[House Report 117-96]
[From the U.S. Government Publishing Office]
117th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 117-96
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2022
_______
July 19, 2021.--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. 4502]
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, 2022,
and for other purposes.
INDEX TO BILL AND REPORT
Page number
Bill Report
Summary of Estimates and Appropriation.....................
3
General Summary of the Bill................................
3
Title I--Department of Labor: 2
13
Employment and Training Administration............. 2
13
Employee Benefits Security Administration.......... 20
27
Pension Benefit Guaranty Corporation............... 21
28
Wage and Hour Division............................. 22
28
Office of Labor-Management Standards............... 22
30
Office of Federal Contract Compliance Programs..... 23
30
Office of Workers' Compensation Programs........... 23
30
Occupational Safety and Health Administration...... 27
33
Mine Safety and Health Administration.............. 28
35
Bureau of Labor Statistics......................... 30
36
Office of Disability Employment Policy............. 30
37
Departmental Management............................ 31
37
General Provisions................................. 36
45
Title II--Department of Health and Human Services: 46
46
Health Resources and Services Administration....... 46
46
Centers for Disease Control and Prevention......... 56
79
National Institutes of Health...................... 63
108
Substance Abuse and Mental Health Services
Administration................................. 73
166
Agency for Healthcare Research and Quality......... 79
187
Centers for Medicare & Medicaid Services........... 80
191
Administration for Children and Families........... 84
205
Administration for Community Living................ 97
225
Office of the Secretary............................ 100
232
Public Health and Social Services Emergency Fund... 104
250
General Provisions................................. 106
257
Title III--Department of Education: 134
261
Education for the Disadvantaged.................... 134
261
Impact Aid......................................... 135
265
School Improvement Programs........................ 136
266
Indian Education................................... 138
270
Innovation and Improvement......................... 138
271
Safe Schools and Citizenship Education............. 139
280
English Language Acquisition....................... 140
283
Special Education.................................. 140
284
Rehabilitation Services............................ 145
288
Special Institutions for Persons with Disabilities. 146
290
Career, Technical and Adult Education.............. 147
291
Student Financial Assistance....................... 148
292
Federal Direct Student Loan Program Account........
294
Student Aid Administration......................... 148
295
Higher Education................................... 151
296
Howard University.................................. 152
308
College Housing and Academic Facilities Loans...... 153
308
Historically Black College and University Capital
Financing Program Account...................... 153
308
Institute of Education Sciences.................... 154
309
Departmental Management............................ 154
311
General Provisions................................. 156
317
Title IV--Related Agencies: 163
319
Committee for the Purchase from People Who Are
Blind or Severely Disabled..................... 163
319
Corporation for National and Community Service..... 164
319
Corporation for Public Broadcasting................ 169
323
Federal Mediation and Conciliation Service......... 170
324
Federal Mine Safety and Health Review Commission... 170
324
Institute of Museum and Library Services........... 171
324
Medicaid and CHIP Payment and Access Commission.... 172
326
Medicare Payment Advisory Commission............... 172
325
National Council on Disability..................... 172
326
National Labor Relations Board..................... 172
326
National Mediation Board........................... 173
327
Occupational Safety and Health Review Commission... 173
328
Railroad Retirement Board.......................... 173
328
Social Security Administration..................... 175
329
Title V--General Provisions: 180
334
House of Representatives Report Requirements
335
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriations, including trust funds for fiscal year 2022, the
budget request for fiscal year 2022, and the Committee
recommendation for fiscal year 2022 in the accompanying bill.
2022 LABOR, HHS, EDUCATION BILL
[Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal Year-- 2022 Committee compared to--
Budget Activity -------------------------------------------------------------------------------
2021 Enacted 2022 Budget 2022 Committee 2021 Enacted 2022 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............. $12,536,098 $14,320,422 $14,720,051 +2,183,953 +399,629
Department of Health and Human $96,962,754 $119,972,989 $119,845,125 +22,882,371 -127,864
Services.......................
