorders.
(C) No duplicate payment.--The Secretary
shall ensure that no duplicate payments under
this paragraph are made with respect to an
applicable beneficiary.
(f) Multipayer Strategy.--In carrying out the Program, the
Secretary shall encourage other payers to provide similar
payments and to use similar criteria as applied under the
Program under subsection (e)(2)(C). The Secretary may enter
into a memorandum of understanding with other payers to align
the methodology for payment provided by such a payer related to
opioid use disorder treatment services with such methodology
for payment under the Program.
(g) Evaluation.--
(1) In general.--The Secretary shall conduct an
intermediate and final evaluation of the program. Each
such evaluation shall determine the extent to which
each of the purposes described in subsection (b) have
been accomplished under the Program.
(2) Reports.--The Secretary shall submit to
Congress--
(A) a report with respect to the intermediate
evaluation under paragraph (1) not later than 3
years after the date of the implementation of
the Program; and
(B) a report with respect to the final
evaluation under paragraph (1) not later than 6
years after such date.
(h) Funding.--
(1) Administrative funding.--For the purposes of
implementing, administering, and carrying out the
Program (other than for purposes described in paragraph
(2)), $5,000,000 shall be available from the Federal
Supplementary Medical Insurance Trust Fund under
section 1841.
(2) Care management fees and incentives.--For the
purposes of making payments under subsection (e),
$10,000,000 shall be available from the Federal
Supplementary Medical Insurance Trust Fund under
section 1841 for each of fiscal years 2021 through
2024.
(3) Availability.--Amounts transferred under this
subsection for a fiscal year shall be available until
expended.
(i) Waivers.--The Secretary may waive any provision of this
title as may be necessary to carry out the Program under this
section.
* * * * * * *
TITLE XIX--GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
* * * * * * *
Sec. 1945. State Option To Provide Coordinated Care Through a
Health Home for Individuals With Chronic Conditions.--
(a) In General.--Notwithstanding section 1902(a)(1) (relating
to statewideness), section 1902(a)(10)(B) (relating to
comparability), and any other provision of this title for which
the Secretary determines it is necessary to waive in order to
implement this section, beginning January 1, 2011, a State, at
its option as a State plan amendment, may provide for medical
assistance under this title to eligible individuals with
chronic conditions who select a designated provider (as
described under subsection (h)(5)), a team of health care
professionals (as described under subsection (h)(6)) operating
with such a provider, or a health team (as described under
subsection (h)(7)) as the individual's health home for purposes
of providing the individual with health home services.
(b) Health Home Qualification Standards.--The Secretary shall
establish standards for qualification as a designated provider
for the purpose of being eligible to be a health home for
purposes of this section.
(c) Payments.--
(1) In general.--A State shall provide a designated
provider, a team of health care professionals operating
with such a provider, or a health team with payments
for the provision of health home services to each
eligible individual with chronic conditions that
selects such provider, team of health care
professionals, or health team as the individual's
health home. Payments made to a designated provider, a
team of health care professionals operating with such a
provider, or a health team for such services shall be
treated as medical assistance for purposes of section
1903(a), except that, subject to paragraph (4), during
the first 8 fiscal year quarters that the State plan
amendment is in effect, the Federal medical assistance
percentage applicable to such payments shall be equal
to 90 percent.
(2) Methodology.--
(A) In general.--The State shall specify in
the State plan amendment the methodology the
State will use for determining payment for the
provision of health home services. Such
methodology for determining payment--
(i) may be tiered to reflect, with
respect to each eligible individual
with chronic conditions provided such
services by a designated provider, a
team of health care professionals
operating with such a provider, or a
health team, as well as the severity or
number of each such individual's
chronic conditions or the specific
capabilities of the provider, team of
health care professionals, or health
team; and
(ii) shall be established consistent
with section 1902(a)(30)(A).
(B) Alternate models of payment.--The
methodology for determining payment for
provision of health home services under this
section shall not be limited to a per-member
per-month basis and may provide (as proposed by
the State and subject to approval by the
Secretary) for alternate models of payment.
(3) Planning grants.--
(A) In general.--Beginning January 1, 2011,
the Secretary may award planning grants to
States for purposes of developing a State plan
amendment under this section. A planning grant
awarded to a State under this paragraph shall
remain available until expended.
(B) State contribution.--A State awarded a
planning grant shall contribute an amount equal
to the State percentage determined under
section 1905(b) (without regard to section 5001
of Public Law 111-5) for each fiscal year for
which the grant is awarded.
(C) Limitation.--The total amount of payments
made to States under this paragraph shall not
exceed $25,000,000.
(4) Special rule relating to substance use disorder
health homes.--
(A) In general.--In the case of a State with
an SUD-focused State plan amendment approved by
the Secretary on or after October 1, 2018, the
Secretary may, at the request of the State,
extend the application of the Federal medical
assistance percentage described in paragraph
(1) to payments for the provision of health
home services to SUD-eligible individuals under
such State plan amendment, in addition to the
first 8 fiscal year quarters the State plan
amendment is in effect, for the subsequent 2
fiscal year quarters that the State plan
amendment is in effect. Nothing in this section
shall be construed as prohibiting a State with
a State plan amendment that is approved under
this section and that is not an SUD-focused
State plan amendment from additionally having
approved on or after such date an SUD-focused
State plan amendment under this section,
including for purposes of application of this
paragraph.
(B) Report requirements.--In the case of a
State with an SUD-focused State plan amendment
for which the application of the Federal
medical assistance percentage has been extended
under subparagraph (A), such State shall, at
the end of the period of such State plan
amendment, submit to the Secretary a report on
the following, with respect to SUD-eligible
individuals provided health home services under
such State plan amendment:
(i) The quality of health care
provided to such individuals, with a
focus on outcomes relevant to the
recovery of each such individual.
(ii) The access of such individuals
to health care.
(iii) The total expenditures of such
individuals for health care.
For purposes of this subparagraph, the
Secretary shall specify all applicable measures
for determining quality, access, and
expenditures.
(C) Best practices.--Not later than October
1, 2020, the Secretary shall make publicly
available on the internet website of the
Centers for Medicare & Medicaid Services best
practices for designing and implementing an
SUD-focused State plan amendment, based on the
experiences of States that have State plan
amendments approved under this section that
include SUD-eligible individuals.
(D) Definitions.--For purposes of this
paragraph:
(i) Sud-eligible individuals.--The
term ``SUD-eligible individual'' means,
with respect to a State, an individual
who satisfies all of the following:
(I) The individual is an
eligible individual with
chronic conditions.
(II) The individual is an
individual with a substance use
disorder.
(III) The individual has not
previously received health home
services under any other State
plan amendment approved for the
State under this section by the
Secretary.
(ii) Sud-focused state plan
amendment.--The term ``SUD-focused
State plan amendment'' means a State
plan amendment under this section that
is designed to provide health home
services primarily to SUD-eligible
individuals.
(d) Hospital Referrals.--A State shall include in the State
plan amendment a requirement for hospitals that are
participating providers under the State plan or a waiver of
such plan to establish procedures for referring any eligible
individuals with chronic conditions who seek or need treatment
in a hospital emergency department to designated providers.
(e) Coordination.--A State shall consult and coordinate, as
appropriate, with the [Substance Abuse and Mental Health
Services Administration] Substance Use And Mental Health
Services Administration in addressing issues regarding the
prevention and treatment of mental illness and substance abuse
among eligible individuals with chronic conditions.
(f) Monitoring.--A State shall include in the State plan
amendment--
(1) a methodology for tracking avoidable hospital
readmissions and calculating savings that result from
improved chronic care coordination and management under
this section; and
(2) a proposal for use of health information
technology in providing health home services under this
section and improving service delivery and coordination
across the care continuum (including the use of
wireless patient technology to improve coordination and
management of care and patient adherence to
recommendations made by their provider).
(g) Report on Quality Measures.--As a condition for receiving
payment for health home services provided to an eligible
individual with chronic conditions, a designated provider shall
report to the State, in accordance with such requirements as
the Secretary shall specify, on all applicable measures for
determining the quality of such services. When appropriate and
feasible, a designated provider shall use health information
technology in providing the State with such information.
(h) Definitions.--In this section:
(1) Eligible individual with chronic conditions.--
(A) In general.--Subject to subparagraph (B),
the term ``eligible individual with chronic
conditions'' means an individual who--
(i) is eligible for medical
assistance under the State plan or
under a waiver of such plan; and
(ii) has at least--
(I) 2 chronic conditions;
(II) 1 chronic condition and
is at risk of having a second
chronic condition; or
(III) 1 serious and
persistent mental health
condition.
(B) Rule of construction.--Nothing in this
paragraph shall prevent the Secretary from
establishing higher levels as to the number or
severity of chronic or mental health conditions
for purposes of determining eligibility for
receipt of health home services under this
section.
(2) Chronic condition.--The term ``chronic
condition'' has the meaning given that term by the
Secretary and shall include, but is not limited to, the
following:
(A) A mental health condition.
(B) Substance use disorder.
(C) Asthma.
(D) Diabetes.
(E) Heart disease.
(F) Being overweight, as evidenced by having
a Body Mass Index (BMI) over 25.
(3) Health home.--The term ``health home'' means a
designated provider (including a provider that operates
in coordination with a team of health care
professionals) or a health team selected by an eligible
individual with chronic conditions to provide health
home services.
(4) Health home services.--
(A) In general.--The term ``health home
services'' means comprehensive and timely high-
quality services described in subparagraph (B)
that are provided by a designated provider, a
team of health care professionals operating
with such a provider, or a health team.
(B) Services described.--The services
described in this subparagraph are--
(i) comprehensive care management;
(ii) care coordination and health
promotion;
(iii) comprehensive transitional
care, including appropriate follow-up,
from inpatient to other settings;
(iv) patient and family support
(including authorized representatives);
(v) referral to community and social
support services, if relevant; and
(vi) use of health information
technology to link services, as
feasible and appropriate.
(5) Designated provider.--The term ``designated
provider'' means a physician, clinical practice or
clinical group practice, rural clinic, community health
center, community mental health center, home health
agency, or any other entity or provider (including
pediatricians, gynecologists, and obstetricians) that
is determined by the State and approved by the
Secretary to be qualified to be a health home for
eligible individuals with chronic conditions on the
basis of documentation evidencing that the physician,
practice, or clinic--
(A) has the systems and infrastructure in
place to provide health home services; and
(B) satisfies the qualification standards
established by the Secretary under subsection
(b).
(6) Team of health care professionals.--The term
``team of health care professionals'' means a team of
health professionals (as described in the State plan
amendment) that may--
(A) include physicians and other
professionals, such as a nurse care
coordinator, nutritionist, social worker,
behavioral health professional, or any
professionals deemed appropriate by the State;
and
(B) be free standing, virtual, or based at a
hospital, community health center, community
mental health center, rural clinic, clinical
practice or clinical group practice, academic
health center, or any entity deemed appropriate
by the State and approved by the Secretary.
(7) Health team.--The term ``health team'' has the
meaning given such term for purposes of section 3502 of
the Patient Protection and Affordable Care Act.
* * * * * * *
----------
CHILD ABUSE PREVENTION AND TREATMENT ACT
* * * * * * *
TITLE I--GENERAL PROGRAM
* * * * * * *
SEC. 105. GRANTS TO STATES, INDIAN TRIBES OR TRIBAL ORGANIZATIONS, AND
PUBLIC OR PRIVATE AGENCIES AND ORGANIZATIONS.
(a) Grants for Programs and Projects.--The Secretary may make
grants to, and enter into contracts with, entities that are
States, Indian tribes or tribal organizations, or public
agencies or private agencies or organizations (or combinations
of such entities) for programs and projects for the following
purposes:
(1) Training programs.--The Secretary may award
grants to public or private organizations under this
subsection--
(A) for the training of professional and
paraprofessional personnel in the fields of
health care, medicine, law enforcement,
judiciary, social work and child protection,
education, child care, and other relevant
fields, or individuals such as court appointed
special advocates (CASAs) and guardian ad
litem, who are engaged in, or intend to work
in, the field of prevention, identification,
and treatment of child abuse and neglect,
including the links between domestic violence
and child abuse and neglect;
(B) to improve the recruitment, selection,
and training of volunteers serving in public
and private children, youth, and family service
organizations in order to prevent child abuse
and neglect;
(C) for the establishment of resource centers
for the purpose of providing information and
training to professionals working in the field
of child abuse and neglect;
(D) for training to enhance linkages among
child protective service agencies and health
care agencies, entities providing physical and
mental health services, community resources,
and developmental disability agencies, to
improve screening, forensic diagnosis, and
health and developmental evaluations, and for
partnerships between child protective service
agencies and health care agencies that support
the coordinated use of existing Federal, State,
local, and private funding to meet the health
evaluation needs of children who have been
subjects of substantiated cases of child abuse
or neglect;
(E) for the training of personnel in best
practices to meet the unique needs of children
with disabilities, including promoting
interagency collaboration;
(F) for the training of personnel in best
practices to promote collaboration with the
families from the initial time of contact
during the investigation through treatment;
(G) for the training of personnel regarding
the legal duties of such personnel and their
responsibilities to protect the legal rights of
children and families;
(H) for the training of personnel in
childhood development including the unique
needs of children under age 3;
(I) for improving the training of supervisory
and nonsupervisory child welfare workers;
(J) for enabling State child welfare agencies
to coordinate the provision of services with
State and local health care agencies, alcohol
and drug abuse prevention and treatment
agencies, mental health agencies, other public
and private welfare agencies, and agencies that
provide early intervention services to promote
child safety, permanence, and family stability;
(K) for cross training for child protective
service workers in research-based strategies
for recognizing situations of substance abuse,
domestic violence, and neglect;
(L) for developing, implementing, or
operating information and education programs or
training programs designed to improve the
provision of services to infants or toddlers
with disabilities with life-threatening
conditions for--
(i) professionals and
paraprofessional personnel concerned
with the welfare of infants or toddlers
with disabilities with life-threatening
conditions, including personnel
employed in child protective services
programs and health care facilities;
and
(ii) the parents of such infants; and
(M) for the training of personnel in best
practices relating to the provision of
differential response.
(2) Triage procedures.--The Secretary may award
grants under this subsection to public and private
agencies that demonstrate innovation in responding to
reports of child abuse and neglect, including programs
of collaborative partnerships between the State child
protective services agency, community social service
agencies and family support programs, law enforcement
agencies, developmental disability agencies, substance
abuse treatment entities, health care entities,
domestic violence prevention entities, mental health
service entities, schools, churches and synagogues, and
other community agencies, to allow for the
establishment of a triage system that--
(A) accepts, screens, and assesses reports
received to determine which such reports
require an intensive intervention and which
require voluntary referral to another agency,
program, or project;
(B) provides, either directly or through
referral, a variety of community-linked
services to assist families in preventing child
abuse and neglect; and
(C) provides further investigation and
intensive intervention when the child's safety
is in jeopardy.
(3) Mutual support programs.--The Secretary may award
grants to private organizations to establish or
maintain a national network of mutual support,
leadership, and self-help programs as a means of
strengthening families in partnership with their
communities.
(4) Kinship care.--The Secretary may award grants to
public and private entities to assist such entities in
developing or implementing procedures using adult
relatives as the preferred placement for children
removed from their home, where such relatives are
determined to be capable of providing a safe nurturing
environment for the child and where such relatives
comply with the State child protection standards.
(5) Linkages among child protective service agencies
and public health, mental health, substance abuse,
developmental disabilities, and domestic violence
service agencies.--The Secretary may award grants to
entities that provide linkages among State or local
child protective service agencies and public health,
mental health, substance abuse, developmental
disabilities, and domestic violence service agencies,
and entities that carry out community-based programs,
for the purpose of establishing linkages that are
designed to ensure that a greater number of
substantiated victims of child maltreatment have their
physical health, mental health, and developmental needs
appropriately diagnosed and treated, in accordance with
all applicable Federal and State privacy laws.
(6) Collaborations between child protective service
entities and domestic violence service entities.--The
Secretary may award grants to public or private
agencies and organizations under this section to
develop or expand effective collaborations between
child protective service entities and domestic violence
service entities to improve collaborative investigation
and intervention procedures, provision for the safety
of the nonabusing parent involved and children, and
provision of services to children exposed to domestic
violence that also support the caregiving role of the
non-abusing parent.
(7) Grants to states to improve and coordinate their
response to ensure the safety, permanency, and well-
being of infants affected by substance use.--
(A) Program authorized.--The Secretary is
authorized to make grants to States for the
purpose of assisting child welfare agencies,
social services agencies, substance use
disorder treatment agencies, hospitals with
labor and delivery units, medical staff, public
health and mental health agencies, and maternal
and child health agencies to facilitate
collaboration in developing, updating,
implementing, and monitoring plans of safe care
described in section 106(b)(2)(B)(iii). Section
112(a)(2) shall not apply to the program
authorized under this paragraph.
(B) Distribution of funds.--
(i) Reservations.--Of the amounts
made available to carry out
subparagraph (A), the Secretary shall
reserve--
(I) no more than 3 percent
for the purposes described in
subparagraph (G); and
(II) up to 3 percent for
grants to Indian Tribes and
tribal organizations to address
the needs of infants born with,
and identified as being
affected by, substance abuse or
withdrawal symptoms resulting
from prenatal drug exposure or
a fetal alcohol spectrum
disorder and their families or
caregivers, which to the extent
practicable, shall be
consistent with the uses of
funds described under
subparagraph (D).
(ii) Allotments to states and
territories.--The Secretary shall allot
the amount made available to carry out
subparagraph (A) that remains after
application of clause (i) to each State
that applies for such a grant, in an
amount equal to the sum of--
(I) $500,000; and
(II) an amount that bears the
same relationship to any funds
made available to carry out
subparagraph (A) and remaining
after application of clause
(i), as the number of live
births in the State in the
previous calendar year bears to
the number of live births in
all States in such year.
(iii) Ratable reduction.--If the
amount made available to carry out
subparagraph (A) is insufficient to
satisfy the requirements of clause
(ii), the Secretary shall ratably
reduce each allotment to a State.
(C) Application.--A State desiring a grant
under this paragraph shall submit an
application to the Secretary at such time and
in such manner as the Secretary may require.
Such application shall include--
(i) a description of--
(I) the impact of substance
use disorder in such State,
including with respect to the
substance or class of
substances with the highest
incidence of abuse in the
previous year in such State,
including--
(aa) the prevalence
of substance use
disorder in such State;
(bb) the aggregate
rate of births in the
State of infants
affected by substance
abuse or withdrawal
symptoms or a fetal
alcohol spectrum
disorder (as determined
by hospitals, insurance
claims, claims
submitted to the State
Medicaid program, or
other records), if
available and to the
extent practicable; and
(cc) the number of
infants identified, for
whom a plan of safe
care was developed, and
for whom a referral was
made for appropriate
services, as reported
under section
106(d)(18);
(II) the challenges the State
faces in developing,
implementing, and monitoring
plans of safe care in
accordance with section
106(b)(2)(B)(iii);
(III) the State's lead agency
for the grant program and how
that agency will coordinate
with relevant State entities
and programs, including the
child welfare agency, the
substance use disorder
treatment agency, hospitals
with labor and delivery units,
health care providers, the
public health and mental health
agencies, programs funded by
the [Substance Abuse and Mental
Health Services Administration]
Substance Use And Mental Health
Services Administration that
provide substance use disorder
treatment for women, the State
Medicaid program, the State
agency administering the block
grant program under title V of
the Social Security Act (42
U.S.C. 701 et seq.), the State
agency administering the
programs funded under part C of
the Individuals with
Disabilities Education Act (20
U.S.C. 1431 et seq.), the
maternal, infant, and early
childhood home visiting program
under section 511 of the Social
Security Act (42 U.S.C. 711),
the State judicial system, and
other agencies, as determined
by the Secretary, and Indian
Tribes and tribal
organizations, as appropriate,
to implement the activities
under this paragraph;
(IV) how the State will
monitor local development and
implementation of plans of safe
care, in accordance with
section 106(b)(2)(B)(iii)(II),
including how the State will
monitor to ensure plans of safe
care address differences
between substance use disorder
and medically supervised
substance use, including for
the treatment of a substance
use disorder;
(V) if applicable, how the
State plans to utilize funding
authorized under part E of
title IV of the Social Security
Act (42 U.S.C. 670 et seq.) to
assist in carrying out any plan
of safe care, including such
funding authorized under
section 471(e) of such Act (as
in effect on October 1, 2018)
for mental health and substance
abuse prevention and treatment
services and in-home parent
skill-based programs and
funding authorized under such
section 472(j) (as in effect on
October 1, 2018) for children
with a parent in a licensed
residential family-based
treatment facility for
substance abuse; and
(VI) an assessment of the
treatment and other services
and programs available in the
State to effectively carry out
any plan of safe care
developed, including
identification of needed
treatment, and other services
and programs to ensure the
well-being of young children
and their families affected by
substance use disorder, such as
programs carried out under part
C of the Individuals with
Disabilities Education Act (20
U.S.C. 1431 et seq.) and
comprehensive early childhood
development services and
programs such as Head Start
programs;
(ii) a description of how the State
plans to use funds for activities
described in subparagraph (D) for the
purposes of ensuring State compliance
with requirements under clauses (ii)
and (iii) of section 106(b)(2)(B); and
(iii) an assurance that the State
will comply with requirements to refer
a child identified as substance-exposed
to early intervention services as
required pursuant to a grant under part
C of the Individuals with Disabilities
Education Act (20 U.S.C. 1431 et seq.).
(D) Uses of funds.--Funds awarded to a State
under this paragraph may be used for the
following activities, which may be carried out
by the State directly, or through grants or
subgrants, contracts, or cooperative
agreements:
(i) Improving State and local systems
with respect to the development and
implementation of plans of safe care,
which--
(I) shall include parent and
caregiver engagement, as
required under section
106(b)(2)(B)(iii)(I), regarding
available treatment and service
options, which may include
resources available for
pregnant, perinatal, and
postnatal women; and
(II) may include activities
such as--
(aa) developing
policies, procedures,
or protocols for the
administration or
development of
evidence-based and
validated screening
tools for infants who
may be affected by
substance use
withdrawal symptoms or
a fetal alcohol
spectrum disorder and
pregnant, perinatal,
and postnatal women
whose infants may be
affected by substance
use withdrawal symptoms
or a fetal alcohol
spectrum disorder;
(bb) improving
assessments used to
determine the needs of
the infant and family;
(cc) improving
ongoing case management
services;
(dd) improving access
to treatment services,
which may be prior to
the pregnant woman's
delivery date; and
(ee) keeping families
safely together when it
is in the best interest
of the child.
(ii) Developing policies, procedures,
or protocols in consultation and
coordination with health professionals,
public and private health facilities,
and substance use disorder treatment
agencies to ensure that--
(I) appropriate notification
to child protective services is
made in a timely manner, as
required under section
106(b)(2)(B)(ii);
(II) a plan of safe care is
in place, in accordance with
section 106(b)(2)(B)(iii),
before the infant is discharged
from the birth or health care
facility; and
(III) such health and related
agency professionals are
trained on how to follow such
protocols and are aware of the
supports that may be provided
under a plan of safe care.
(iii) Training health professionals
and health system leaders, child
welfare workers, substance use disorder
treatment agencies, and other related
professionals such as home visiting
agency staff and law enforcement in
relevant topics including--
(I) State mandatory reporting
laws established under section
106(b)(2)(B)(i) and the
referral and process
requirements for notification
to child protective services
when child abuse or neglect
reporting is not mandated;
(II) the co-occurrence of
pregnancy and substance use
disorder, and implications of
prenatal exposure;
(III) the clinical guidance
about treating substance use
disorder in pregnant and
postpartum women;
(IV) appropriate screening
and interventions for infants
affected by substance use
disorder, withdrawal symptoms,
or a fetal alcohol spectrum
disorder and the requirements
under section
106(b)(2)(B)(iii); and
(V) appropriate
multigenerational strategies to
address the mental health needs
of the parent and child
together.
(iv) Establishing partnerships,
agreements, or memoranda of
understanding between the lead agency
and other entities (including health
professionals, health facilities, child
welfare professionals, juvenile and
family court judges, substance use and
mental disorder treatment programs,
early childhood education programs,
maternal and child health and early
intervention professionals (including
home visiting providers), peer-to-peer
recovery programs such as parent
mentoring programs, and housing
agencies) to facilitate the
implementation of, and compliance with,
section 106(b)(2) and clause (ii) of
this subparagraph, in areas which may
include--
(I) developing a
comprehensive, multi-
disciplinary assessment and
intervention process for
infants, pregnant women, and
their families who are affected
by substance use disorder,
withdrawal symptoms, or a fetal
alcohol spectrum disorder, that
includes meaningful engagement
with and takes into account the
unique needs of each family and
addresses differences between
medically supervised substance
use, including for the
treatment of substance use
disorder, and substance use
disorder;
(II) ensuring that treatment
approaches for serving infants,
pregnant women, and perinatal
and postnatal women whose
infants may be affected by
substance use, withdrawal
symptoms, or a fetal alcohol
spectrum disorder, are designed
to, where appropriate, keep
infants with their mothers
during both inpatient and
outpatient treatment; and
(III) increasing access to
all evidence-based medication-
assisted treatment approved by
the Food and Drug
Administration, behavioral
therapy, and counseling
services for the treatment of
substance use disorders, as
appropriate.
(v) Developing and updating systems
of technology for improved data
collection and monitoring under section
106(b)(2)(B)(iii), including existing
electronic medical records, to measure
the outcomes achieved through the plans
of safe care, including monitoring
systems to meet the requirements of
this Act and submission of performance
measures.
(E) Reporting.--Each State that receives
funds under this paragraph, for each year such
funds are received, shall submit a report to
the Secretary, disaggregated by geographic
location, economic status, and major racial and
ethnic groups, except that such disaggregation
shall not be required if the results would
reveal personally identifiable information on,
with respect to infants identified under
section 106(b)(2)(B)(ii)--
(i) the number who experienced
removal associated with parental
substance use;
(ii) the number who experienced
removal and subsequently are reunified
with parents, and the length of time
between such removal and reunification;
(iii) the number who are referred to
community providers without a child
protection case;
(iv) the number who receive services
while in the care of their birth
parents;
(v) the number who receive post-
reunification services within 1 year
after a reunification has occurred; and
(vi) the number who experienced a
return to out-of-home care within 1
year after reunification.
(F) Secretary's report to congress.--The
Secretary shall submit an annual report to the
Committee on Health, Education, Labor, and
Pensions and the Committee on Appropriations of
the Senate and the Committee on Education and
the Workforce and the Committee on
Appropriations of the House of Representatives
that includes the information described in
subparagraph (E) and recommendations or
observations on the challenges, successes, and
lessons derived from implementation of the
grant program.
(G) Assisting states' implementation.--The
Secretary shall use the amount reserved under
subparagraph (B)(i)(I) to provide written
guidance and technical assistance to support
States in complying with and implementing this
paragraph, which shall include--
(i) technical assistance, including
programs of in-depth technical
assistance, to additional States,
territories, and Indian Tribes and
tribal organizations in accordance with
the substance-exposed infant initiative
developed by the National Center on
Substance Abuse and Child Welfare;
(ii) guidance on the requirements of
this Act with respect to infants born
with and identified as being affected
by substance use or withdrawal symptoms
or fetal alcohol spectrum disorder, as
described in clauses (ii) and (iii) of
section 106(b)(2)(B), including by--
(I) enhancing States'
understanding of requirements
and flexibilities under the
law, including by clarifying
key terms;
(II) addressing state-
identified challenges with
developing, implementing, and
monitoring plans of safe care,
including those reported under
subparagraph (C)(i)(II);
(III) disseminating best
practices on implementation of
plans of safe care, on such
topics as differential
response, collaboration and
coordination, and
identification and delivery of
services for different
populations, while recognizing
needs of different populations
and varying community
approaches across States; and
(IV) helping States improve
the long-term safety and well-
being of young children and
their families;
(iii) supporting State efforts to
develop information technology systems
to manage plans of safe care; and
(iv) preparing the Secretary's report
to Congress described in subparagraph
(F).
(H) Sunset.--The authority under this
paragraph shall sunset on September 30, 2023.
(b) Discretionary Grants.--In addition to grants or contracts
made under subsection (a), grants or contracts under this
section may be used for the following:
(1) Respite and crisis nursery programs provided by
community-based organizations under the direction and
supervision of hospitals.
(2) Respite and crisis nursery programs provided by
community-based organizations.
(3) Programs based within children's hospitals or
other pediatric and adolescent care facilities, that
provide model approaches for improving medical
diagnosis of child abuse and neglect and for health
evaluations of children for whom a report of
maltreatment has been substantiated.
(4)(A) Providing hospital-based information and
referral services to--
(i) parents of children with disabilities;
and
(ii) children who have been victims of child
abuse or neglect and their parents.
(B) Except as provided in subparagraph (C)(iii),
services provided under a grant received under this
paragraph shall be provided at the hospital involved--
(i) upon the birth or admission of a child
with disabilities; and
(ii) upon the treatment of a child for child
abuse and neglect.
(C) Services, as determined as appropriate by the
grantee, provided under a grant received under this
paragraph shall be hospital-based and shall consist
of--
(i) the provision of notice to parents that
information relating to community services is
available;
(ii) the provision of appropriate information
to parents of a child with disabilities
regarding resources in the community,
particularly parent training resources, that
will assist such parents in caring for their
child;
(iii) the provision of appropriate
information to parents of a child who has been
a victim of child abuse or neglect regarding
resources in the community, particularly parent
training resources, that will assist such
parents in caring for their child and reduce
the possibility of child abuse and neglect;
(iv) the provision of appropriate follow-up
services to parents of a child described in
subparagraph (B) after the child has left the
hospital; and
(v) where necessary, assistance in
coordination of community services available to
parents of children described in subparagraph
(B).
The grantee shall assure that parental involvement
described in this subparagraph is voluntary.
(D) For purposes of this paragraph, a qualified
grantee is an acute care hospital that--
(i) is in a combination with--
(I) a health-care provider
organization;
(II) a child welfare organization;
(III) a disability organization; and
(IV) a State child protection agency;
(ii) submits an application for a grant under
this paragraph that is approved by the
Secretary;
(iii) maintains an office in the hospital
involved for purposes of providing services
under such grant;
(iv) provides assurances to the Secretary
that in the conduct of the project the
confidentiality of medical, social, and
personal information concerning any person
described in subparagraph (A) or (B) shall be
maintained, and shall be disclosed only to
qualified persons providing required services
described in subparagraph (C) for purposes
relating to conduct of the project; and
(v) assumes legal responsibility for carrying
out the terms and conditions of the grant.
(E) In awarding grants under this paragraph, the
Secretary shall--
(i) give priority under this section for two
grants under this paragraph, provided that one
grant shall be made to provide services in an
urban setting and one grant shall be made to
provide services in rural setting; and
(ii) encourage qualified grantees to combine
the amounts received under the grant with other
funds available to such grantees.
(5) Such other innovative programs and projects that
show promise of preventing and treating cases of child
abuse and neglect as the Secretary may approve.
(c) Evaluation.--In making grants for projects under this
section, the Secretary shall require all such projects to be
evaluated for their effectiveness. Funding for such evaluations
shall be provided either as a stated percentage of a
demonstration grant or as a separate grant or contract entered
into by the Secretary for the purpose of evaluating a
particular demonstration project or group of projects. In the
case of an evaluation performed by the recipient of a grant,
the Secretary shall make available technical assistance for the
evaluation, where needed, including the use of a rigorous
application of scientific evaluation techniques.
* * * * * * *
----------
HIGHER EDUCATION ACT OF 1965
* * * * * * *
TITLE III--INSTITUTIONAL AID
* * * * * * *
PART D--HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING
* * * * * * *
SEC. 344. LIMITATIONS ON FEDERAL INSURANCE FOR BONDS ISSUED BY THE
DESIGNATED BONDING AUTHORITY.
(a) Limit on Amount.--At no time shall the aggregate
principal amount of outstanding bonds insured under this part
together with any accrued unpaid interest thereon exceed
$1,100,000,000, of which--
(1) not more than $733,333,333 shall be used for
loans to eligible institutions that are private
historically Black colleges and universities; and
(2) not more than $366,666,667 shall be used for
loans to eligible institutions which are historically
Black public colleges and universities.
For purposes of paragraphs (1) and (2), Lincoln University of
Pennsylvania is an historically Black public institution. [No
institution of higher education that has received assistance
under section 8 of the Act of March 2, 1867 (20 U.S.C. 123)
shall be eligible to receive assistance under this part.]
(b) Limitation on Credit Authority.--The authority of the
Secretary to issue letters of credit and insurance under this
part is effective only to the extent provided in advance by
appropriations Acts.
(c) Religious Activity Prohibition.--No loan may be made
under this part for any educational program, activity or
service related to sectarian instruction or religious worship
or provided by a school or department of divinity or to an
institution in which a substantial portion of its functions is
subsumed in a religious mission.
(d) Discrimination Prohibition.--No loan may be made to an
institution under this part if the institution discriminates on
account of race, color, religion, national origin, sex (to the
extent provided in title IX of the Education Amendments of
1972), or disabling condition; except that the prohibition with
respect to religion shall not apply to an institution which is
controlled by or which is closely identified with the tenets of
a particular religious organization if the application of this
section would not be consistent with the religious tenets of
such organization.
* * * * * * *
TITLE IV--STUDENT ASSISTANCE
* * * * * * *
Part G--General Provisions Relating to Student Assistance Programs
* * * * * * *
SEC. 484. STUDENT ELIGIBILITY.
(a) In General.--In order to receive any grant, loan, or work
assistance under this title, a student must--
(1) be enrolled or accepted for enrollment in a
degree, certificate, or other program (including a
program of study abroad approved for credit by the
eligible institution at which such student is enrolled)
leading to a recognized educational credential at an
institution of higher education that is an eligible
institution in accordance with the provisions of
section 487, except as provided in subsections (b)(3)
and (b)(4), and not be enrolled in an elementary or
secondary school;
(2) if the student is presently enrolled at an
institution, be maintaining satisfactory progress in
the course of study the student is pursuing in
accordance with the provisions of subsection (c);
(3) not owe a refund on grants previously received at
any institution under this title, or be in default on
any loan from a student loan fund at any institution
provided for in part E, or a loan made, insured, or
guaranteed by the Secretary under this title for
attendance at any institution;
(4) file with the Secretary, as part of the original
financial aid application process, a certification,
which need not be notarized, but which shall include--
(A) a statement of educational purpose
stating that the money attributable to such
grant, loan, or loan guarantee will be used
solely for expenses related to attendance or
continued attendance at such institution; and
(B) such student's social security number;
(5) be a citizen or national of the United States, a
permanent resident of the United States, or a DACA
recipient (as defined in subsection (u)), have
temporary protected status under section 244 of the
Immigration and Nationality Act (8 U.S.C. 1254a), have
or able be to provide evidence from the Immigration and
Naturalization Service that he or she is in the United
States for other than a temporary purpose with the
intention of becoming a citizen or permanent resident;
and
(6) if the student has been convicted of, or has pled
nolo contendere or guilty to, a crime involving fraud
in obtaining funds under this title, have completed the
repayment of such funds to the Secretary, or to the
holder in the case of a loan under this title obtained
by fraud.
(b) Eligibility for Student Loans.--(1) In order to be
eligible to receive any loan under this title (other than a
loan under section 428B or 428C, or under section 428H pursuant
to an exercise of discretion under section 479A) for any period
of enrollment, a student who is not a graduate or professional
student (as defined in regulations of the Secretary), and who
is enrolled in a program at an institution which has a
participation agreement with the Secretary to make awards under
subpart 1 of part A of this title, shall--
(A)(i) have received a determination of eligibility
or ineligibility for a Pell Grant under such subpart 1
for such period of enrollment; and (ii) if determined
to be eligible, have filed an application for a Pell
Grant for such enrollment period; or
(B) have (A) filed an application with the Pell Grant
processor for such institution for such enrollment
period, and (B) received from the financial aid
administrator of the institution a preliminary
determination of the student's eligibility or
ineligibility for a grant under such subpart 1.
(2) In order to be eligible to receive any loan under section
428A for any period of enrollment, a student shall--
(A) have received a determination of need for a loan
under section 428(a)(2)(B) of this title;
(B) if determined to have need for a loan under
section 428, have applied for such a loan; and
(C) has applied for a loan under section 428H, if
such student is eligible to apply for such a loan.
(3) A student who--
(A) is carrying at least one-half the normal full-
time work load for the course of study that the student
is pursuing, as determined by an eligible institution,
and
(B) is enrolled in a course of study necessary for
enrollment in a program leading to a degree or
certificate,
shall be, notwithstanding paragraph (1) of subsection (a),
eligible to apply for loans under part B or D of this title.
The eligibility described in this paragraph shall be restricted
to one 12-month period.
(4) A student who--
(A) is carrying at least one-half the normal full-
time work load for the course of study the student is
pursuing, as determined by the institution, and
(B) is enrolled or accepted for enrollment in a
program at an eligible institution necessary for a
professional credential or certification from a State
that is required for employment as a teacher in an
elementary or secondary school in that State,
shall be, notwithstanding paragraph (1) of subsection (a),
eligible to apply for loans under part B, D, or E or work-study
assistance under part C of this title.
(5) Notwithstanding any other provision of this subsection,
no incarcerated student is eligible to receive a loan under
this title.
(c) Satisfactory Progress.--(1) For the purpose of subsection
(a)(2), a student is maintaining satisfactory progress if--
(A) the institution at which the student is in
attendance, reviews the progress of the student at the
end of each academic year, or its equivalent, as
determined by the institution, and
(B) the student has a cumulative C average, or its
equivalent or academic standing consistent with the
requirements for graduation, as determined by the
institution, at the end of the second such academic
year.
(2) Whenever a student fails to meet the eligibility
requirements of subsection (a)(2) as a result of the
application of this subsection and subsequent to that failure
the student has academic standing consistent with the
requirements for graduation, as determined by the institution,
for any grading period, the student may, subject to this
subsection, again be eligible under subsection (a)(2) for a
grant, loan, or work assistance under this title.
(3) Any institution of higher education at which the student
is in attendance may waive the provisions of paragraph (1) or
paragraph (2) of this subsection for undue hardship based on--
(A) the death of a relative of the student,
(B) the personal injury or illness of the student, or
(C) special circumstances as determined by the
institution.