Department of Education......... $73,536,533 $102,823,263 $102,823,263 +29,286,730 - - -
Related Agencies................ $15,428,615 $16,845,305 $16,867,354 +1,438,739 +22,049
----------------------------------------------------------------------------------------------------------------
General Summary of the Bill
For fiscal year 2022, the Committee recommends a total of
$237,466,000,000 in current year discretionary funding--the
302(b) allocation--and $253,805,000,000 in overall programmatic
funding, including offsets and adjustments. The fiscal year
2022 recommendation is an increase of $55,236,000,000 above the
fiscal year 2021 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. Many of the bill's programs have been severely
strained over the past 18 months during the simultaneous public
health and economic emergencies related to COVID-19.
Fortunately, the President's fiscal year 2022 budget proposes
to invest significant resources in these critical programs that
provide opportunities for millions of families. Through this
bill, the Committee is moving ambitiously to help the country
recover from the worst pandemic in a century and move forward
to strengthen opportunities for every individual to have a
better chance at a better life--with a good education, a good
job, and access to affordable health care.
The Committee recommends historic investments in education
programs, including meeting the Biden-Harris Administration's
commitment to more than double federal funding for Title I
Grants to Local Educational Agencies in fiscal year 2022 to a
new level of $36,037,000,000. These investments will strengthen
Federal support for high-poverty schools and support the
delivery of a high-quality education for all students.
The Committee also recommends a historic investment in
rebuilding our public health system. As the country recovers
from the worst pandemic in a century, the Committee includes
more than $10,500,000,000 for the Centers for Disease Control
and Prevention (CDC), an increase of nearly $2,700,000,000,
which is the largest increase in budget authority ever provided
to the CDC. This includes a new flexible funding stream of
$1,000,000,000 for public health infrastructure and capacity,
as well as an increase of $250,000,000 for CDC's global health
activities.
The Committee continues to build on investments made over
the past six years in biomedical research by increasing funding
for the National Institutes of Health (NIH) by $6,500,000,000,
including an increase of $3,500,000,000 for basic biomedical
research at existing NIH institutes and centers. As part of the
Committee's investment in health research, the Committee also
includes $3,000,000,000 to support the President's request to
establish the Advanced Research Projects Agency for Health, or
ARPA-H, to accelerate the pace of scientific breakthroughs that
have the potential to transform health care and address our
most complex health challenges.
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 $1,000,000,000
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 2022
include:
Investing in Public 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
$65,551,722,000 for Federal K-12 education programs, including
Individuals with Disabilities Education Act (IDEA), an increase
of $24,998,971,000 over the fiscal year 2021 enacted level and
the same as the Biden-Harris Administration's fiscal year 2022
budget request. The recommendation is a 62 percent increase
over last year.
In particular, the Committee recommends an additional
$19,500,000,000 over the fiscal year 2021 enacted level for
Title I Grants to Local Educational Agencies for a total of
$36,036,802,000. 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
$202,600,000 over the fiscal year 2021 enacted level and
$82,600,000 above the fiscal year 2022 budget request. 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 $15,537,429,000 for IDEA Part B
Grants to States, which is $2,599,972,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. 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 first
step toward fully funding IDEA.
Public Health Infrastructure
The COVID-19 pandemic exposed the inadequacies of the
current public health ecosystem. After the COVID-19 pandemic is
over, public health agencies cannot go back to what they were
and 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 more
than $10,500,000,000 for the CDC, an increase of nearly
$2,700,000,000.
The Committee provides a new, annual funding line to turn
the tide on the nation's public health infrastructure by
providing a stable source of disease-agnostic funding so that
nation's State, local, territorial, and Federal public health
agencies are better equipped to coordinate together to save
lives. This bill includes $1,000,000,000 for Public Health
Infrastructure and Capacity to begin to address mission-
critical gaps nationwide.