(d) Students Who Are Not High School Graduates.--
(1) Student eligibility.--In order for a student who
does not have a certificate of graduation from a school
providing secondary education, or the recognized
equivalent of such certificate, to be eligible for any
assistance under subparts 1, 3, and 4 of part A and
parts B, C, D, and E of this title, the student shall
meet the requirements of one of the following
subparagraphs:
(A) The student is enrolled in an eligible
career pathway program and meets one of the
following standards:
(i) The student shall take an
independently administered examination
and shall achieve a score, specified by
the Secretary, demonstrating that such
student can benefit from the education
or training being offered. Such
examination shall be approved by the
Secretary on the basis of compliance
with such standards for development,
administration, and scoring as the
Secretary may prescribe in regulations.
(ii) The student shall be determined
as having the ability to benefit from
the education or training in accordance
with such process as the State shall
prescribe. Any such process described
or approved by a State for the purposes
of this section shall be effective 6
months after the date of submission to
the Secretary unless the Secretary
disapproves such process. In
determining whether to approve or
disapprove such process, the Secretary
shall take into account the
effectiveness of such process in
enabling students without secondary
school diplomas or the equivalent
thereof to benefit from the instruction
offered by institutions utilizing such
process, and shall also take into
account the cultural diversity,
economic circumstances, and educational
preparation of the populations served
by the institutions.
(iii) The student shall be determined
by the institution of higher education
as having the ability to benefit from
the education or training offered by
the institution of higher education
upon satisfactory completion of 6
credit hours or the equivalent
coursework that are applicable toward a
degree or certificate offered by the
institution of higher education.
(B) The student has completed a secondary
school education in a home school setting that
is treated as a home school or private school
under State law.
(2) Eligible career pathway program.--In this
subsection, the term ``eligible career pathway
program'' means a program that combines rigorous and
high-quality education, training, and other services
that--
(A) aligns with the skill needs of industries
in the economy of the State or regional economy
involved;
(B) prepares an individual to be successful
in any of a full range of secondary or
postsecondary education options, including
apprenticeships registered under the Act of
August 16, 1937 (commonly known as the
``National Apprenticeship Act''; 50 Stat. 664,
chapter 663; 29 U.S.C. 50 et seq.) (referred to
individually in this Act as an
``apprenticeship'', except in section 171);
(C) includes counseling to support an
individual in achieving the individual's
education and career goals;
(D) includes, as appropriate, education
offered concurrently with and in the same
context as workforce preparation activities and
training for a specific occupation or
occupational cluster;
(E) organizes education, training, and other
services to meet the particular needs of an
individual in a manner that accelerates the
educational and career advancement of the
individual to the extent practicable;
(F) enables an individual to attain a
secondary school diploma or its recognized
equivalent, and at least 1 recognized
postsecondary credential; and
(G) helps an individual enter or advance
within a specific occupation or occupational
cluster.
(e) Certification for GSL Eligibility.--Each eligible
institution may certify student eligibility for a loan by an
eligible lender under part B of this title prior to completing
the review for accuracy of the information submitted by the
applicant required by regulations issued under this title, if--
(1) checks for the loans are mailed to the eligible
institution prior to disbursements;
(2) the disbursement is not made until the review is
complete; and
(3) the eligible institution has no evidence or
documentation on which the institution may base a
determination that the information submitted by the
applicant is incorrect.
(f) Loss of Eligibility for Violation of Loan Limits.--(1) No
student shall be eligible to receive any grant, loan, or work
assistance under this title if the eligible institution
determines that the student fraudulently borrowed in violation
of the annual loan limits under part B, part D, or part E of
this title in the same academic year, or if the student
fraudulently borrowed in excess of the aggregate maximum loan
limits under such part B, part D, or part E.
(2) If the institution determines that the student
inadvertently borrowed amounts in excess of such annual or
aggregate maximum loan limits, such institution shall allow the
student to repay any amount borrowed in excess of such limits
prior to certifying the student's eligibility for further
assistance under this title.
(g) Verification of Immigration Status.--
(1) In general.--The Secretary shall implement a
system under which the statements and supporting
documentation, if required, of an individual declaring
that such individual is in compliance with the
requirements of subsection (a)(5) shall be verified
prior to the individual's receipt of a grant, loan, or
work assistance under this title.
(2) Special rule.--The documents collected and
maintained by an eligible institution in the admission
of a student to the institution may be used by the
student in lieu of the documents used to establish both
employment authorization and identity under section
274A(b)(1)(B) of the Immigration and Nationality Act (8
U.S.C. 1324a) to verify eligibility to participate in
work-study programs under part C of this title.
(3) Verification mechanisms.--The Secretary is
authorized to verify such statements and supporting
documentation through a data match, using an automated
or other system, with other Federal agencies that may
be in possession of information relevant to such
statements and supporting documentation.
(4) Review.--In the case of such an individual who is
not a citizen or national of the United States, if the
statement described in paragraph (1) is submitted but
the documentation required under paragraph (2) is not
presented or if the documentation required under
paragraph (2)(A) is presented but such documentation is
not verified under paragraph (3)--
(A) the institution--
(i) shall provide a reasonable
opportunity to submit to the
institution evidence indicating a
satisfactory immigration status, and
(ii) may not delay, deny, reduce, or
terminate the individual's eligibility
for the grant, loan, or work assistance
on the basis of the individual's
immigration status until such a
reasonable opportunity has been
provided; and
(B) if there are submitted documents which
the institution determines constitute
reasonable evidence indicating such status--
(i) the institution shall transmit to
the Immigration and Naturalization
Service either photostatic or other
similar copies of such documents, or
information from such documents, as
specified by the Immigration and
Naturalization Service, for official
verification,
(ii) pending such verification, the
institution may not delay, deny,
reduce, or terminate the individual's
eligibility for the grant, loan, or
work assistance on the basis of the
individual's immigration status, and
(iii) the institution shall not be
liable for the consequences of any
action, delay, or failure of the
Service to conduct such verification.
(h) Limitations of Enforcement Actions Against
Institutions.--The Secretary shall not take any compliance,
disallowance, penalty, or other regulatory action against an
institution of higher education with respect to any error in
the institution's determination to make a student eligible for
a grant, loan, or work assistance based on citizenship or
immigration status--
(1) if the institution has provided such eligibility
based on a verification of satisfactory immigration
status by the Immigration and Naturalization Service,
(2) because the institution, under subsection
(g)(4)(A)(i), was required to provide a reasonable
opportunity to submit documentation, or
(3) because the institution, under subsection
(g)(4)(B)(i), was required to wait for the response of
the Immigration and Naturalization Service to the
institution's request for official verification of the
immigration status of the student.
(i) Validity of Loan Guarantees for Loan Payments Made Before
Immigration Status Verification Completed.--Notwithstanding
subsection (h), if--
(1) a guaranty is made under this title for a loan
made with respect to an individual,
(2) at the time the guaranty is entered into, the
provisions of subsection (h) had been complied with,
(3) amounts are paid under the loan subject to such
guaranty, and
(4) there is a subsequent determination that, because
of an unsatisfactory immigration status, the individual
is not eligible for the loan,
the official of the institution making the determination shall
notify and instruct the entity making the loan to cease further
payments under the loan, but such guaranty shall not be voided
or otherwise nullified with respect to such payments made
before the date the entity receives the notice.
(k) Special Rule for Correspondence Courses.--A student shall
not be eligible to receive grant, loan, or work assistance
under this title for a correspondence course unless such course
is part of a program leading to an associate, bachelor or
graduate degree.
(l) Courses Offered Through Distance Education.--
(1) Relation to correspondence courses.--
(A) In general.--A student enrolled in a
course of instruction at an institution of
higher education that is offered principally
through distance education and leads to a
recognized certificate, or recognized
associate, recognized baccalaureate, or
recognized graduate degree, conferred by such
institution, shall not be considered to be
enrolled in correspondence courses.
(B) Exception.--An institution of higher
education referred to in subparagraph (A) shall
not include an institution or school described
in section 3(3)(C) of the Carl D. Perkins
Career and Technical Education Act of 2006.
(2) Reductions of financial aid.--A student's
eligibility to receive grants, loans, or work
assistance under this title shall be reduced if a
financial aid officer determines under the
discretionary authority provided in section 479A that
distance education results in a substantially reduced
cost of attendance to such student.
(3) Special rule.--For award years beginning prior to
July 1, 2008, the Secretary shall not take any
compliance, disallowance, penalty, or other action
based on a violation of this subsection against a
student or an eligible institution when such action
arises out of such institution's prior award of student
assistance under this title if the institution
demonstrates to the satisfaction of the Secretary that
its course of instruction would have been in
conformance with the requirements of this subsection.
(m) Students With a First Baccalaureate or Professional
Degree.--A student shall not be ineligible for assistance under
parts B, C, D, and E of this title because such student has
previously received a baccalaureate or professional degree.
(n) Data Base Matching.--To enforce the Selective Service
registration provisions of section 12(f) of the Military
Selective Service Act (50 U.S.C. App. 462(f)), the Secretary
shall conduct data base matches with the Selective Service,
using common demographic data elements. Appropriate
confirmation, through an application output document or through
other means, of any person's registration shall fulfill the
requirement to file a separate statement of compliance. In the
absence of a confirmation from such data matches, an
institution may also use data or documents that support either
the student's registration, or the absence of a registration
requirement for the student, to fulfill the requirement to file
a separate statement of compliance. The mechanism for reporting
the resolution of nonconfirmed matches shall be prescribed by
the Secretary in regulations.
(o) Study Abroad.--Nothing in this Act shall be construed to
limit or otherwise prohibit access to study abroad programs
approved by the home institution at which a student is
enrolled. An otherwise eligible student who is engaged in a
program of study abroad approved for academic credit by the
home institution at which the student is enrolled shall be
eligible to receive grant, loan, or work assistance under this
title, without regard to whether such study abroad program is
required as part of the student's degree program.
(p) Verification of Social Security Number.--The Secretary
of Education, in cooperation with the Commissioner of the
Social Security Administration, shall verify any social
security number provided by a student to an eligible
institution under subsection (a)(4) and shall enforce the
following conditions:
(1) Except as provided in paragraphs (2) and (3), an
institution shall not deny, reduce, delay, or terminate
a student's eligibility for assistance under this part
because social security number verification is pending.
(2) If there is a determination by the Secretary that
the social security number provided to an eligible
institution by a student is incorrect, the institution
shall deny or terminate the student's eligibility for
any grant, loan, or work assistance under this title
until such time as the student provides documented
evidence of a social security number that is determined
by the institution to be correct.
(3) If there is a determination by the Secretary that
the social security number provided to an eligible
institution by a student is incorrect, and a correct
social security number cannot be provided by such
student, and a loan has been guaranteed for such
student under part B of this title, the institution
shall notify and instruct the lender and guaranty
agency making and guaranteeing the loan, respectively,
to cease further disbursements of the loan, but such
guaranty shall not be voided or otherwise nullified
with respect to such disbursements made before the date
that the lender and the guaranty agency receives such
notice.
(4) Nothing in this subsection shall permit the
Secretary to take any compliance, disallowance,
penalty, or other regulatory action against--
(A) any institution of higher education with
respect to any error in a social security
number, unless such error was a result of fraud
on the part of the institution; or
(B) any student with respect to any error in
a social security number, unless such error was
a result of fraud on the part of the student.
(r) Suspension of Eligibility for Drug-Related Offenses.--
(1) In general.--A student who is convicted of any
offense under any Federal or State law involving the
possession or sale of a controlled substance for
conduct that occurred during a period of enrollment for
which the student was receiving any grant, loan, or
work assistance under this title shall not be eligible
to receive any grant, loan, or work assistance under
this title from the date of that conviction for the
period of time specified in the following table:
**ERR02If convicted of an offense involving:
The possession of con-
trolled substance: Ineligibility period is:
First offense..... 1 year ...........................................
Second offense.... 2 years ..........................................
Third offense..... Indefinite. .......................................
The sale of a cont olled
substance: Ineligibility period is:
First offense..... 2 years ..........................................
Second offense.... Indefinite.........................................
(2) Rehabilitation.--A student whose eligibility has
been suspended under paragraph (1) may resume
eligibility before the end of the ineligibility period
determined under such paragraph if--
(A) the student satisfactorily completes a
drug rehabilitation program that--
(i) complies with such criteria as
the Secretary shall prescribe in
regulations for purposes of this
paragraph; and
(ii) includes two unannounced drug
tests;
(B) the student successfully passes two
unannounced drug tests conducted by a drug
rehabilitation program that complies with such
criteria as the Secretary shall prescribe in
regulations for purposes of subparagraph
(A)(i); or
(C) the conviction is reversed, set aside, or
otherwise rendered nugatory.
(3) Definitions.--In this subsection, the term
``controlled substance'' has the meaning given the term
in section 102(6) of the Controlled Substances Act (21
U.S.C. 802(6)).
(s) Students With Intellectual Disabilities.--
(1) Definitions.--In this subsection the terms
``comprehensive transition and postsecondary program
for students with intellectual disabilities'' and
``student with an intellectual disability'' have the
meanings given the terms in section 760.
(2) Requirements.--Notwithstanding subsections (a),
(c), and (d), in order to receive any grant or work
assistance under section 401, subpart 3 of part A, or
part C, a student with an intellectual disability
shall--
(A) be enrolled or accepted for enrollment in
a comprehensive transition and postsecondary
program for students with intellectual
disabilities at an institution of higher
education;
(B) be maintaining satisfactory progress in
the program as determined by the institution,
in accordance with standards established by the
institution; and
(C) meet the requirements of paragraphs (3),
(4), (5), and (6) of subsection (a).
(3) Authority.--Notwithstanding any other provision
of law unless such provision is enacted with specific
reference to this section, the Secretary is authorized
to waive any statutory provision applicable to the
student financial assistance programs under section
401, subpart 3 of part A, or part C (other than a
provision of part F related to such a program), or any
institutional eligibility provisions of this title, as
the Secretary determines necessary to ensure that
programs enrolling students with intellectual
disabilities otherwise determined to be eligible under
this subsection may receive such financial assistance.
(4) Regulations.--Notwithstanding regulations
applicable to grant or work assistance awards made
under section 401, subpart 3 of part A, and part C
(other than a regulation under part F related to such
an award), including with respect to eligible programs,
instructional time, credit status, and enrollment
status as described in section 481, the Secretary shall
promulgate regulations allowing programs enrolling
students with intellectual disabilities otherwise
determined to be eligible under this subsection to
receive such awards.
(t) Data Analysis on Access to Federal Student Aid For
Certain Populations.--
(1) Development of the system.--Within one year of
enactment of the Higher Education Opportunity Act, the
Secretary shall analyze data from the FAFSA containing
information regarding the number, characteristics, and
circumstances of students denied Federal student aid
based on a drug conviction while receiving Federal aid.
(2) Results from analysis.--The results from the
analysis of such information shall be made available on
a continuous basis via the Department website and the
Digest of Education Statistics.
(3) Data updating.--The data analyzed under this
subsection shall be updated at the beginning of each
award year and at least one additional time during such
award year.
(4) Report to congress.--The Secretary shall prepare
and submit to the authorizing committees, in each
fiscal year, a report describing the results obtained
by the establishment and operation of the data system
authorized by this subsection.
(u) DACA Recipient.--In this section the term
``DACA recipient'' means an alien (as defined
in section 101(a)(3) of the Immigration and
Nationality Act (8 U.S.C. 1101(a)(3)) who is
inadmissible to the United State or deportable
from the United States under the immigration
laws (as defined in section 101(a)(17) of such
Act (8 U.S.C. 1101(a)(17)), and who the
Secretary of Homeland Security has, in his or
her discretion, determined should be afforded a
grant of deferred action under the Deferred
Action for Childhood Arrivals (DACA) policy.
* * * * * * *
SEC. 487. PROGRAM PARTICIPATION AGREEMENTS.
(a) Required for Programs of Assistance; Contents.--In order
to be an eligible institution for the purposes of any program
authorized under this title, an institution must be an
institution of higher education or an eligible institution (as
that term is defined for the purpose of that program) and
shall, except with respect to a program under subpart 4 of part
A, enter into a program participation agreement with the
Secretary. The agreement shall condition the initial and
continuing eligibility of an institution to participate in a
program upon compliance with the following requirements:
(1) The institution will use funds received by it for
any program under this title and any interest or other
earnings thereon solely for the purpose specified in
and in accordance with the provision of that program.
(2) The institution shall not charge any student a
fee for processing or handling any application, form,
or data required to determine the student's eligibility
for assistance under this title or the amount of such
assistance.
(3) The institution will establish and maintain such
administrative and fiscal procedures and records as may
be necessary to ensure proper and efficient
administration of funds received from the Secretary or
from students under this title, together with
assurances that the institution will provide, upon
request and in a timely fashion, information relating
to the administrative capability and financial
responsibility of the institution to--
(A) the Secretary;
(B) the appropriate guaranty agency; and
(C) the appropriate accrediting agency or
association.
(4) The institution will comply with the provisions
of subsection (c) of this section and the regulations
prescribed under that subsection, relating to fiscal
eligibility.
(5) The institution will submit reports to the
Secretary and, in the case of an institution
participating in a program under part B or part E, to
holders of loans made to the institution's students
under such parts at such times and containing such
information as the Secretary may reasonably require to
carry out the purpose of this title.
(6) The institution will not provide any student with
any statement or certification to any lender under part
B that qualifies the student for a loan or loans in
excess of the amount that student is eligible to borrow
in accordance with sections 425(a), 428(a)(2), and
428(b)(1) (A) and (B).
(7) The institution will comply with the requirements
of section 485.
(8) In the case of an institution that advertises job
placement rates as a means of attracting students to
enroll in the institution, the institution will make
available to prospective students, at or before the
time of application (A) the most recent available data
concerning employment statistics, graduation
statistics, and any other information necessary to
substantiate the truthfulness of the advertisements,
and (B) relevant State licensing requirements of the
State in which such institution is located for any job
for which the course of instruction is designed to
prepare such prospective students.
(9) In the case of an institution participating in a
program under part B or D, the institution will inform
all eligible borrowers enrolled in the institution
about the availability and eligibility of such
borrowers for State grant assistance from the State in
which the institution is located, and will inform such
borrowers from another State of the source for further
information concerning such assistance from that State.
(10) The institution certifies that it has in
operation a drug abuse prevention program that is
determined by the institution to be accessible to any
officer, employee, or student at the institution.
(11) In the case of any institution whose students
receive financial assistance pursuant to section
484(d), the institution will make available to such
students a program proven successful in assisting
students in obtaining a certificate of high school
equivalency.
(12) The institution certifies that--
(A) the institution has established a campus
security policy; and
(B) the institution has complied with the
disclosure requirements of section 485(f).
(13) The institution will not deny any form of
Federal financial aid to any student who meets the
eligibility requirements of this title on the grounds
that the student is participating in a program of study
abroad approved for credit by the institution.
(14)(A) The institution, in order to participate as
an eligible institution under part B or D, will develop
a Default Management Plan for approval by the Secretary
as part of its initial application for certification as
an eligible institution and will implement such Plan
for two years thereafter.
(B) Any institution of higher education which changes
ownership and any eligible institution which changes
its status as a parent or subordinate institution
shall, in order to participate as an eligible
institution under part B or D, develop a Default
Management Plan for approval by the Secretary and
implement such Plan for two years after its change of
ownership or status.
(C) This paragraph shall not apply in the case of an
institution in which (i) neither the parent nor the
subordinate institution has a cohort default rate in
excess of 10 percent, and (ii) the new owner of such
parent or subordinate institution does not, and has
not, owned any other institution with a cohort default
rate in excess of 10 percent.
(15) The institution acknowledges the authority of
the Secretary, guaranty agencies, lenders, accrediting
agencies, the Secretary of Veterans Affairs, and the
State agencies under subpart 1 of part H to share with
each other any information pertaining to the
institution's eligibility to participate in programs
under this title or any information on fraud and abuse.
(16)(A) The institution will not knowingly employ an
individual in a capacity that involves the
administration of programs under this title, or the
receipt of program funds under this title, who has been
convicted of, or has pled nolo contendere or guilty to,
a crime involving the acquisition, use, or expenditure
of funds under this title, or has been judicially
determined to have committed fraud involving funds
under this title or contract with an institution or
third party servicer that has been terminated under
section 432 involving the acquisition, use, or
expenditure of funds under this title, or who has been
judicially determined to have committed fraud involving
funds under this title.
(B) The institution will not knowingly contract with
or employ any individual, agency, or organization that
has been, or whose officers or employees have been--
(i) convicted of, or pled nolo contendere or
guilty to, a crime involving the acquisition,
use, or expenditure of funds under this title;
or
(ii) judicially determined to have committed
fraud involving funds under this title.
(17) The institution will complete surveys conducted
as a part of the Integrated Postsecondary Education
Data System (IPEDS) or any other Federal postsecondary
institution data collection effort, as designated by
the Secretary, in a timely manner and to the
satisfaction of the Secretary.
(18) The institution will meet the requirements
established pursuant to section 485(g).
(19) The institution will not impose any penalty,
including the assessment of late fees, the denial of
access to classes, libraries, or other institutional
facilities, or the requirement that the student borrow
additional funds, on any student because of the
student's inability to meet his or her financial
obligations to the institution as a result of the
delayed disbursement of the proceeds of a loan made
under this title due to compliance with the provisions
of this title, or delays attributable to the
institution.
(20) The institution will not provide any commission,
bonus, or other incentive payment based directly or
indirectly on success in securing enrollments or
financial aid to any persons or entities engaged in any
student recruiting or admission activities or in making
decisions regarding the award of student financial
assistance, except that this paragraph shall not apply
to the recruitment of foreign students residing in
foreign countries who are not eligible to receive
Federal student assistance.
(21) The institution will meet the requirements
established by the Secretary and accrediting agencies
or associations, and will provide evidence to the
Secretary that the institution has the authority to
operate within a State.
(22) The institution will comply with the refund
policy established pursuant to section 484B.
(23)(A) The institution, if located in a State to
which section 4(b) of the National Voter Registration
Act of 1993 (42 U.S.C. 1973gg-2(b)) does not apply,
will make a good faith effort to distribute a mail
voter registration form, requested and received from
the State, to each student enrolled in a degree or
certificate program and physically in attendance at the
institution, and to make such forms widely available to
students at the institution.
(B) The institution shall request the forms from the
State 120 days prior to the deadline for registering to
vote within the State. If an institution has not
received a sufficient quantity of forms to fulfill this
section from the State within 60 days prior to the
deadline for registering to vote in the State, the
institution shall not be held liable for not meeting
the requirements of this section during that election
year.
(C) This paragraph shall apply to general and special
elections for Federal office, as defined in section
301(3) of the Federal Election Campaign Act of 1971 (2
U.S.C. 431(3)), and to the elections for Governor or
other chief executive within such State).
(D) The institution shall be considered in
compliance with the requirements of
subparagraph (A) for each student to whom the
institution electronically transmits a message
containing a voter registration form acceptable
for use in the State in which the institution
is located, or an Internet address where such a
form can be downloaded, if such information is
in an electronic message devoted exclusively to
voter registration.
(24) In the case of a proprietary institution of
higher education (as defined in section 102(b)), such
institution will derive not less than [ten percent]
fifteen percent of such institution's revenues from
sources other than Federal funds that are disbursed or
delivered to or on behalf of a student to be used to
attend such institution (referred to in this paragraph
and subsection (d) as ``Federal education assistance
funds''), as calculated in accordance with subsection
(d)(1), or will be subject to the sanctions described
in subsection (d)(2).
(25) In the case of an institution that participates
in a loan program under this title, the institution
will--
(A) develop a code of conduct with respect to
such loans with which the institution's
officers, employees, and agents shall comply,
that--
(i) prohibits a conflict of interest
with the responsibilities of an
officer, employee, or agent of an
institution with respect to such loans;
and
(ii) at a minimum, includes the
provisions described in subsection (e);
(B) publish such code of conduct prominently
on the institution's website; and
(C) administer and enforce such code by, at a
minimum, requiring that all of the
institution's officers, employees, and agents
with responsibilities with respect to such
loans be annually informed of the provisions of
the code of conduct.
(26) The institution will, upon written request,
disclose to the alleged victim of any crime of violence
(as that term is defined in section 16 of title 18,
United States Code), or a nonforcible sex offense, the
report on the results of any disciplinary proceeding
conducted by such institution against a student who is
the alleged perpetrator of such crime or offense with
respect to such crime or offense. If the alleged victim
of such crime or offense is deceased as a result of
such crime or offense, the next of kin of such victim
shall be treated as the alleged victim for purposes of
this paragraph.
(27) In the case of an institution that has entered
into a preferred lender arrangement, the institution
will at least annually compile, maintain, and make
available for students attending the institution, and
the families of such students, a list, in print or
other medium, of the specific lenders for loans made,
insured, or guaranteed under this title or private
education loans that the institution recommends,
promotes, or endorses in accordance with such preferred
lender arrangement. In making such list, the
institution shall comply with the requirements of
subsection (h).
(28)(A) The institution will, upon the request of an
applicant for a private education loan, provide to the
applicant the form required under section 128(e)(3) of
the Truth in Lending Act (15 U.S.C. 1638(e)(3)), and
the information required to complete such form, to the
extent the institution possesses such information.
(B) For purposes of this paragraph, the term
``private education loan'' has the meaning given such
term in section 140 of the Truth in Lending Act.
(29) The institution certifies that the institution--
(A) has developed plans to effectively combat
the unauthorized distribution of copyrighted
material, including through the use of a
variety of technology-based deterrents; and
(B) will, to the extent practicable, offer
alternatives to illegal downloading or peer-to-
peer distribution of intellectual property, as
determined by the institution in consultation
with the chief technology officer or other
designated officer of the institution.
(b) Hearings.--(1) An institution that has received written
notice of a final audit or program review determination and
that desires to have such determination reviewed by the
Secretary shall submit to the Secretary a written request for
review not later than 45 days after receipt of notification of
the final audit or program review determination.
(2) The Secretary shall, upon receipt of written notice under
paragraph (1), arrange for a hearing and notify the institution
within 30 days of receipt of such notice the date, time, and
place of such hearing. Such hearing shall take place not later
than 120 days from the date upon which the Secretary notifies
the institution.
(c) Audits; Financial Responsibility; Enforcement of
Standards.--(1) Notwithstanding any other provisions of this
title, the Secretary shall prescribe such regulations as may be
necessary to provide for--
(A)(i) except as provided in clauses (ii) and (iii),
a financial audit of an eligible institution with
regard to the financial condition of the institution in
its entirety, and a compliance audit of such
institution with regard to any funds obtained by it
under this title or obtained from a student or a parent
who has a loan insured or guaranteed by the Secretary
under this title, on at least an annual basis and
covering the period since the most recent audit,
conducted by a qualified, independent organization or
person in accordance with standards established by the
Comptroller General for the audit of governmental
organizations, programs, and functions, and as
prescribed in regulations of the Secretary, the results
of which shall be submitted to the Secretary and shall
be available to cognizant guaranty agencies, eligible
lenders, State agencies, and the appropriate State
agency notifying the Secretary under subpart 1 of part
H, except that the Secretary may modify the
requirements of this clause with respect to
institutions of higher education that are foreign
institutions, and may waive such requirements with
respect to a foreign institution whose students receive
less than $500,000 in loans under this title during the
award year preceding the audit period;
(ii) with regard to an eligible institution which is
audited under chapter 75 of title 31, United States
Code, deeming such audit to satisfy the requirements of
clause (i) for the period covered by such audit; or
(iii) at the discretion of the Secretary, with regard
to an eligible institution (other than an eligible
institution described in section 102(a)(1)(C)) that has
obtained less than $200,000 in funds under this title
during each of the 2 award years that precede the audit
period and submits a letter of credit payable to the
Secretary equal to not less than \1/2\ of the annual
potential liabilities of such institution as determined
by the Secretary, deeming an audit conducted every 3
years to satisfy the requirements of clause (i), except
for the award year immediately preceding renewal of the
institution's eligibility under section 498(g);
(B) in matters not governed by specific program
provisions, the establishment of reasonable standards
of financial responsibility and appropriate
institutional capability for the administration by an
eligible institution of a program of student financial
aid under this title, including any matter the
Secretary deems necessary to the sound administration
of the financial aid programs, such as the pertinent
actions of any owner, shareholder, or person exercising
control over an eligible institution;
(C)(i) except as provided in clause (ii), a
compliance audit of a third party servicer (other than
with respect to the servicer's functions as a lender if
such functions are otherwise audited under this part
and such audits meet the requirements of this clause),
with regard to any contract with an eligible
institution, guaranty agency, or lender for
administering or servicing any aspect of the student
assistance programs under this title, at least once
every year and covering the period since the most
recent audit, conducted by a qualified, independent
organization or person in accordance with standards
established by the Comptroller General for the audit of
governmental organizations, programs, and functions,
and as prescribed in regulations of the Secretary, the
results of which shall be submitted to the Secretary;
or
(ii) with regard to a third party servicer that is
audited under chapter 75 of title 31, United States
Code, such audit shall be deemed to satisfy the
requirements of clause (i) for the period covered by
such audit;
(D)(i) a compliance audit of a secondary market with
regard to its transactions involving, and its servicing
and collection of, loans made under this title, at
least once a year and covering the period since the
most recent audit, conducted by a qualified,
independent organization or person in accordance with
standards established by the Comptroller General for
the audit of governmental organizations, programs, and
functions, and as prescribed in regulations of the
Secretary, the results of which shall be submitted to
the Secretary; or
(ii) with regard to a secondary market that is
audited under chapter 75 of title 31, United States
Code, such audit shall be deemed to satisfy the
requirements of clause (i) for the period covered by
the audit;
(E) the establishment, by each eligible institution
under part B responsible for furnishing to the lender
the statement required by section 428(a)(2)(A)(i), of
policies and procedures by which the latest known
address and enrollment status of any student who has
had a loan insured under this part and who has either
formally terminated his enrollment, or failed to re-
enroll on at least a half-time basis, at such
institution, shall be furnished either to the holder
(or if unknown, the insurer) of the note, not later
than 60 days after such termination or failure to re-
enroll;
(F) the limitation, suspension, or termination of the
participation in any program under this title of an
eligible institution, or the imposition of a civil
penalty under paragraph (3)(B) whenever the Secretary
has determined, after reasonable notice and opportunity
for hearing, that such institution has violated or
failed to carry out any provision of this title, any
regulation prescribed under this title, or any
applicable special arrangement, agreement, or
limitation, except that no period of suspension under
this section shall exceed 60 days unless the
institution and the Secretary agree to an extension or
unless limitation or termination proceedings are
initiated by the Secretary within that period of time;
(G) an emergency action against an institution, under
which the Secretary shall, effective on the date on
which a notice and statement of the basis of the action
is mailed to the institution (by registered mail,
return receipt requested), withhold funds from the
institution or its students and withdraw the
institution's authority to obligate funds under any
program under this title, if the Secretary--
(i) receives information, determined by the
Secretary to be reliable, that the institution
is violating any provision of this title, any
regulation prescribed under this title, or any
applicable special arrangement, agreement, or
limitation,
(ii) determines that immediate action is
necessary to prevent misuse of Federal funds,
and
(iii) determines that the likelihood of loss
outweighs the importance of the procedures
prescribed under subparagraph (D) for
limitation, suspension, or termination,
except that an emergency action shall not exceed 30
days unless limitation, suspension, or termination
proceedings are initiated by the Secretary against the
institution within that period of time, and except that
the Secretary shall provide the institution an
opportunity to show cause, if it so requests, that the
emergency action is unwarranted;
(H) the limitation, suspension, or termination of the
eligibility of a third party servicer to contract with
any institution to administer any aspect of an
institution's student assistance program under this
title, or the imposition of a civil penalty under
paragraph (3)(B), whenever the Secretary has
determined, after reasonable notice and opportunity for
a hearing, that such organization, acting on behalf of
an institution, has violated or failed to carry out any
provision of this title, any regulation prescribed
under this title, or any applicable special
arrangement, agreement, or limitation, except that no
period of suspension under this subparagraph shall
exceed 60 days unless the organization and the
Secretary agree to an extension, or unless limitation
or termination proceedings are initiated by the
Secretary against the individual or organization within
that period of time; and
(I) an emergency action against a third party
servicer that has contracted with an institution to
administer any aspect of the institution's student
assistance program under this title, under which the
Secretary shall, effective on the date on which a
notice and statement of the basis of the action is
mailed to such individual or organization (by
registered mail, return receipt requested), withhold
funds from the individual or organization and withdraw
the individual or organization's authority to act on
behalf of an institution under any program under this
title, if the Secretary--
(i) receives information, determined by the
Secretary to be reliable, that the individual
or organization, acting on behalf of an
institution, is violating any provision of this
title, any regulation prescribed under this
title, or any applicable special arrangement,
agreement, or limitation,
(ii) determines that immediate action is
necessary to prevent misuse of Federal funds,
and
(iii) determines that the likelihood of loss
outweighs the importance of the procedures
prescribed under subparagraph (F), for
limitation, suspension, or termination,
except that an emergency action shall not exceed 30
days unless the limitation, suspension, or termination
proceedings are initiated by the Secretary against the
individual or organization within that period of time,
and except that the Secretary shall provide the
individual or organization an opportunity to show
cause, if it so requests, that the emergency action is
unwarranted.
(2) If an individual who, or entity that, exercises
substantial control, as determined by the Secretary in
accordance with the definition of substantial control in
subpart 3 of part H, over one or more institutions
participating in any program under this title, or, for purposes
of paragraphs (1) (H) and (I), over one or more organizations
that contract with an institution to administer any aspect of
the institution's student assistance program under this title,
is determined to have committed one or more violations of the
requirements of any program under this title, or has been
suspended or debarred in accordance with the regulations of the
Secretary, the Secretary may use such determination,
suspension, or debarment as the basis for imposing an emergency
action on, or limiting, suspending, or terminating, in a single
proceeding, the participation of any or all institutions under
the substantial control of that individual or entity.
(3)(A) Upon determination, after reasonable notice and
opportunity for a hearing, that an eligible institution has
engaged in substantial misrepresentation of the nature of its
educational program, its financial charges, or the
employability of its graduates, the Secretary may suspend or
terminate the eligibility status for any or all programs under
this title of any otherwise eligible institution, in accordance
with procedures specified in paragraph (1)(D) of this
subsection, until the Secretary finds that such practices have
been corrected.
(B)(i) Upon determination, after reasonable notice and
opportunity for a hearing, that an eligible institution--
(I) has violated or failed to carry out any provision
of this title or any regulation prescribed under this
title; or
(II) has engaged in substantial misrepresentation of
the nature of its educational program, its financial
charges, and the employability of its graduates,
the Secretary may impose a civil penalty upon such institution
of not to exceed $25,000 for each violation or
misrepresentation.
(ii) Any civil penalty may be compromised by the Secretary.
In determining the amount of such penalty, or the amount agreed
upon in compromise, the appropriateness of the penalty to the
size of the institution of higher education subject to the
determination, and the gravity of the violation, failure, or
misrepresentation shall be considered. The amount of such
penalty, when finally determined, or the amount agreed upon in
compromise, may be deducted from any sums owing by the United
States to the institution charged.
(4) The Secretary shall publish a list of State agencies
which the Secretary determines to be reliable authority as to
the quality of public postsecondary vocational education in
their respective States for the purpose of determining
eligibility for all Federal student assistance programs.
(5) The Secretary shall make readily available to appropriate
guaranty agencies, eligible lenders, State agencies notifying
the Secretary under subpart 1 of part H, and accrediting
agencies or associations the results of the audits of eligible
institutions conducted pursuant to paragraph (1)(A).
(6) The Secretary is authorized to provide any information
collected as a result of audits conducted under this section,
together with audit information collected by guaranty agencies,
to any Federal or State agency having responsibilities with
respect to student financial assistance, including those
referred to in subsection (a)(15) of this section.
(7) Effective with respect to any audit conducted under this
subsection after December 31, 1988, if, in the course of
conducting any such audit, the personnel of the Department of
Education discover, or are informed of, grants or other
assistance provided by an institution in accordance with this
title for which the institution has not received funds
appropriated under this title (in the amount necessary to
provide such assistance), including funds for which
reimbursement was not requested prior to such discovery or
information, such institution shall be permitted to offset that
amount against any sums determined to be owed by the
institution pursuant to such audit, or to receive reimbursement
for that amount (if the institution does not owe any such
sums).
(d) Implementation of Non-Federal Revenue Requirement.--
(1) Calculation.--In making calculations under
subsection (a)(24), a proprietary institution of higher
education shall--
(A) use the cash basis of accounting, except
in the case of loans described in subparagraph
(D)(i) that are made by the proprietary
institution of higher education;
(B) consider as revenue only those funds
generated by the institution from--
(i) tuition, fees, and other
institutional charges for students
enrolled in programs eligible for
assistance under this title;
(ii) activities conducted by the
institution that are necessary for the
education and training of the
institution's students, if such
activities are--
(I) conducted on campus or at
a facility under the control of
the institution;
(II) performed under the
supervision of a member of the
institution's faculty; and
(III) required to be
performed by all students in a
specific educational program at
the institution; and
(iii) funds paid by a student, or on
behalf of a student by a party other
than the institution, for an education
or training program that is not
eligible for funds under this title, if
the program--
(I) is approved or licensed
by the appropriate State
agency;
(II) is accredited by an
accrediting agency recognized
by the Secretary; or
(III) provides an industry-
recognized credential or
certification;
(C) presume that any Federal education
assistance funds that are disbursed or
delivered to or on behalf of a student will be
used to pay the student's tuition, fees, or
other institutional charges, regardless of
whether the institution credits those funds to
the student's account or pays those funds
directly to the student, except to the extent
that the student's tuition, fees, or other
institutional charges are satisfied by--
(i) grant funds provided by non-
Federal public agencies or private
sources independent of the institution;
(ii) funds provided under a
contractual arrangement with a Federal,
State, or local government agency for
the purpose of providing job training
to low-income individuals who are in
need of that training;
(iii) funds used by a student from
savings plans for educational expenses
established by or on behalf of the
student and which qualify for special
tax treatment under the Internal
Revenue Code of 1986; or
(iv) institutional scholarships
described in subparagraph (D)(iii);
(D) include institutional aid as revenue to
the school only as follows:
(i) in the case of loans made by a
proprietary institution of higher
education on or after July 1, 2008 and
prior to July 1, 2012, the net present
value of such loans made by the
institution during the applicable
institutional fiscal year accounted for
on an accrual basis and estimated in
accordance with generally accepted
accounting principles and related
standards and guidance, if the loans--
(I) are bona fide as
evidenced by enforceable
promissory notes;
(II) are issued at intervals
related to the institution's
enrollment periods; and
(III) are subject to regular
loan repayments and
collections;
(ii) in the case of loans made by a
proprietary institution of higher
education on or after July 1, 2012,
only the amount of loan repayments
received during the applicable
institutional fiscal year, excluding
repayments on loans made and accounted
for as specified in clause (i); and
(iii) in the case of scholarships
provided by a proprietary institution
of higher education, only those
scholarships provided by the
institution in the form of monetary aid
or tuition discounts based upon the
academic achievements or financial need
of students, disbursed during each
fiscal year from an established
restricted account, and only to the
extent that funds in that account
represent designated funds from an
outside source or from income earned on
those funds;
(E) in the case of each student who receives
a loan on or after July 1, 2008, and prior to
July 1, 2011, that is authorized under section
428H or that is a Federal Direct Unsubsidized
Stafford Loan, treat as revenue received by the
institution from sources other than funds
received under this title, the amount by which
the disbursement of such loan received by the
institution exceeds the limit on such loan in
effect on the day before the date of enactment
of the Ensuring Continued Access to Student
Loans Act of 2008; and
(F) exclude from revenues--
(i) the amount of funds the
institution received under part C,
unless the institution used those funds
to pay a student's institutional
charges;
(ii) the amount of funds the
institution received under subpart 4 of
part A;
(iii) the amount of funds provided by
the institution as matching funds for a
program under this title;
(iv) the amount of funds provided by
the institution for a program under
this title that are required to be
refunded or returned; and
(v) the amount charged for books,
supplies, and equipment, unless the
institution includes that amount as
tuition, fees, or other institutional
charges.