In addition, this bill includes increases of: $50,000,000
for Public Health Workforce and Career Development to invest in
essential public health workers who protect our communities and
are empowered by science; $100,000,000 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; $15,000,000 for the
National Center for Health Statistics to initiate investments
in the next generation of surveys; and $250,000,000 for Global
Health to modernize and expand disease surveillance and
response capabilities to strengthen global health security.
NIH Research
The unprecedented speed with which scientists were able to
develop effective COVID-19 vaccines would not have been
possible without years of sustained investments made by
Congress in biomedical research supported by the National
Institutes of Health (NIH). The Committee continues and
accelerates this investment by providing $46,434,000,000, an
increase of $6,500,000,000 above the fiscal year 2021 enacted
level. The bill includes an increase of $3,500,000,000 for
traditional NIH research and activities, the largest annual
appropriations increase for NIH since fiscal year 2003.
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 no less than five percent for each Institute and
Center. 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 includes $3,000,000,000 to establish the
Advanced Projects Research Agency for Health (ARPA-H), as
proposed in the President's budget request. 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, and
amyotrophic lateral sclerosis (ALS).
Employment and Training
The economic recession resulting from the COVID-19 pandemic
impacted American families and further exposed existing
inequities in our society. For example, while the unemployment
rate peaked at 14.8 percent in April 2020 and is now at 5.9
percent, the unemployment rate for Black workers peaked in May
2020 at 16.7 percent and is now at 9.2 percent and the
unemployment rate for Hispanic workers peaked at 18.9 percent
in April 2020 and is now at 7.4 percent. The unemployment rate
for White workers peaked at 14.1 percent in April 2020 and is
now at 5.2 percent. In addition, COVID-19 had devastating
impacts on women's participation in the labor force, especially
for women of color. As our nation emerges from the COVID-19
pandemic, unemployment assistance and workforce development
opportunities will continue to play a critical role in our
recovery.
As such, the Committee recommendation includes needed
investments in workforce and training systems. Specifically,
the recommendation includes $6,237,181,000 for Workforce
Innovation and Opportunity Act Programs, an increase of
$825,326,000 above the fiscal year 2021 enacted level and
$271,750,000 above the fiscal year 2022 budget request. The
recommendation includes $285,000,000 for registered
apprenticeships, an increase of $100,000,000 above the fiscal
year 2021 enacted level and the same as the fiscal year 2022
budget request. The recommendation also includes $100,000,000
for the Strengthening Community Colleges Training Grant
program, an increase of $55,000,000 above the fiscal year 2021
enacted level and the fiscal year 2022 budget request. This
program helps community colleges build capacity for training
workers. The recommendation includes $100,000,000 for a new
grant program to support communities suffering dislocations
related to changes in fossil fuel and other energy industries.
The recommendation also includes $2,866,214,000 for
Unemployment Compensation State Operations, an increase of
$509,398,000 over the fiscal year 2021 enacted level and the
same as the fiscal year 2022 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 struggling
with the economic consequences of COVID-19 and prepare workers
for new employment opportunities.
Protecting America's Workers
The Committee recommends $2,095,685,000 for Department of
Labor agencies responsible for worker protection and worker
rights. This is an increase of $305,015,000 over the fiscal
year 2021 enacted level and $1,161,000 over the fiscal year
2022 budget request.
The Wage and Hour Division employs fewer investigators
today than it did in 1948, 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
$300,000,000, an increase of $54,000,000 over the fiscal year
2021 enacted level and an increase of $23,500,000 over the
fiscal year 2022 budget request.
The Occupational Safety and Health Administration (OSHA)
currently has the lowest number of health and safety inspectors
in the agency's 48-year history. OSHA enforcement is critical
to preventing workplace tragedies from occurring, which is why
it is concerning that, under current staffing levels, the
agency would need 165 years to inspect each workplace under its
jurisdiction just once. To reverse the erosion of enforcement
capacity at OSHA, the Committee includes $691,787,000, an
increase of $100,000,000 over the fiscal year 2021 enacted
level and $27,163,000 over the fiscal year 2022 budget request
for this critical worker protection agency.
The Committee also recommends $316,925,000 for the
National Labor Relations Board, an increase of $42,701,000 over
the fiscal year 2021 enacted level and $15,000,000 over the
fiscal year 2022 budget request. This increase will address
decline in field staff the Board has seen over the past four
years.
Early Childhood Education
The Committee includes over $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 $3,075,000,000 over the
fiscal year 2021 enacted level.
Child care is one of the most critical needs of families
with young children--it is essential--and yet CCDBG currently
reaches only 15 percent of children who are eligible to receive
child care services. The increase included in this bill will
provide CCDBG-funded child care for approximately 200,000
additional children, which will also enable more parents in
low-income families to remain in the workforce. Women,
particularly women of color, are disproportionately impacted by
the child care crisis in this country, and the investment in
this bill builds on the $52,500,000,000 in supplemental funding
that Congress provided for child care during the coronavirus
pandemic: $3,500,000,000 in the Coronavirus Aid, Relief, and
Economic Security (CARES) Act (P.L. 116-136), $10,000,000,000
through the Coronavirus Response and Relief Supplemental
Appropriations (CRRSA) Act, 2021 (P.L. 116-260), and
$39,000,000,000 through the American Rescue Plan (P.L. 117-2).
The bill includes an increase of $1,434,000,000 for Head
Start, including increases of $250,000,000 for Quality
Improvement Funding for Trauma-Informed Care and $750,000,000
to expand Head Start, Early Head Start, and Early Head Start-
Child Care Partnerships to over 40,000 additional infants and
toddlers from low-income families. The bill also includes
$200,000,000 for Head Start programs to extend to full day
services, to better support working parents and bring
additional programs into compliance with the 2016 Head Start
Program Performance Standards.
The Committee further recommends $450,000,000, an increase
of $175,000,000, 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 $400 over the fiscal
year 2021 enacted level, from $6,495 to $6,895, which is the
same as the fiscal year 2022 discretionary budget request.
In addition, the Committee recommendation provides
$1,434,000,000 for Federal Work Study, an increase of
$244,000,000 over the fiscal year 2021 enacted level and the
fiscal year 2022 budget request. The Committee recommendation
also includes $1,028,000,000 for the Federal Supplemental
Educational Opportunity Grants, an increase of $148,000,000
over the fiscal year 2021 enacted level and the fiscal year
2022 budget request.
The Committee recommendation includes $1,297,761,000 for
the TRIO programs, an increase of $200,761,000 over the fiscal
year 2021 enacted level and the same as the fiscal year 2022
budget request. The recommendation also includes $408,000,000
for the Gaining Early Awareness and Readiness for Undergraduate
Programs, which is $40,000,000 more than the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request.
In an effort to assist postsecondary institutions in
addressing barriers in completion and attainment, the Committee
recommendation includes a total of $1,134,054,000 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 $345,000,000 over the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request.
The Committee also includes robust funding to support
teacher preparation. The recommendation includes $20,000,000 in
new funding for the Augustus F. Hawkins Centers of Excellence
program, and the recommendation includes $132,092,000 for the
Teacher Quality Partnerships program, an increase of
$80,000,000 over the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request.
Maternal Health
The U.S. has the highest maternal mortality rate among
developed nations, with a particularly high mortality rate for
Black and American Indian/Alaska Native women. To help
eliminate race-based disparities in outcomes among birthing
people and drive down the rate of maternal mortality, the bill
provides an increase of $56,000,000 for CDC's Safe Motherhood
and Infant Health programs. This funding allows for the
expansion of Maternal Mortality Review Committees and Perinatal
Quality Collaboratives to all 50 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. The bill includes an increase of over
$178,000,000 at HRSA to support activities to improve maternal
health, including an increase of $30,000,000 for State Maternal
Health Innovation Grants, an increase of $5,300,000 to expand
the Alliance for Maternal Health Safety Bundles to more States,
an increase of $2,000,000 to support and expand availability of
the Maternal Mental Health Hotline, $25,000,000 to conduct a
demonstration program on pregnancy medical homes, an increase
of $5,000,000 to double funding for Screening and Treatment for
Maternal Depression and Related Disorders, an increase of
$5,400,000 for Rural Maternity and Obstetrics Management
Strategies. The bill also includes increased investments in
research related to maternal health and health disparities at
NIH and the Agency for Healthcare Research and Quality (AHRQ).