(2) Sanctions.--
(A) Ineligibility.--A proprietary institution
of higher education that fails to meet a
requirement of subsection (a)(24) for two
consecutive institutional fiscal years shall be
ineligible to participate in the programs
authorized by this title for a period of not
less than two institutional fiscal years. To
regain eligibility to participate in the
programs authorized by this title, a
proprietary institution of higher education
shall demonstrate compliance with all
eligibility and certification requirements
under section 498 for a minimum of two
institutional fiscal years after the
institutional fiscal year in which the
institution became ineligible.
(B) Additional enforcement.--In addition to
such other means of enforcing the requirements
of this title as may be available to the
Secretary, if a proprietary institution of
higher education fails to meet a requirement of
subsection (a)(24) for any institutional fiscal
year, then the institution's eligibility to
participate in the programs authorized by this
title becomes provisional for the two
institutional fiscal years after the
institutional fiscal year in which the
institution failed to meet the requirement of
subsection (a)(24), except that such
provisional eligibility shall terminate--
(i) on the expiration date of the
institution's program participation
agreement under this subsection that is
in effect on the date the Secretary
determines that the institution failed
to meet the requirement of subsection
(a)(24); or
(ii) in the case that the Secretary
determines that the institution failed
to meet a requirement of subsection
(a)(24) for two consecutive
institutional fiscal years, on the date
the institution is determined
ineligible in accordance with
subparagraph (A).
(3) Publication on college navigator website.--The
Secretary shall publicly disclose on the College
Navigator website--
(A) the identity of any proprietary
institution of higher education that fails to
meet a requirement of subsection (a)(24); and
(B) the extent to which the institution
failed to meet such requirement.
(4) Report to congress.--Not later than July 1, 2009,
and July 1 of each succeeding year, the Secretary shall
submit to the authorizing committees a report that
contains, for each proprietary institution of higher
education that receives assistance under this title, as
provided in the audited financial statements submitted
to the Secretary by each institution pursuant to the
requirements of subsection (a)(24)--
(A) the amount and percentage of such
institution's revenues received from sources
under this title; and
(B) the amount and percentage of such
institution's revenues received from other
sources.
(e) Code of Conduct Requirements.--An institution of higher
education's code of conduct, as required under subsection
(a)(25), shall include the following requirements:
(1) Ban on revenue-sharing arrangements.--
(A) Prohibition.--The institution shall not
enter into any revenue-sharing arrangement with
any lender.
(B) Definition.--For purposes of this
paragraph, the term ``revenue-sharing
arrangement'' means an arrangement between an
institution and a lender under which--
(i) a lender provides or issues a
loan that is made, insured, or
guaranteed under this title to students
attending the institution or to the
families of such students; and
(ii) the institution recommends the
lender or the loan products of the
lender and in exchange, the lender pays
a fee or provides other material
benefits, including revenue or profit
sharing, to the institution, an officer
or employee of the institution, or an
agent.
(2) Gift ban.--
(A) Prohibition.--No officer or employee of
the institution who is employed in the
financial aid office of the institution or who
otherwise has responsibilities with respect to
education loans, or agent who has
responsibilities with respect to education
loans, shall solicit or accept any gift from a
lender, guarantor, or servicer of education
loans.
(B) Definition of gift.--
(i) In general.--In this paragraph,
the term ``gift'' means any gratuity,
favor, discount, entertainment,
hospitality, loan, or other item having
a monetary value of more than a de
minimus amount. The term includes a
gift of services, transportation,
lodging, or meals, whether provided in
kind, by purchase of a ticket, payment
in advance, or reimbursement after the
expense has been incurred.
(ii) Exceptions.--The term ``gift''
shall not include any of the following:
(I) Standard material,
activities, or programs on
issues related to a loan,
default aversion, default
prevention, or financial
literacy, such as a brochure, a
workshop, or training.
(II) Food, refreshments,
training, or informational
material furnished to an
officer or employee of an
institution, or to an agent, as
an integral part of a training
session that is designed to
improve the service of a
lender, guarantor, or servicer
of education loans to the
institution, if such training
contributes to the professional
development of the officer,
employee, or agent.
(III) Favorable terms,
conditions, and borrower
benefits on an education loan
provided to a student employed
by the institution if such
terms, conditions, or benefits
are comparable to those
provided to all students of the
institution.
(IV) Entrance and exit
counseling services provided to
borrowers to meet the
institution's responsibilities
for entrance and exit
counseling as required by
subsections (b) and (l) of
section 485, as long as--
(aa) the
institution's staff are
in control of the
counseling, (whether in
person or via
electronic
capabilities); and
(bb) such counseling
does not promote the
products or services of
any specific lender.
(V) Philanthropic
contributions to an institution
from a lender, servicer, or
guarantor of education loans
that are unrelated to education
loans or any contribution from
any lender, guarantor, or
servicer that is not made in
exchange for any advantage
related to education loans.
(VI) State education grants,
scholarships, or financial aid
funds administered by or on
behalf of a State.
(iii) Rule for gifts to family
members.--For purposes of this
paragraph, a gift to a family member of
an officer or employee of an
institution, to a family member of an
agent, or to any other individual based
on that individual's relationship with
the officer, employee, or agent, shall
be considered a gift to the officer,
employee, or agent if--
(I) the gift is given with
the knowledge and acquiescence
of the officer, employee, or
agent; and
(II) the officer, employee,
or agent has reason to believe
the gift was given because of
the official position of the
officer, employee, or agent.
(3) Contracting arrangements prohibited.--
(A) Prohibition.--An officer or employee who
is employed in the financial aid office of the
institution or who otherwise has
responsibilities with respect to education
loans, or an agent who has responsibilities
with respect to education loans, shall not
accept from any lender or affiliate of any
lender any fee, payment, or other financial
benefit (including the opportunity to purchase
stock) as compensation for any type of
consulting arrangement or other contract to
provide services to a lender or on behalf of a
lender relating to education loans.
(B) Exceptions.--Nothing in this subsection
shall be construed as prohibiting--
(i) an officer or employee of an
institution who is not employed in the
institution's financial aid office and
who does not otherwise have
responsibilities with respect to
education loans, or an agent who does
not have responsibilities with respect
to education loans, from performing
paid or unpaid service on a board of
directors of a lender, guarantor, or
servicer of education loans;
(ii) an officer or employee of the
institution who is not employed in the
institution's financial aid office but
who has responsibility with respect to
education loans as a result of a
position held at the institution, or an
agent who has responsibility with
respect to education loans, from
performing paid or unpaid service on a
board of directors of a lender,
guarantor, or servicer of education
loans, if the institution has a written
conflict of interest policy that
clearly sets forth that officers,
employees, or agents must recuse
themselves from participating in any
decision of the board regarding
education loans at the institution; or
(iii) an officer, employee, or
contractor of a lender, guarantor, or
servicer of education loans from
serving on a board of directors, or
serving as a trustee, of an
institution, if the institution has a
written conflict of interest policy
that the board member or trustee must
recuse themselves from any decision
regarding education loans at the
institution.
(4) Interaction with borrowers.--The institution
shall not--
(A) for any first-time borrower, assign,
through award packaging or other methods, the
borrower's loan to a particular lender; or
(B) refuse to certify, or delay certification
of, any loan based on the borrower's selection
of a particular lender or guaranty agency.
(5) Prohibition on offers of funds for private
loans.--
(A) Prohibition.--The institution shall not
request or accept from any lender any offer of
funds to be used for private education loans
(as defined in section 140 of the Truth in
Lending Act), including funds for an
opportunity pool loan, to students in exchange
for the institution providing concessions or
promises regarding providing the lender with--
(i) a specified number of loans made,
insured, or guaranteed under this
title;
(ii) a specified loan volume of such
loans; or
(iii) a preferred lender arrangement
for such loans.
(B) Definition of opportunity pool loan.--In
this paragraph, the term ``opportunity pool
loan'' means a private education loan made by a
lender to a student attending the institution
or the family member of such a student that
involves a payment, directly or indirectly, by
such institution of points, premiums,
additional interest, or financial support to
such lender for the purpose of such lender
extending credit to the student or the family.
(6) Ban on staffing assistance.--
(A) Prohibition.--The institution shall not
request or accept from any lender any
assistance with call center staffing or
financial aid office staffing.
(B) Certain assistance permitted.--Nothing in
paragraph (1) shall be construed to prohibit
the institution from requesting or accepting
assistance from a lender related to--
(i) professional development training
for financial aid administrators;
(ii) providing educational counseling
materials, financial literacy
materials, or debt management materials
to borrowers, provided that such
materials disclose to borrowers the
identification of any lender that
assisted in preparing or providing such
materials; or
(iii) staffing services on a short-
term, nonrecurring basis to assist the
institution with financial aid-related
functions during emergencies, including
State-declared or federally declared
natural disasters, federally declared
national disasters, and other localized
disasters and emergencies identified by
the Secretary.
(7) Advisory board compensation.--Any employee who is
employed in the financial aid office of the
institution, or who otherwise has responsibilities with
respect to education loans or other student financial
aid of the institution, and who serves on an advisory
board, commission, or group established by a lender,
guarantor, or group of lenders or guarantors, shall be
prohibited from receiving anything of value from the
lender, guarantor, or group of lenders or guarantors,
except that the employee may be reimbursed for
reasonable expenses incurred in serving on such
advisory board, commission, or group.
(f) Institutional Requirements for Teach-Outs.--
(1) In general.--In the event the Secretary initiates
the limitation, suspension, or termination of the
participation of an institution of higher education in
any program under this title under the authority of
subsection (c)(1)(F) or initiates an emergency action
under the authority of subsection (c)(1)(G) and its
prescribed regulations, the Secretary shall require
that institution to prepare a teach-out plan for
submission to the institution's accrediting agency or
association in compliance with section 496(c)(3), the
Secretary's regulations on teach-out plans, and the
standards of the institution's accrediting agency or
association.
(2) Teach-out plan defined.--In this subsection, the
term ``teach-out plan'' means a written plan that
provides for the equitable treatment of students if an
institution of higher education ceases to operate
before all students have completed their program of
study, and may include, if required by the
institution's accrediting agency or association, an
agreement between institutions for such a teach-out
plan.
(g) Inspector General Report on Gift Ban Violations.--The
Inspector General of the Department shall--
(1) submit an annual report to the authorizing
committees identifying all violations of an
institution's code of conduct that the Inspector
General has substantiated during the preceding year
relating to the gift ban provisions described in
subsection (e)(2); and
(2) make the report available to the public through
the Department's website.
(h) Preferred Lender List Requirements.--
(1) In general.--In compiling, maintaining, and
making available a preferred lender list as required
under subsection (a)(27), the institution will--
(A) clearly and fully disclose on such
preferred lender list--
(i) not less than the information
required to be disclosed under section
153(a)(2)(A);
(ii) why the institution has entered
into a preferred lender arrangement
with each lender on the preferred
lender list, particularly with respect
to terms and conditions or provisions
favorable to the borrower; and
(iii) that the students attending the
institution, or the families of such
students, do not have to borrow from a
lender on the preferred lender list;
(B) ensure, through the use of the list of
lender affiliates provided by the Secretary
under paragraph (2), that--
(i) there are not less than three
lenders of loans made under part B that
are not affiliates of each other
included on the preferred lender list
and, if the institution recommends,
promotes, or endorses private education
loans, there are not less than two
lenders of private education loans that
are not affiliates of each other
included on the preferred lender list;
and
(ii) the preferred lender list under
this paragraph--
(I) specifically indicates,
for each listed lender, whether
the lender is or is not an
affiliate of each other lender
on the preferred lender list;
and
(II) if a lender is an
affiliate of another lender on
the preferred lender list,
describes the details of such
affiliation;
(C) prominently disclose the method and
criteria used by the institution in selecting
lenders with which to enter into preferred
lender arrangements to ensure that such lenders
are selected on the basis of the best interests
of the borrowers, including--
(i) payment of origination or other
fees on behalf of the borrower;
(ii) highly competitive interest
rates, or other terms and conditions or
provisions of loans under this title or
private education loans;
(iii) high-quality servicing for such
loans; or
(iv) additional benefits beyond the
standard terms and conditions or
provisions for such loans;
(D) exercise a duty of care and a duty of
loyalty to compile the preferred lender list
under this paragraph without prejudice and for
the sole benefit of the students attending the
institution, or the families of such students;
(E) not deny or otherwise impede the
borrower's choice of a lender or cause
unnecessary delay in loan certification under
this title for those borrowers who choose a
lender that is not included on the preferred
lender list; and
(F) comply with such other requirements as
the Secretary may prescribe by regulation.
(2) Lender affiliates list.--
(A) In general.--The Secretary shall maintain
and regularly update a list of lender
affiliates of all eligible lenders, and shall
provide such list to institutions for use in
carrying out paragraph (1)(B).
(B) Use of most recent list.--An institution
shall use the most recent list of lender
affiliates provided by the Secretary under
subparagraph (A) in carrying out paragraph
(1)(B).
(i) Definitions.--For the purpose of this section:
(1) Agent.--The term ``agent'' has the meaning given
the term in section 151.
(2) Affiliate.--The term ``affiliate'' means a person
that controls, is controlled by, or is under common
control with another person. A person controls, is
controlled by, or is under common control with another
person if--
(A) the person directly or indirectly, or
acting through one or more others, owns,
controls, or has the power to vote five percent
or more of any class of voting securities of
such other person;
(B) the person controls, in any manner, the
election of a majority of the directors or
trustees of such other person; or
(C) the Secretary determines (after notice
and opportunity for a hearing) that the person
directly or indirectly exercises a controlling
interest over the management or policies of
such other person's education loans.
(3) Education loan.--The term ``education loan'' has
the meaning given the term in section 151.
(4) Eligible institution.--The term ``eligible
institution'' means any such institution described in
section 102 of this Act.
(5) Officer.--The term ``officer'' has the meaning
given the term in section 151.
(6) Preferred lender arrangement.--The term
``preferred lender arrangement'' has the meaning given
the term in section 151.
(j) Construction.--Nothing in the amendments made by the
Higher Education Amendments of 1992 shall be construed to
prohibit an institution from recording, at the cost of the
institution, a hearing referred to in subsection (b)(2),
subsection (c)(1)(D), or subparagraph (A) or (B)(i) of
subsection (c)(2), of this section to create a record of the
hearing, except the unavailability of a recording shall not
serve to delay the completion of the proceeding. The Secretary
shall allow the institution to use any reasonable means,
including stenographers, of recording the hearing.
* * * * * * *
----------
FAFSA SIMPLIFICATION ACT
* * * * * * *
DIVISION FF--OTHER MATTER
* * * * * * *
TITLE VII--FAFSA SIMPLIFICATION
* * * * * * *
SEC. 702. MAKING IT EASIER TO APPLY FOR FEDERAL AID AND MAKING THAT AID
PREDICTABLE.
[Subsections (a) through (l)--omitted-Amends other Acts]
(m) FAFSA.--
(1) [Omitted-Amends other Act]
(2) Reports.--Notwithstanding section 701(b) of this
title, the Secretary of Education shall have the
authority to issue reports and begin consumer testing
prior to July 1, 2023, as provided in the amendment
made by paragraph (1).
(n) Student Eligibility.--
(1) Amendments.--
(A) In general.--Section 484 of the Higher
Education Act of 1965 (20 U.S.C. 1091) is
amended--
(i) by striking subsections (n) and
(r);
(ii) by redesignating subsections
(o), (p), (s), and (t), as subsections
(n), (o), (q), and (r), respectively;
(iii) by inserting between
subsections (o) and (q), as
redesignated under clause (i), the
following:
``(p) Use of Income Data With IRS.--The Secretary, in
cooperation with the Secretary of the Treasury, shall fulfill
the data transfer requirements under section 6103(l)(13) of the
Internal Revenue Code of 1986 and the procedure and
requirements outlined in section 494.''; and
(iv) [by adding at the end] by
inserting after subsection (r), as
redesignated under clause (i), the
following:
``(s) Exception to Required Registration With the Selective
Service System.--Notwithstanding section 12(f) of the Military
Selective Service Act (50 U.S.C. 3811(f)), an individual shall
not be ineligible for assistance or a benefit provided under
this title if the individual is required under section 3 of
such Act (50 U.S.C. 3802) to present himself for and submit to
registration under such section and fails to do so in
accordance with any proclamation issued under such section, or
in accordance with any rule or regulation issued under such
section.
``(t) Confined or Incarcerated Individuals.--
``(1) Definitions.--In this subsection:
``(A) Confined or incarcerated individual.--
The term `confined or incarcerated
individual'--
``(i) means an individual who is
serving a criminal sentence in a
Federal, State, or local penal
institution, prison, jail, reformatory,
work farm, or other similar
correctional institution; and
``(ii) does not include an individual
who is in a halfway house or home
detention or is sentenced to serve only
weekends.
``(B) Prison education program.--The term
`prison education program' means an education
or training program that--
``(i) is an eligible program under
this title offered by an institution of
higher education (as defined in section
101 or 102(a)(1)(B));
``(ii) is offered by an institution
that has been approved to operate in a
correctional facility by the
appropriate State department of
corrections or other entity that is
responsible for overseeing correctional
facilities, or by the Bureau of
Prisons;
``(iii) has been determined by the
appropriate State department of
corrections or other entity that is
responsible for overseeing correctional
facilities, or by the Bureau of
Prisons, to be operating in the best
interest of students, the determination
of which shall be made by the State
department of corrections or other
entity or by the Bureau of Prisons,
respectively, and may be based on--
``(I) rates of confined or
incarcerated individuals
continuing their education
post-release;
``(II) job placement rates
for such individuals;
``(III) earnings for such
individuals;
``(IV) rates of recidivism
for such individuals;
``(V) the experience,
credentials, and rates of
turnover or departure of
instructors;
``(VI) the transferability of
credits for courses available
to confined or incarcerated
individuals and the
applicability of such credits
toward related degree or
certificate programs; or
``(VII) offering relevant
academic and career advising
services to participating
confined or incarcerated
individuals while they are
confined or incarcerated, in
advance of reentry, and upon
release;
``(iv) offers transferability of
credits to at least 1 institution of
higher education (as defined in section
101 or 102(a)(1)(B)) in the State in
which the correctional facility is
located, or, in the case of a Federal
correctional facility, in the State in
which most of the individuals confined
or incarcerated in such facility will
reside upon release;
``(v) is offered by an institution
that has not been subject, during the 5
years preceding the date of the
determination, to--
``(I) any suspension,
emergency action, or
termination of programs under
this title;
``(II) any adverse action by
the institution's accrediting
agency or association; or
``(III) any action by the
State to revoke a license or
other authority to operate;
``(vi) satisfies any applicable
educational requirements for
professional licensure or
certification, including licensure or
certification examinations needed to
practice or find employment in the
sectors or occupations for which the
program prepares the individual, in the
State in which the correctional
facility is located or, in the case of
a Federal correctional facility, in the
State in which most of the individuals
confined or incarcerated in such
facility will reside upon release; and
``(vii) does not offer education that
is designed to lead to licensure or
employment for a specific job or
occupation in the State if such job or
occupation typically involves
prohibitions on the licensure or
employment of formerly incarcerated
individuals in the State in which the
correctional facility is located, or,
in the case of a Federal correctional
facility, in the State in which most of
the individuals confined or
incarcerated in such facility will
reside upon release.
``(2) Technical assistance.--The Secretary, in
collaboration with the Attorney General, shall provide
technical assistance and guidance to the Bureau of
Prisons, State departments of corrections, and other
entities that are responsible for overseeing
correctional facilities in making determinations under
paragraph (1)(B)(iii).
``(3) Federal pell grant eligibility.--
Notwithstanding subsection (a), in order for a confined
or incarcerated individual who otherwise meets the
eligibility requirements of this title to be eligible
to receive a Federal Pell Grant under section 401, the
individual shall be enrolled or accepted for enrollment
in a prison education program.
``(4) Evaluation.--
``(A) In general.--Not later than 1 year
after the date of enactment of the FAFSA
Simplification Act, in order to evaluate and
improve the impact of activities supported
under this subsection, the Secretary, in
partnership with the Director of the Institute
of Education Sciences, shall award 1 or more
grants or contracts to, or enter into
cooperative agreements with, experienced public
and private institutions and organizations to
enable the institutions and organizations to
conduct an external evaluation that shall--
``(i) assess the ability of confined
or incarcerated individuals to access
and complete the Free Application for
Federal Student Aid;
``(ii) examine in-custody outcomes
and post-release outcomes related to
providing Federal Pell Grants to
confined or incarcerated individuals,
including--
``(I) attainment of a
postsecondary degree or
credential;
``(II) safety in penal
institutions with prison
education programs;
``(III) the size of waiting
lists for prison education
programs;
``(IV) the extent to which
such individuals continue their
education post-release;
``(V) employment and earnings
outcomes for such individuals;
and
``(VI) rates of recidivism
for such individuals;
``(iii) track individuals who
received Federal Pell Grants under
subpart 1 of part A at 1, 3, and 5
years after the individuals' release
from confinement or incarceration; and
``(iv) examine the extent to which
institutions provide re-entry or
relevant career services to
participating confined or incarcerated
individuals as part of the prison
education program and the efficacy of
such services, if offered.
``(B) Report.--Beginning not later than 1
year after the Secretary awards the grant,
contract, or cooperative agreement described in
subparagraph (A) and annually thereafter, each
institution of higher education operating a
prison education program under this subsection
shall submit a report to the Secretary on
activities assisted and students served under
this subsection, which shall include the
information, as applicable, contained in
clauses (i) through (iv) of subparagraph (A).
``(5) Report.--Not later than 1 year after the date
of enactment of the FAFSA Simplification Act and on at
least an annual basis thereafter, the Secretary shall
submit to the authorizing committees, and make publicly
available on the website of the Department, a report on
the--
``(A) impact of this subsection which shall
include, at a minimum--
``(i) the names and types of
institutions of higher education
offering prison education programs at
which confined or incarcerated
individuals are enrolled and receiving
Federal Pell Grants;
``(ii) the number of confined or
incarcerated individuals receiving
Federal Pell Grants through each prison
education program;
``(iii) the amount of Federal Pell
Grant expenditures for each prison
education program;
``(iv) the average amount of Federal
Pell Grant expenditures per full-time
equivalent students in a prison
education program compared to the
average amount of Federal Pell Grant
expenditures per full-time equivalent
students not in prison education
programs;
``(v) the demographics of confined or
incarcerated individuals receiving
Federal Pell Grants;
``(vi) the cost of attendance for
such individuals;
``(vii) the mode of instruction (such
as distance education, in-person
instruction, or a combination of such
modes) for each prison education
program;
``(viii) information on the academic
outcomes of such individuals (such as
credits attempted and earned, and
credential and degree completion) and
any information available from student
satisfaction surveys conducted by the
applicable institution or correctional
facility;
``(ix) information on post-release
outcomes of such individuals,
including, to the extent practicable,
continued postsecondary enrollment,
earnings, credit transfer, and job
placement;
``(x) rates of recidivism for
confined or incarcerated individuals
receiving Federal Pell Grants;
``(xi) information on transfers of
confined or incarcerated individuals
between prison education programs;
``(xii) the most common programs and
courses offered in prison education
programs; and
``(xiii) rates of instructor turnover
or departure for courses offered in
prison education programs;
``(B) results of each prison education
program at each institution of higher
education, including the information described
in clauses (ii) through (xiii) of subparagraph
(A); and
``(C) findings regarding best practices with
respect to prison education programs.''.
(B) Conforming amendment.--Section 428B(f)(2)
of the Higher Education Act of 1965 (20 U.S.C.
1078-2(f)(2)) is amended by striking ``section
484(p)'' and inserting ``section 484(o)''.
(C) Institutional and financial assistance
information for students.--Section 485 of the
Higher Education Act of 1965 (20 U.S.C. 1092)
is amended by repealing subsection (k).
(2) Early effective date permitted.--Notwithstanding
section 701(b) of this Act, sections 401(b)(6) and
484(r) of the Higher Education Act of 1965 (20 U.S.C.
1070a(b)(6); 1091(r)) as in effect on the date of
enactment of this Act, and section 12(f) of the
Military Selective Service Act (50 U.S.C. 3811(f)), the
Secretary of Education may implement the amendments
made by paragraph (1) of this subsection before (but
not later than) July 1, 2023. The Secretary shall
specify in a designation on what date, under what
conditions, and for which award years the Secretary
will implement such amendments prior to July 1, 2023.
The Secretary shall publish any designation under this
paragraph in the Federal Register at least 60 days
before implementation.
(o) [Omitted-Amend other Act]
(p) [Omitted-Amend other Act]
* * * * * * *
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 that outlying areas may submit a
single application for consolidated grant awards and may use
the funds for any of the programs and activities authorized
under subtitle B of title I of 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 and
demonstration 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 may reserve a
higher percentage of funds for technical assistance than what
is provided in section 168(b) of the 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 ``Employment and Training
Administration'' providing that an individual may qualify as an
``eligible seasonal farmworker'' under section 167(i)(3) of the
WIOA if such individual is a member of a family with a total
family income equal to or less than 150 percent of the poverty
line.
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, 2023.
Language is included under ``Job Corps'' providing that no
funds from any other appropriation may be used for meal
services at Job Corps.
Language is included under ``Community Service Employment
for Older Americans'' allowing funds to be recaptured and
reobligated.
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 eligibility assessments.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing funds to States
to improve operations and modernize State Unemployment
Insurance systems.
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 for additional
administrative funds from the Unemployment Trust Fund if
unemployment claims exceed certain levels.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing authority for
States to use funds to assist other States to carry out
authorized activities in cases of a major disaster declared by
the President under the Robert T. Stafford Disaster Relief and
Emergency Assistance Act.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments on behalf of States for
the use of the National Directory of New Hires.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments from funds appropriated
for States' grants on behalf of States to the entity operating
the State Information Data Exchange System.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that
appropriations for establishing a national one-stop career
system may be obligated in contracts, grants or agreements with
States or non-State entities.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that States
awarded grants to support national activities of the Federal-
State unemployment insurance system may award subgrants to
other States.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that funds
available for integrated Unemployment Insurance and Employment
Service automation may be used by States notwithstanding cost
allocation principles prescribed under the Office of Management
and Budget ``Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards.''
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may reallot funds among States
participating in a consortium.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' allowing the Secretary to
collect fees 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 pre-termination or
termination 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 unobligated balances of reimbursements shall remain
available until expended for the payment of compensation,
benefits, and expenses.
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 of benefit claims.
Language is included under ``Administrative Expenses,
Energy Employees Occupational Illness Compensation Fund''
providing that the Secretary may prescribe regulations for
requiring identification for the filing of benefit claims.
Language is included under ``Occupational Safety and Health
Administration'' providing that up to a certain amount of fees
collected from the training institute may be retained and used
for related training and education.
Language is included under ``Occupational Safety and Health
Administration'' providing that fees collected from Nationally
Recognized Testing Laboratories may be used to administer
laboratory recognition programs that ensure safety of equipment
used in the workplace.
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 administer 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 subject to 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 service
members, spouses or other family caregivers of the service
member, and to Gold Star Spouses.
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 Department may award grants under
section 2023 of Title 38, United States Code.
Language is included under ``Veterans' Employment and
Training'' providing that services may be provided to certain
homeless or recently incarcerated veterans under section 2021,
2021A, and 2023 of Title 38, United States Code.
Language is included under ``Veterans' Employment and
Training'' providing that funds made available to assist
homeless veterans may be used for data systems and contract
support track participant and performance information.
Language is included under ``Veterans' Employment and
Training'' providing that the fees assessed pursuant to the
HIRE Vets Medallion Award Fund shall be available to the
Secretary for expenses of the HIRE Vets Medallion Award Program
and that the start date prescribed in the Act shall not apply.
Language is included under ``General Provisions''
prohibiting the use of Job Corps funds to pay the salaries and
bonuses at a rate in excess of Executive Level II.
Language is included under ``General Provisions''
prohibiting the use 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 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'' allowing
the Secretary to furnish a certain amount of excess personal
property to apprenticeship programs through grants, contracts,
and other arrangements.
Language is included under ``General Provisions'' modifying
certain authorities related to the Secretary's security detail.
Language is included under ``General Provisions'' providing
that the Secretary may dispose or divest of certain Job Corps
center property and use the proceeds to carry out the program
in the same geographic location.
Language is included under ``General Provisions''
preventing appropriated funds from being used to close any
Civilian Conservation Center, except when necessary for the
health and safety of students.
Language is included under ``General Provisions''
prohibiting the Secretary from using any of the funds in the
Act to implement the ``Wagner-Peyser Act Staffing Flexibility''
final rule.
Language is included under ``General Provisions''
prohibiting the Secretary from using any of the funds in the
Act to implement the ``Industry Recognized Apprenticeship
Programs'' final rule.
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 751 and 756.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing permissive
authority to the Secretary to waive requirements for entities
awarded funds from sections 751(d)(2)(A) and 751 (d)(2)(B).
Language is included under ``Health Resources and Services
Administration--Health Workforce'' applying the requirements
for the minimum number of awards made to HBCUs and MSIs to
additional health workforce grant programs.
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 ``Health Resources and Services
Administration--Health Workforce'' allowing funds for the Nurse
Corps and National Health Service Corps Scholarship and Loan
programs to be used to make prior year adjustments.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing funding under the
National Health Service Corps Loan Repayment Program for
substance use disorder counselors and placement in Indian
Health Service facilities.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' making funds available for
loan repayment to mental and behavioral health providers,
including peer support specialists.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' to provide funds for the
purpose of establishing or expanding optional community-based
nurse practitioner fellowship programs.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' to provide funds for the
purpose of supporting graduate education for physicians
provided by public institutions of higher education and shall
remain available until expended.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' to provide funds for grants
to public institutions of higher education meeting certain
requirements for graduate education for physicians.
Language is included under ``Health Resources and Services
Administration--Ryan White HIV/AIDS Program'' to make funds
available to the Secretary to carry out grants and contracts
under title XXVI or 311(c) for the purposes of ending the HIV/
AIDS epidemic.
Language is included under ``Health Resources and Services
Administration--Rural Health'' to provide funding for State
Offices of Rural Health notwithstanding section 338J(k), which
terminates the program after an aggregate funding amount.
Language is included under ``Health Resources and Services
Administration--Family Planning'' placing additional
restrictions on the use of funds.
Language is included under ``Centers for Disease Control
and Prevention--Environmental Health'' providing funds for the
Vessel Sanitation Program.
Language is included under ``Centers for Disease Control
and Prevention--Buildings and Facilities'' providing the use of
funds to support acquisition, renovation, or replacement, of
the National Institute Occupational Safety and Health's
underground and surface coal mining research capacity.
Language is included under ``Centers for Disease Control
and Prevention--Buildings and Facilities'' providing funds from
former employees with existing Individual Learning Accounts
unobligated to be available to support acquisition, renovation,
or replacement, of the National Institute for Occupational
Safety and Health's underground and surface coal mining
research capacity.
Language is included under ``Centers for Disease Control
and Prevention--CDC-Wide'' permitting CDC to operate and
maintain an aircraft.
Language is included under ``National Institutes of
Health--Office of the Director'' allowing funds to be used for
the Research Policy Board authorized by section 2034(f) of the
21st Century Cures Act (P.L. 114-255).
Language is included under ``Substance Use 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 Use And Mental
Health Services Administration--Mental Health'' requiring
states to spend 10 percent of the Mental Health Block Grant for
programs for crisis care programs for individuals with early
serious mental illness and children with serious mental and
emotional disturbances.
Language is included under ``Substance Use And Mental
Health Services Administration--Mental Health'' requiring
states to spend at least 10 percent of the Mental Health Block
Grant for programs that address early intervention and
prevention of mental disorders among at-risk children and
adults.
Language is included under ``Substance Use 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 Use And Mental Health
Services Administration--Substance Use Services'' requiring
states to use the rate of HIV cases instead of the AIDS cases
to calculate the HIV set-aside in the Substance Use Prevention
and Treatment Block Grant.
Language is included under ``Substance Use And Mental
Health Services Administration--Substance Use Services''
requiring states to spend not less than 10 percent of the
Substance Use Prevention and Treatment Block Grant for recovery
support services.
Language is included under ``Substance Use And Mental
Health Services Administration--Substance Use Services''
exempting the Substance Use 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'' limiting the amount of
funding available under that heading for quality improvement
organizations.
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--Low Income Home Energy Assistance'' modifying the
formula distribution of funds.
Language is included under ``Administration for Children
and Families--Refugee and Entrant Assistance'' to specify the
purposes of specified funds.
Language is included under ``Administration for Children
and Families--Refugee and Entrant Assistance'' to exempt the
matching requirements of certain funds as required in section
235(c)(6)(C)(iii) of the William Wilberforce Trafficking
Victims Protection Reauthorization Act of 2008.
Language is included under ``Administration for Children
and Families--Refugee and Entrant Assistance'' to provide the
Director of the Office of Refugee Resettlement flexibility to
allocate certain funds.
Language is included under ``Administration for Children
and Families--Payments to States for the Child Care and
Development Block Grant'' increasing the tribal set-aside.
Language is included under ``Administration for Children
and Families--Payments to States for the Child Care and
Development Block Grant'' to make amounts available for Federal
administrative expenses.
Language is included under ``Administration for Children
and Families--Children and Families Services Programs'' to
allow amounts to be available for Grants to Support Culturally
Specific Populations and Grants to Support Survivors of Sexual
Assault.
Language is included under ``Administration for Children
and Families--Children and Families Services Programs''
providing for payments under the Head Start Act for a cost of
living adjustment, the calculation of a base grant, quality
improvement funding, including quality improvement funding for
Migrant and Seasonal Head Start, expansion funding for Head
Start and Early Head Start programs, including necessary
administrative costs, and the Tribal Colleges and Universities
Head Start Partnership program.
Language is included under ``Administration for Children
and Families--Children and Families Services Programs''
modifying the definition of the poverty line as defined in
section 673(2) of the CSBG Act.
Language is included under ``Administration for Children
and Families--Children and Families Services Programs''
allowing for the direct payments of cash assistance to victims
of family, domestic, or dating violence as limited in section
308(d)(1) of the Family Violence Prevention and Services Act.
Language is included under Administration for Community
Living to allow funding provided for adult protective services
grants under section 2042 of title XX of the Social Security
Act to be set-aside for Tribes and Tribal organizations.
Language is included under Administration for Community
Living continuing 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 days 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 ``Office of the Secretary'' to
provide funding for the Advanced Research Projects Agency for
Health and establish requirements regarding the appointment of
the director, hiring authorities, and compensation.
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 sets the PHS evaluation set-aside to 2.5
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 least 15 days in advance of any transfer.
Section 206 modifies the 60-day flexibility for National
Health Service Corps contract terminations to provide more
flexibility.
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 prohibits the Secretary from denying
participation in the Medicare Advantage program to entities who
do not provide coverage or referrals for abortion services.
Section 210 prohibits funds from being used to advocate or
promote gun control.
Section 211 limits assignments of Public Health Service
staff to assist in child survival activities to not more than
60 employees.
Section 212 permits funding for HHS international HIV/AIDS
and other infectious disease, chronic and environmental
disease, and other health activities abroad to be spent under
the State Department Basic Authorities Act of 1956.
Section 213 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 $5,000,000 per project
with a total limit for NIH of $100,000,000.
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 includes specific report requirements for CMS's
marketplaces activities in the fiscal year 2024 budget request.
Section 220 prohibits CMS Program Account from being used
to support risk corridor payments.
Section 221 directs the spending and transfer of amount in
the Prevention and Public Health fund.
Section 222 modifies a provision relating to breast cancer
screening.
Section 223 requires the NIH to continue to use existing
guidance for calculating indirect cost negotiated rates.
Section 224 permits transfer authority within NIH, to the
Director of NIH for activities related to opioid misuse, opioid
alternatives, pain management, and substance use disorder
treatment.
Section 225 includes certain Congressional notification
requirements.
Section 226 includes a provision related to a report on
staffing.
Section 227 allows HHS to cover travel expenses when
necessary for employees to obtain medical care when they are
assigned to duty in a location with a public health emergency.
Sec. 228. The Committee modifies a provision related to
donations for unaccompanied children.
Sec. 229. The Committee modifies a provision related to the
use of funds to house unaccompanied children in facilities that
are not State-licensed for the care of unaccompanied children.
Sec. 230. The Committee continues a provision related to
the notification requirements regarding the use of facilities
that are not State-licensed for the care of unaccompanied
children.
Sec. 231. The Committee modifies a provision related to
Members of Congress and oversight of facilities responsible for
the care of unaccompanied children.
Sec. 232. The Committee continues a provision requiring
monthly reporting on unaccompanied children who were separated
from their parents or legal guardians and transferred to the
care of the Office of Refugee Resettlement.
Sec. 233. The Committee includes a new provision
prohibiting the use of funds for sharing any information
pertaining to unaccompanied children for use or reference in
removal proceedings or immigration enforcement.