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 $688,000,000,
which is an increase of $245,000,000 for the third 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 doubles the total funding to $50,000,000 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.
Mental and Behavioral Health
The existing mental health and substance use disorder
crises were worsened by the COVID-19 pandemic, with Americans
reporting increased levels of anxiety, depression, suicidal
ideation, and substance use. Between September 2019 and August
2020, more than 85,000 people nationwide died from drug
overdoses, and 47,000 people died from suicide in 2019.
The Committee recommendation includes $9,160,277,000 for
the Substance Abuse 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
$1,366,020,000 for mental health activities. This includes an
increase of $825,000,000 for the Mental Health Block Grant and
an increase of $125,000,000 for Certified Community Behavioral
Health Clinics. The bill increases the mental health crisis
set-aside to ten percent, creates a new set-aside for
prevention and early intervention, and makes investments to
prepare for the launch of a new three digit National Suicide
Prevention Lifeline.
The Committee includes $100,000,000 to establish the Mental
Health Crisis Response Partnership Pilot Program, to help
communities 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
$28,113,000 increase to the National Child Traumatic Stress
Initiative, a $17,000,000 increase for Infant and Early
Childhood Mental Health, and an additional $25,000,000 for
Children's Mental Health services.
The Committee includes a total increase of $1,657,187,000
for substance use treatment activities. This includes an
increase of $1,000,000,000 for the Substance Abuse Prevention
and Treatment Block Grant and an increase of $500,000,000 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
$35,284,000 for substance misuse prevention activities.
OVERSIGHT OF THE EXECUTIVE BRANCH
The Committee has also fulfilled its responsibility to
maintain oversight of the Executive Branch by holding seven
oversight hearings--in addition to annual hearings on the
fiscal year 2022 budget request. The Committee has focused on
ongoing crises in health care, education, and labor, which have
highlighted unjust racial disparities which were further
exacerbated by the COVID-19 pandemic. These oversight hearings
have informed many of the decisions in the fiscal year 2022
Labor-HHS Education bill.
COVID-19 and the Child Care Crisis
The Committee held a virtual hearing to discuss the
devastating impacts that the COVID-19 pandemic had on a child
care industry already in crisis. Affordable child care was
already a significant and severe issue, but rising operating
costs and decreased enrollment as a result of the pandemic were
too much for the razor thin margins of many child care
providers, and other providers were left grasping for financial
assistance. The Committee heard from policy experts, a State
administrator, and a program director, about the critical
financial needs of child care providers struggling to stay
afloat, the necessity of child care for parents and especially
for women in the workforce, and the impact that the child care
shortage has on job reports and unemployment statistics. The
hearing highlighted how COVID-19 exacerbated the child care
crisis, and exposed the necessity for a financially stable
child care industry, to support women and communities of color,
and for post-pandemic economic recovery. Soon after the
Committee's hearing, House and Senate Democrats passed the
American Rescue Plan (P.L. 117-2) which included
$39,000,000,000 for the Child Care and Development Block Grant
program.
Ready or Not: U.S. Public Health Infrastructure
The Committee held a virtual hearing to examine the status
and challenges of our nation's public health infrastructure,
with a particular focus on public health data, laboratories,
and workforce. The COVID-19 pandemic exposed the inadequacies
of the current public health ecosystem, and the Committee heard
from State and local public health officials about the
importance of flexible, long-term investments in public health.