Sec. 234. The Committee includes a new provision ensuring
that efforts are taken to place unaccompanied children who are
siblings together.
Sec. 235. The Committee includes a new provision requiring
the Secretary to submit a detailed spend plan outlining
anticipated uses of funds in the Refugee and Entrant Assistance
account.
Sec. 236. The Committee includes a new provision
authorizing the use of funds in the Refugee and Entrant
Assistance account for services to children, parents, and legal
guardians who were separated at the United States-Mexico border
in connection with the Zero-Tolerance Policy.
Section 237 allows for primary and secondary school costs
for eligible dependents of HHS personnel stationed in a U.S.
territory.
Section 238 rescinds balances from the Nonrecurring
Expenses Fund.
Section 239 increases flexibility for grantees of the Ryan
White HIV/AIDS program.
Section 240 prohibits funds from being awarded to an
organization that does not comply with Federal
nondiscrimination regulations.
Section 241 provides certain administrative flexibility to
be available during a public health emergency.
Section 242 changes the name of the National Institute on
Drug Abuse to the National Institute on Drugs and Addiction.
Section 243 changes the name of the National Institute of
Alcohol Abuse and Alcoholism to the National Institute of
Alcohol Effects and Alcohol-Related Disorders.
Section 244 amends the PHS Act and related statutes to
revise references to the Substance Abuse and Mental Health
Services Administration.
Section 245 includes notification requirements in the
Social Security Act.
Section 246 extends the availability of NIH multi-year
research grants awarded in fiscal year 2017.
Section 247 amends the PHS Act for CDC fellowship or
training participants.
TITLE III--DEPARTMENT OF EDUCATION
Language is included under ``Impact Aid'' allowing
continued eligibility for students affected by the deployment
or death of their military parent so long as the children
attend school in the same local education agency they attended
prior to the parent's death or deployment.
Language is included under ``School Improvement Programs''
allowing the Secretary of Education to reserve up to 5 percent
of Supplemental Education Grants funds to provide technical
assistance for these grants.
Language is included under ``Special Education'' clarifying
the amounts required to be transferred to the Department of the
Interior under the Grants to States program.
Language is included under ``Special Education'' outlining
procedures for reducing a State's award because of a failure to
meet the maintenance of State financial support requirements of
the Individuals with Disabilities Education Act.
Language is included under ``Special Education''
authorizing the Department to use certain funds to provide
technical assistance and support to States to improve data
collection capacity.
Language is included under ``Special Education''
authorizing the Department to use funds appropriated for the
State Personnel Development Grants program to evaluate program
performance.
Language is included under ``Special Education'' permitting
States to subgrant funds that they reserve for ``Other State-
level activities'' under the Grants to States, Preschool Grants
to States, and Grants for Infants and Families programs.
Language is included under ``Special Education'' allowing
the Department to provide all States that apply for the State
Incentive Grants program, in years in which five or fewer
States apply for funding, 20 percent of the funds reserved for
the program.
Language is included under ``Special Education'' to promote
continuity of services for eligible infants and their families.
Language is included under ``Special Education'' to
increase access for infants and families who have been
traditionally underrepresented in the Grants for Infants and
Families program, eliminate out-of-pocket costs for
participating families, and conduct certain activities with
individuals expecting to become parents of infants or toddlers
with disabilities.
Language is included under ``Rehabilitation Services''
allowing the Secretary to use amounts that remain available
after the reallotment of funds to States under the Vocational
Rehabilitation State Grants program for innovative activities
designed to increase competitive integrated employment for
youth and other individuals with disabilities.
Language is included under ``Special Institutions for
Persons with Disabilities'' allowing the National Technical
Institute for the Deaf to use, at its discretion, funds for the
endowment program as authorized under section 207 of the
Education of the Deaf Act of 1986.
Language is included under ``Special Institutions for
Persons with Disabilities'' allowing Gallaudet University to
use, at its discretion, funds for the endowment program as
authorized under section 207 of the Education of the Deaf Act
of 1986.
Language is included under ``Career, Technical, and Adult
Education'' permitting accredited registered apprenticeship
programs to be eligible for funding under the Perkins Act.
Language is included under ``Student Aid Administration''
requiring that servicers be evaluated on their ability to meet
contract requirements, future performance on the contracts, and
history of compliance with applicable consumer protections
laws, including Federal and State law.
Language is included under ``Student Aid Administration''
requiring that FSA hold prime contractors accountable for
meeting the requirements of the contract where subcontracting
is permitted, and that contractors have the capacity to meet
and are held accountable for performance on service levels and
have a history of compliance with applicable consumer
protection laws, including Federal and State law.
Language is included under ``Higher Education'' allowing
funds to carry out Title VI of the Higher Education Act and
section 102(b)(6) of the Mutual Educational and Cultural
Exchange Act of 1961 to be used to support visits and study in
foreign countries for participants in advanced foreign
countries by individuals who are participating in advanced
foreign language training and international studies in areas
that are vital to United States national security and who plan
to apply their language skills and knowledge of these countries
in the fields of government, the professions, or international
development.
Language is included under ``Higher Education'' allowing
one percent of funds to carry out Title VI of the Higher
Education Act and section 102(b)(6) of the Mutual Educational
and Cultural Exchange Act of 1961 to be used for program
evaluation, national outreach, and information dissemination
activities.
Language is included under ``Higher Education'' allowing up
to one-and-one-half percent of the funds made available under
chapter 2 of subpart 2 of part A of Title IV of the Higher
Education Act to be used for evaluation.
Language is included under ``Higher Education'' stating the
section 313(d) of the Higher Education Act (HEA) does not apply
to an institution of higher education that is eligible to
receive funding under section 318 of the HEA.
Language is included under ``Departmental Management''
restricting the Department from dissolving the Budget Service
of the Department of Education, relative to the organization
and operation of the Budget Service as in effect on January 1,
2018.
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'' allowing
ESEA funds consolidated for evaluation purposes to be available
from July 1, 2023 through September 30, 2024.
Language is included under ``General Provisions'' allowing
certain institutions to continue to use endowment income for
student scholarships.
Language is included under ``General Provisions'' extending
the authorization of the National Advisory Committee on
Institutional Quality and Integrity.
Language is included under ``General Provisions'' extending
the authority to provide account maintenance fees to guaranty
agencies for Federal student loans.
Language is included under ``General Provisions'' allowing
funds to be made available for payments for student loan
servicing to an institution of higher education for loans under
part E of Title IV of the HEA.
Language is included under ``General Provisions'' amending
section 401(b)(7)(A)(iv)(XI) of the HEA.
Language is included under ``General Provisions'' providing
funds for outreach to certain borrowers of loans made under
part D of title IV of the Higher Education Act.
Language is included under ``General Provisions'' modifying
terms for unobligated funds for loan cancellation for certain
borrowers of loans under part B or D of title IV of the Higher
Education Act.
Language is included under ``General Provisions'' allowing
up to 0.5 percent of funds appropriated in this Act for
programs authorized under the Higher Education Act, except for
the Pell Grant program, to be used for evaluation of any Higher
Education Act program.
Language is included under ``General Provisions''
prohibiting the use of funds for charter schools that contract
with a for-profit entity to operate, oversee or manage the
activities of the school.
Language is included under ``General Provisions''
prohibiting the Department from withholding appropriated funds
from an institution of higher education because of an
institution's scientific research on marihuana.
Language is included under ``General Provisions''
prohibiting the use of funds for schools that use electric
shock devices and equipment on students.
Language is included under ``General Provisions'' amending
the HEA to provide for greater accountability of for-profit
institutions of higher education.
Language is included under ``General Provisions'' allowing
individuals who are DREAMERs or have temporary protected status
to receive federal financial assistance.
Language is included under ``General Provisions'' amending
section 344(a) of the Higher Education Act.
TITLE IV--RELATED AGENCIES
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.
Language is included under ``Corporation for National and
Community Service'' requiring the Corporation to make awards on
a competitive basis pursuant to section 501(a)(4)(F) of the
1990 Act, section 198P notwithstanding.
Language is included under ``Corporation for National and
Community Service'' regarding changes to program requirements
or policy through rulemaking.
Language is included under ``Corporation for National and
Community Service'' regarding National Service Trust minimum
share requirements.
Language is included under ``Corporation for National and
Community Service'' limiting the use of an educational award
under section 148(a)(4) to individuals who are veterans.
Language is included under ``Corporation for National and
Community Service'' related to criminal background checks.
Language is included under ``Corporation for National and
Community Service'' related to 1,200 hour service positions.
Language is included under ``Corporation for National and
Community Service'' related to allowing VISTA members age 55
and older to transfer education awards to eligible individuals.
Language is included under ``Corporation for National and
Community Service'' related to allowing individuals with
Deferred Action for Childhood Arrivals (DACA) status who
successfully serve a term in AmeriCorps State and National,
NCCC, or VISTA, to be eligible for a Segal AmeriCorps Education
Award.
Language is included under ``Corporation for National and
Community Service'' related to allowing AmeriCorps NCCC to keep
teams in place over the 12-month statutory restriction for work
on disaster response or recovery.
Language is included under ``Corporation for National and
Community Service'' related to allowing AmeriCorps NCCC members
ages 18-26 to participate for a period of three to six months.
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.
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 use of funds for certain research
involving human embryos.
Section 507 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 508 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 509 prohibits any transfer of funds made available
in this Act except by the authority provided in this Act or
another appropriation Act.
Section 510 limits funds in the bill for public libraries
to those that comply with the requirements of the Children's
Internet Protection Act.
Section 511 dictates the procedures for the reprogramming
of any funds provided in the bill.
Section 512 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 513 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 514 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 individually or in total.
Section 515 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 516 prohibits use of funds to implement a Social
Security totalization agreement with Mexico.
Section 517 prohibits the use of funds for the downloading
or exchanging of pornography.
Section 518 directs certain reporting requirements for
conference expenditures.
Section 519 requires disclosure of U.S. taxpayer funding
for programs used in advertising.
Section 520 authorizes performance partnership pilots.
Section 521 requires quarterly reports on the status of
balances of appropriations from the Departments of Labor,
Health and Human Services and Education.
Section 522 requires the Departments of Labor, Health and
Human Services, and Education to provide a list of any new or
competitive grant award notifications, including supplements,
not less than three business days prior to the announcement of
recipients of such awards.
Section 523 requires each Department and related agency
funded through this Act to provide answers to questions
submitted for the record by Members of the Committee within 45
business days after receipt.
Section 524 makes funds from the Children's Health
Insurance Program Performance Bonus Fund unavailable for
obligation in fiscal year 2023.
Section 525 provides additional authorities for funds made
available for research or evaluation purposes.
Appropriations Not Authorized by Law
Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of
the House of Representatives, the following table lists the
appropriations in the accompanying bill which are not
authorized by law for the period concerned (dollars in
thousands):
----------------------------------------------------------------------------------------------------------------
Appropriations in
Agency Program Last Year of Authorization Last Year of Appropriations in
Authorization Level Authorization this Bill
----------------------------------------------------------------------------------------------------------------
DEPARTMENT OF LABOR ETA
Adult Employment and FY 2020........... $899,987,000...... $854,649,000...... $940,649,000
Training Activities.
Youth Employment and FY 2020........... 963,837,000....... 913,130,000....... 1,033,130,000
Training Activities.
Dislocated Worker Employment FY 2020........... 1,436,137,000..... 1,052,053,000..... 1,161,553,000
and Training Activities.
Native Americans............ FY 2020........... 54,137,000........ 55,000,000........ 63,800,000
Migrant and Seasonal FY 2020........... 96,211,000........ 91,896,000........ 105,000,000
Farmworker programs.
YouthBuild.................. FY 2020........... 91,087,000........ 94,534,000........ 145,000,000
Reintegration of Ex- FY 2020........... 106,906,000....... 98,079,000........ 150,000,000
Offenders.
Job Corps................... FY 2020........... 1,983,236,000..... 1,743,655,000..... 1,798,000,000
One-Stop Career Centers/ FY 2020........... 70,667,000........ 62,653,000........ 67,653,000
Labor Market Information.
DEPARTMENT OF HEALTH AND HUMAN
SERVICES HRSA
School-Based Health Centers. FY 2013........... 50,000,000........ 47,450,000........ 50,000,000
Nurse Practitioner Optional N/A............... N/A............... N/A............... 6,000,000
Fellowship Program.
Medical Student Education... N/A............... N/A............... N/A............... 60,000,000
Early Hearing Detection and FY 2022........... 19,522,758........ 17,818,000........ 18,818,000
Intervention.
Heritable Disorders......... FY 2019........... 19,900,000........ 18,883,000........ 21,883,000
Pediatric Mental Health FY 2022........... 9,000,000......... 10,000,000........ 14,000,000
Access.
Screening and Treatment for FY 2022........... 5,000,000......... 5,000,000......... 11,500,000
Maternal Depression.
Emergency Relief--Part A.... FY 2013........... 789,471,000....... 649,373,000....... 691,045,000
Comprehensive Care--Part B.. FY 2013........... 1,562,169,000..... 1,314,446,000..... 1,385,517,000
Early Intervention--Part C.. FY 2013........... 285,766,000....... 205,544,000....... 211,861,000
Coordinated Services and FY 2013........... 87,273,000........ 75,088,000........ 79,114,000
Access to Research for
Women, Infants, Children
and Youth--Part D.
Dental Reimbursement--Part F FY 2013........... 15,802,000........ 12,991,000........ 13,826,000
AIDS Education and Training FY 2013........... 42,178,000........ 33,275,000........ 35,413,000
Centers--Part F.
Special Projects of National FY 2013........... 25,000,000........ 25,000,000........ 28,000,000
Significance--Part F.
Ending the HIV/AIDS Epidemic N/A............... N/A............... N/A............... 250,000,000
Organ Transplantation....... FY 1993........... Such Sums......... 2,767,000......... 31,049,000
Rural Hospital Flexibility FY 2012........... Such Sums......... 41,040,000........ 68,500,000
Grants.
State Offices of Rural FY 2002........... Such Sums......... 4,000,000......... 12,500,000
Health.
Family Planning Grants...... FY 1985........... 158,400,000....... 142,500,000....... 500,000,000
CDC
Sexually Transmitted FY 1998........... Such Sums......... 112,117,000....... 179,310,000
Infections.
National Center for Health FY 2003........... Such Sums......... 125,899,000....... 190,397,000
Statistics.
WISEWOMAN................... FY 2003........... Such Sums......... 12,419,000........ 37,620,000
National Cancer Registries.. FY 2003........... Such Sums......... N/A............... 56,440,000
Asthma Surveillance & Grants FY 2005........... Such Sums......... 32,422,000........ 33,500,000
Folic Acid.................. FY 2005........... Such Sums......... 2,188,000......... 3,150,000
Injury Prevention and FY 2005........... Such Sums......... 138,237,000....... 897,779,000
Control.
Oral Health Promotion....... FY 2005........... Such Sums......... 11,204,000........ 20,750,000
Screening, Referrals, and FY 2005........... 40,000,000........ 36,474,000........ 66,000,000
Education Regarding Lead
Poisoning.
Birth Defects, Developmental FY 2007........... Such Sums......... 122,242,000....... 225,060,000
Disability, Disability and
Health.
Breast and Cervical Cancer.. FY 2012........... 275,000,000....... 204,779,000....... 206,880,000
Public Health Workforce and FY 2013........... 39,500,000........ 64,000,000........ 106,000,000
Career Development.
National Diabetes Prevention FY 2014........... Such Sums......... 10,000,000........ 38,300,000
Program.
Johanna's Law............... FY 2014........... 18,000,000........ 4,972,000......... 12,500,000
Section 317 Immunization.... FY 2014........... Such Sums......... 610,847,000....... 825,797,000
Young Women's Breast Health FY 2019........... 4,900,000......... 4,960,000......... 8,960,000
Awareness and Support of
Young Women Diagnosed with
Breast Cancer (PHSA 399NN).
Center for Research and FY 2003........... Such Sums......... 26,830,000........ 29,961,0000
Demonstration of Health
Promotion and Disease
Prevention.
Preventive Health Measures FY 2004........... Such Sums......... 14,091,000........ 15,205,000
with regard to Prostate
Cancer.
Combating Antimicrobial FY 2006........... Such Sums......... 17,443,000........ 202,000,000
Resistance.
National Strategy for FY 2013........... 243,101,000....... 132,997,000....... 140,034,000
Combating and Eliminating
Tuberculosis.
Newborn Screening Laboratory FY 2019........... 8,000,000......... 17,250,000........ 23,250,000
Quality and Surveillance.
Rape Prevention............. FY 2018........... 50,000,000........ 49,430,000........ 71,750,000
Early Hearing Detection and FY 2022........... 11,852,000........ 10,760,000........ 10,760,000
Intervention.
Firefighter Cancer Registry. FY 2022........... 2,500,000......... 2,500,000......... 5,500,000
NIH
National Institutes of FY 2020........... 36,472,442,775.... 40,954,400,000.... 47,459,000,000
Health.
SAMHSA
Protection and Advocacy for FY 2003........... 19,500,000........ 36,146,000........ 40,000,000
Individuals with Mental
Illness.
State Opioid Response Grants N/A............... N/A............... N/A............... 1,775,000,000
AHRQ
Research on Health Costs, FY 2005........... Such Sums......... 324,000,000....... 385,000,000
Quality, and Outcomes.
ACF
Low Income Home Energy FY 2007........... 5,100,000,000..... 2,161,170,000..... 4,000,000,000
Assistance Program.
Child Care and Development FY 2020........... 2,748,591,018..... 5,826,000,000..... 7,165,330,000
Block Grant.
Children and Families
Services Programs.
Adoption and Legal FY 2016........... 43,000,000........ 37,943,000........ 75,000,000
Guardianship Incentive
Payments.
Native American Programs.... FY 2002........... Such Sums......... 45,826,000........ 63,762,000
Community Services Block FY 2003........... Such Sums......... 645,762,000....... 800,000,000
Grant.
Community Economic FY 2003........... Such Sums......... 27,082,000........ 22,383,000
Development.
Rural Community Development. FY 2003........... Such Sums......... 7,203,000......... 12,000,000
Head Start.................. FY 2012........... Such Sums......... 7,968,544,000..... 12,396,820,000
Preschool Development Grants FY 2021........... Such Sums......... 275,000,000....... 350,000,000
Runaway and Homeless Youth FY 2013........... Such Sums......... 107,852,000....... 155,000,000
Programs.
CAPTA programs.............. FY 2015........... Such Sums......... 143,981,000....... 226,000,000
Family Violence Programs.... FY 2015........... 178,500,000....... 139,500,000....... 300,000,000
National Domestic Violence FY 2015........... Such Sums......... 4,500,000......... 27,360,000
Hotline.
Child Welfare Services...... FY 2016........... 325,000,000....... 268,735,000....... 273,735,000
Refugee and Entrant
Assistance Programs.
Refugee Support Services.... FY 2002........... Such Sums......... 212,912,000....... 450,000,000
Transitional and Medical FY 2002........... Such Sums......... 227,243,000....... 760,000,000
Services.
Survivors of Torture........ FY 2007........... 25,000,000........ 9,817,000......... 20,000,000
Anti-Trafficking in Persons FY 2021........... 28,755,000........ 28,755,000........ 35,000,000
Programs.
ACL
Lifespan Respite Care....... FY 2011........... 94,810,000........ 2,495,000......... 14,220,000
State Health Insurance FY 1996........... 10,000,000........ N/A............... 58,115,000
Assistance Program.
Developmental Disabilities.. FY 2007........... Such Sums......... 155,115,000....... 203,283,000
Voting Access for People FY 2005........... 17,410,000........ 13,879,000........ 12,414,000
with Disabilities.
Elder Justice/ Adult FY 2014........... 129,000,000....... 0................. 100,000,000
Protective Services.
Assistive Technology........ FY 2010........... Such Sums......... 25,000,000........ 44,000,000
Traumatic Brain Injury...... FY 2019........... 8,600,000......... 11,321,000........ 13,118,000
Paralysis Resource Center... FY 2011........... 25,000,000........ 6,352,000......... 10,185,000
Limb Loss................... N/A............... N/A............... N/A............... 4,200
Independent Living and the FY 2020........... 214,135,000....... 228,153,000....... 257,470,000
National Institute on
Disability, Independent
Living and Rehabilitation
Research.
PHSSEF
Preparedness and Emergency N/A............... N/A............... N/A............... 28,300,000
Operations.
Policy and Planning......... N/A............... N/A............... N/A............... 17,877,000
ASPR Operations............. N/A............... N/A............... N/A............... 34,376,000
Cybersecurity............... N/A............... N/A............... N/A............... 153,815,000
Office of National Security. N/A............... N/A............... N/A............... 8,983,000
ARPA-H
Advanced Research Projects.. N/A............... N/A............... N/A............... 2,750,000,000
DEPARTMENT OF EDUCATION
Title I Grants to LEAs...... FY 2020........... 16,182,345,000.... 16,309,802,000.... 20,536,802,000
Innovative Approaches to FY 2020........... 180,014,000 (for 27,000,000........ 31,000,000
Literacy (IAL). IAL and CLSD).
Comprehensive Literacy FY 2020........... 180,014 (for IAL 192,000,000....... 192,000,000
Development (CLSD). and CLSD).
Migrant..................... FY 2020........... 374,751,000....... 375,626,000....... 375,626,000
Neglected and Delinquent/ FY 2020........... 47,614,000........ 47,614,000........ 48,239,000
High Risk Youth.
Impact Aid.................. FY 2020........... 1,388,603,000..... 1,486,112,000..... 1,614,112,000
Supporting Effective FY 2020........... 2,295,830,000..... 2,131,830,000..... 2,270,080,000
Instruction State Grants.
Nita M. Lowey 21st Century FY 2020........... 1,100,000,000..... 1,249,673,000..... 1,409,673,000
Community Learning Centers.
State Assessments........... FY 2020........... 378,000,000....... 378,000,000....... 390,000,000
Education for Homeless FY 2020........... 85,000,00......... 101,500,000....... 122,000,000
Children and Youth.
Education for Native FY 2020........... 32,397,000........ 36,897,000........ 40,897,000
Hawaiians.
Alaska Native Education FY 2020........... 31,453,000........ 35,953,000........ 37,953,000
Equity.
Rural Education............. FY 2020........... 169,840,000....... 185,840,000....... 195,000,000
Student Support and Academic FY 2020........... 1,600,000,000..... 1,210,000,000..... 1,355,000,000
Enrichment Grants.
Indian Education Grants to FY 2020........... 106,525,000....... 105,381,000....... 110,381,000
Local Educational Agencies.
Special Programs for Indian FY 2020........... 17,993,000........ 67,993,000........ 72,000,000
children.
Indian Education National FY 2020........... 5,565,000......... 7,365,000......... 12,865,000
Activities.
Education Innovation and FY 2020........... 90,611,000........ 190,000,000....... 384,000,000
Research.
American History and Civics. FY 2020........... 19,567,000........ 4,815,000......... 15,500,000
Charter Schools Grants...... FY 2020........... 300,000,000....... 440,000,000....... 400,000,000
Magnet Schools Assistance... FY 2020........... 108,530,000....... 107,000,000....... 149,000,000
Teacher and School Leader FY 2020........... 229,909,000....... 200,000,000....... 88,500,000
Incentive Grants.
Ready-to-Learn Programming FY 2020........... 56,093,000 (for 29,000,000........ 32,500,000
(RTL). RTL, Arts, and
Javits).
Supporting Effective FY 2020........... Up to 55,022,000 80,000,000........ 90,000,000
Educator Development. (minimum
53,574,000).
Arts in Education (Arts).... FY 2020........... 56,093,000 (for 30,000,000........ 38,500,000
RTL, Arts, and
Javits).
Javits Gifted and Talented FY 2020........... 56,093,000 (for 13,000,000........ 16,500,000
Students (Javits). RTL, Arts, and
Javits).
Statewide Family Engagement FY 2020........... 10,000,000........ 10,000,000........ 16,000,000
Centers.
Promise Neighborhoods (PN).. FY 2020........... 69,037,000 (for PN 80,000,000........ 96,000,000
and FSCS).
School Safety National FY 2020........... 5,000,000......... 105,000,000....... 1,134,000
Activities.
Full-Service Community FY 2020........... 69,037,000 (for PN 25,000,000........ 468,000,000
Schools (FSCS). and FSCS).
English Language Acquisition FY 2020........... 884,960,000....... 787,400,000....... 1,000,000,000
Vocational Rehabilitation FY 2021........... 3,675,021,000..... 3,675,021,000..... 3,949,707,000
State Grants.
Client Assistance State FY 2021........... 14,098,000........ 13,000,000........ 13,000,000
Grants.
Supported Employment State FY 2021........... 32,363,000........ 22,548,000........ 22,548,000
Grants.
Training.................... FY 2021........... 39,540,000........ 29,388,000........ 29,388,000
Demonstration and Training FY 2021........... 6,809,000......... 5,796,000......... 15,796,000
Programs.
Services for Older Blind FY 2021........... 39,141,000........ 33,317,000........ 33,317,000
Individuals.
Protection and Advocacy of FY 2021........... 20,735,000........ 18,150,000........ 21,150,000
Individual Rights.
Helen Keller National Center FY 2004........... Such Sums......... 8,666,000......... 20,000,000
for Deaf-Blind Youths and
Adults.
National Technical Institute FY 2015........... Such Sums......... 67,016,000........ 91,500,000
for the Deaf.
Gallaudet University........ FY 2015........... Such Sums......... 120,275,000....... 156,361,000
Adult Basic and Literacy FY 2021........... 665,067,000....... 674,955,000....... 714,000,000
Education State Grants.
Adult Education National FY 2021........... 13,573,000........ 13,712,000........ 18,712,000
Leadership Activities.
Aid for Institutional FY 2015........... Such Sums......... 429,762,000....... 1,110,117,000
Development.
Aid for Hispanic-Serving FY 2015........... Such Sums......... 109,223,000....... 246,732,000
Institutions.
International Education And FY 2015........... Such Sums......... 72,164,000........ 88,664,000
Foreign Language.
Teacher Quality Partnerships FY 2011........... Such Sums......... 43,000,000........ 132,092,000
Federal TRIO Programs....... FY 2015........... Such Sums......... 839,752,000....... 1,297,761,000
IDEA National Activities.... FY 2010........... Such Sums......... 260,203,000....... 440,560,000
IDEA Grants for Infants and FY 2010........... Such Sums......... 439,427,000....... 621,306,000
Families.
Special Programs for Migrant FY 2015........... Such Sums......... 37,474,000........ 58,123,000
Students.
Comprehensive Centers....... FY 2008........... Such Sums......... 57,113,000........ 54,000,000
RELATED AGENCIES
Corporation for Public FY 1996........... 425,000,000....... 275,000,000....... 585,000,000
Broadcasting.
Corporation for National and FY 2014........... Such Sums......... 1,049,954,000..... 1,315,266,000
Community Service.
----------------------------------------------------------------------------------------------------------------
Program Duplication
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, 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.
Committee Hearings
In compliance with clause 3(c)(6) of rule XIII (117th
Congress) the following hearings were used to develop the
fiscal year 2023 Bill:
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on March
31, 2022, entitled ``FY 2023 Budget Request for the Department
of Health and Human Services.'' The Subcommittee received
testimony from:
The Honorable Xavier Becerra, Secretary, Department of
Health and Human Services.
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
April 6, 2022, entitled ``Social and Emotional Learning and
Whole Child Approaches in K-12 Education.'' The Subcommittee
received testimony from:
Pamela Cantor, M.D., Founder & Science Advisor, Turnaround
for Children.
Linda Darling-Hammond, Ed.D., President & CEO, Learning
Policy Institute.
Max Eden, Research Fellow, American Enterprise Institute.
Tim Shriver, Ph.D., Co-founder and Board Chair,
Collaborative for Academic, Social, and Emotional Learning.
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on April
28, 2022, entitled ``FY 2023 Budget Request for the Department
of Education.'' The Subcommittee received testimony from:
The Honorable Miguel Cardona, Secretary, Department of
Education
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on May
11, 2022, entitled ``FY 2023 Budget Request for the National
Institutes of Health.'' The Subcommittee received testimony
from:
Dr. Lawrence Tabak, Acting Director, National Institutes of
Health
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
May 12, 2022, entitled ``Healthy Aging: Maximizing the
Independence, Well-being, and Health of Older Adults.'' The
Subcommittee received testimony from:
Dr. Martha B. Pelaez, Board Member, National Council on
Aging and Evidence-Based Leadership Collaborative.
Patricia Lyons, President and CEO, Senior Citizens, Inc.
Karen Orsi, Director, Oklahoma Mental Health and Aging
Coalition.
Robert B. Blancato, National Coordinator, Elder Justice
Coalition
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on May
17, 2022, entitled ``FY 2023 Budget Request for the Department
of Labor.'' The Subcommittee received testimony from:
The Honorable Martin Walsh, Secretary, Department of Labor
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a hearing on May 24, 2022,
entitled ``FY 2023 Member Day.'' The Subcommittee received
testimony from:
The Honorable Mikie Sherrill, Member of Congress
The Honorable Veronica Escobar, Member of Congress
The Honorable Sylvia Garcia, Member of Congress
The Honorable Kim Schrier, Member of Congress
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
May 25, 2022, entitled ``Tackling Teacher Shortages.'' The
Subcommittee received testimony from:
Desiree Carver-Thomas, Researcher and Policy Analyst,
Learning Policy Institute
Dr. Lindsey Burke, Director of the Center for Education
Policy, Heritage Foundation
Randi Weingarten, President, American Federation of
Teachers
Dr. Jane West, Education Policy Consultant
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a hearing on May 26, 2022,
entitled ``Public Witness Day.'' The Subcommittee received
testimony from:
Bob Lanter, Executive Director, California Workforce
Association
Jodi Grant, Executive Director, Afterschool Alliance
Mark Jenkins, Executive Director, Connecticut Harm
Reduction Alliance
Jane Weintraub, DDS, MPH, FACD, FICD, Professor, University
of North Carolina at Chapel Hill Adams School of Dentistry,
American Association for Dental, Oral, and Craniofacial
Research
Marwan Haddad, MD, MPH, Medical Director of the Center for
Key Populations at Community Health Center, Inc., HIVMA
Medicine Association
Cynthia McCurren, PHD, RN, Board Chair, American
Association of Colleges of Nursing
Julie Ajinkya, PHD, Senior Vice President & Chief Strategy
Officer, APIA Scholars
Brian Wallach, Co-Founder, I AM ALS
Karen Knudsen, MBA, PHD, Chief Executive Officer, American
Cancer Society and American Cancer Action Network
Belinda Pettiford, MPH, President, Association of Maternal
and Child Health Programs
Dr. Anne Matthews, Chair, Polio Eradication Advocacy Task
Force for the United States, The Rotary Foundation of Rotary
International
Mairead Painter, Connecticut State Long-Term Care
Ombudsman, National Association of State Long-Term Care
Ombudsman Programs
Hannah Wesolowski, Chief Advocacy Officer, National
Alliance on Mental Illness
Thomas Fleisher, MD, FAAAAI, Executive Vice President,
American Academy of Allergy, Asthma, & Immunology
Dr. Sandra Harris-Hooker, Senior Vice President for
Research Administration and Professor of Pathology, Morehouse
School of Medicine
Katie Ray-Jones, Chief Executive Officer, The National
Domestic Violence Hotline
Rick Ginsberg, Dean of the School of Education, University
of Kansas, The Learning and Education Academic Research Network
(LEARN) Coalition
Antonio Flores, PHD, President & CEO, Hispanic Association
of Colleges and Universities
Janet Hamilton, Executive Director, Council of State and
Territorial Epidemiologists
Moira Szilagyi, MD, PHD, FAAP, President, American Academy
of Pediatrics
Mark Anthony Figueroa, GEAR UP Alumnus, National Council
for Community and Education Partnerships
Esther Lucero, President & CEO, Seattle Indian Health Board
Lodriguez Murray, Senior Vice President, Public Policy and
Government Affairs, United Negro College Fund
Nancy Gonzales, Owner, Lil' Bears Family Day Care, American
Federation of State, County, and Municipal Employees
BUDGETARY IMPACT OF THE FY 2023 LABOR, HEALTH AND HUMAN SERVICES,
EDUCATION, AND RELATED AGENCIES APPROPRIATIONS BILL PREPARED IN
CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SECTION
308(A) OF THE CONGRESSIONAL BUDGET ACT OF 1974
[In millions of dollars]
COMPARISON WITH 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 allocation under section 302(b) of the Budget
Act.
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
302 (b) Allocation This Bill
---------------------------------------------------------------
Budget Budget
Authority Outlays Authority Outlays
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee
allocations to its subcommittees: Subcommittee
on Labor, Health and Human Services, and
Education, and Related Agencies
General Purpose Discretionary............... 224,399 303,500 224,399 \1\293,642
Mandatory................................... 1,134,027 1,130,832 1,134,027 \1\1,130,832
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
NOTE.--The amounts in this report do not include $495 million in discretionary budget authority and $548 million
in associated outlays from amounts becoming available in fiscal year 2023 that were previously designated as
being for an emergency requirement pursuant to a concurrent resolution on the budget. Consistent with the
Congressional Budget Act of 1974, in the House of Representatives such amounts do not count against the
Committee's allocation.
In addition, the amounts in this report do not include $1,085 million in discretionary budget authority and $561
million in associated outlays provided for the purposes specified in the 21st Century Cures Act (Public Law
114-255). Pursuant to title I of that Act, such funding does not count for the purposes of the Congressional
Budget Act of 1974 or the Balanced Budget and Emergency Deficit Control Act of 1985.
In addition, consistent with the funding recommended in the bill for program integrity initiatives, in
accordance with the Congressional Budget Act of 1974 and subsections (h), (i), and (j) of section 1 of H. Res.
1151 (117th Congress), and after the bill is reported to the House, the chair of the Committee on the Budget
will provide a revised section 302(a) allocation reflecting an additional $2,345 million in discretionary
budget authority and $,1892 million in associated outlays for those recommended amounts. That new allocation
will eliminate the technical difference prior to floor consideration.
FIVE-YEAR OUTLAY PROJECTIONS
Pursuant to clause 3(c)(2) of rule XIII and section
308(a)(1)(B) of the Congressional Budget Act of 1974, the
following table contains five-year projections associated with
the budget authority provided in the accompanying bill as
provided to the Committee by the Congressional Budget Office.
[In millions of dollars]
------------------------------------------------------------------------
Outlays
------------------------------------------------------------------------
Projection of outlays associated with the
recommendation:
2023............................................. \1\1,220,966
2024............................................. 128,005
2025............................................. 31,447
2026............................................. 8,972
2027 and future years............................ 2,759
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.
FINANCIAL ASSISTANCE TO STATE AND LOCAL GOVERNMENTS
Pursuant to clause 3(c)(2) of rule XIII and section
308(a)(1)(C) of the Congressional Budget Act of 1974, the
Congressional Budget Office has provided the following
estimates of new budget authority and outlays provided by the
accompanying bill for financial assistance to State and local
governments.
[In millions of dollars]
------------------------------------------------------------------------
Budget Authority Outlays
------------------------------------------------------------------------
Financial assistance to State and 468,414 \1\642,004
local governments for 2023.......
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.
MINORITY VIEWS
We appreciate the efforts of the Majority in producing a
Labor, Health and Human Services, Education, and Related
Agencies (Labor-HHS) Appropriations bill for Fiscal Year 2023
that funds priorities of Members on both sides of the aisle. We
were pleased the Committee adopted an amendment proposed by a
Republican Member that maintains enforcement of Title 42, an
important public health policy used at our Nation's borders,
until the Administration provides a plan for its safe removal.
We were also pleased the Majority included language proposed by
Republicans, which ensures taxpayer money cannot be used to
purchase crack pipes for consuming illegal substances and
ensures taxpayer money will not go to the Wuhan Institute of
Virology, or any other laboratory located in a country
determined by the Secretary of State to be a foreign adversary,
including China, Russia, North Korea, and Iran. These common
sense funding restrictions improved this bill, and we are
hopeful they will be retained in the final package.
Despite the many good programs supported in the bill,
Republicans are unanimous in our opposition to this measure. It
is simply too extreme and out of step with the American people.
First, the bill provides a hefty 14 percent, nearly $30
billion, increase in funding over current levels. The price tag
alone is unrealistic, revealing radical left-wing spending
priorities and a total disregard for fiscal responsibility.
While American families are experiencing the highest
inflation rates and consumer prices seen in four decades, the
Majority has chosen to exacerbate these problems by dumping
millions of dollars into new, unauthorized social programs.
Another reason we oppose this radical measure is the
Majority's removal of the Hyde Amendment, which protects life
and prevents federal taxpayer-funded abortions. Since it was
first enacted in 1976, it is estimated this provision has saved
more than two million lives while protecting the conscience
rights of the great majority of Americans who are opposed to
publicly funded abortions for religious, moral, or fiscal
reasons.
Republicans offered an amendment in Committee to reinstate
this important protection for all Americans. The amendment was
cosponsored by every Republican on the Committee, and this
language must be reinstated to complete work on a final
spending bill.
The amendment also sought to continue longstanding
protections for healthcare workers who refuse to participate
directly in abortions against their own moral beliefs and
consciences. Disappointingly, the Majority rejected an
amendment to reinstate the Hyde/Weldon language in Committee.
Beyond these extreme positions, the bill includes many
other troubling policies and provisions. Amendments were
offered by Republican Members to:
stop new regulations proposed by the Biden
Administration that will make it difficult for charter
schools to operate;
strike language that limits apprenticeship
programs to only those run by labor unions;
prevent the Biden Administration from
authorizing en-masse cancellation of student loan debt
that will only exacerbate our economic problems;
prohibit the development, administration, or
enforcement of new rules that mandate COVID-19
vaccination; and
prohibit the Administration from declaring a
public health emergency under the guise of imposing
restrictions on second amendment rights.
Unfortunately, each of these amendments were defeated by
the Majority in Committee. Long-standing language should be
retained and poison pills must be removed to achieve a final
bipartisan spending deal.
We urge the Majority to abandon their pursuit of radical,
extremist views and move back toward the bipartisan compromise
they know is necessary to fund the government.
We are hopeful that in the weeks ahead, we will be able to
address both the policy and funding issues, including
reinstatement of the bipartisan Hyde/Weldon language. Without
this, these spending bills will not become law. Our goal should
be to avoid a long-term continuing resolution and build on the
good progress we have made in the past by working together.
Kay Granger.
Tom Cole.