As a result of this hearing, this bill includes a new funding
line of $1,000,000,000 for Public Health Infrastructure and
Capacity. The Committee's action denotes that the tide has
turned for public health funding, as it establishes a disease-
agnostic source of funding to address mission-critical gaps in
public health infrastructure nationwide.
Health and Safety Protections for Meatpacking, Poultry, and
Agricultural Workers
The Committee held a virtual hearing to examine dangerous
conditions faced by meat, poultry, and farm workers, especially
during the COVID-19 pandemic, and to highlight the role strong
federal enforcement from the Occupational Health and Safety
Administration (OSHA) can play in addressing the problem. The
Committee heard from a worker safety and health expert, a
farmworker advocate, and the child of a Smithfield meatpacking
worker about the concerning hazards workers faced during the
pandemic and the need for urgent action from OSHA to hold these
industries accountable to protect vulnerable workers. As a
result of this hearing, this bill includes an increase of
$100,000,000 for OSHA above the fiscal year 2021 enacted level.
The recommendation, a 17 percent increase over last year, will
support additional OSHA inspectors and restore the agency's
capacity to conduct more complex, labor-intensive inspections.
COVID-19 and the Mental Health and Substance Use Crises
The Committee held a virtual hearing to examine the impact
of the COVID-19 pandemic on the mental health and substance use
crises and the responses to this emergency, and heard
recommendations on how to build a stronger behavioral health
system capable of meeting the demand for services. The COVID-19
pandemic dramatically worsened these existing crises, creating
new barriers to treatment while increasing numbers of Americans
are reporting anxiety, depression, and substance use. People
with existing vulnerabilities have been disproportionately
affected--including communities of color, underserved
communities, essential workers, people who were already
struggling with a mental illness or substance use disorder or
were otherwise in poor health, children, and families
struggling economically. As a result of this hearing, the
Committee is making substantial investments to strengthen the
behavioral health continuum of care to increase access to
prevention, screening, treatment and other critical services.
Addressing the Maternal Health Crisis
The Committee held a virtual hearing to identify the
reasons why the U.S. lags behind other industrialized nations
in maternal health outcomes; examine the disparities in
maternal health outcomes by race, socioeconomic status,
residence, and other factors; and identify opportunities to
address these issues through investments in HHS programs. As a
result of this hearing, the bill increases funding for programs
across HRSA, CDC, NIH, and AHRQ to improve access to quality
maternal and postpartum health care and reduce disparities in
maternal health outcomes.
Building Capacity, Building Community: Increasing Investments in
Community Colleges
The Committee held a virtual hearing that explored the
importance of community colleges, as well as their strengths
and challenges. Today, there are more than 1,000 community
colleges. Community colleges touch upon the lives of
individuals in every State and even the outlying areas.
Community colleges are typically open access institutions,
serving a diverse student body with unique challenges. While,
typically, the associate's degree is the highest degree awarded
at community colleges, these institutions also offer a wide
variety of postsecondary credentials. In this way, community
colleges are uniquely positioned to meet the workforce
development and educational needs of our country
simultaneously. As a result of this hearing, the recommendation
includes robust increases for programs that help support
community colleges and their students: the WIOA programs, the
Strengthening Community Colleges Training Grant program, the
Apprenticeship Grants program, the Strengthening Institutions
program, and the Child Care Access Means Parents in School
program.
Mental Health Emergencies: Building a Robust Crisis Response System
The Committee held a virtual hearing on how to create a
robust mental health crisis care system with services available
to anyone, anywhere, anytime, with a goal of diverting people
experiencing a mental health crisis from the criminal justice
system into mental health treatment. The lack of sufficient
mental health care resources in communities means mental
illness often goes untreated, which can lead to law enforcement
responding to mental health emergencies because there are no
alternatives to respond to the crisis. As a result of this
hearing, the bill increases funding for mental health crisis
services and creates a Mental Health Crisis Response
Partnership Pilot 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.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
Appropriation, fiscal year 2021....................... $10,025,760,000
Budget request, fiscal year 2022...................... 11,254,695,000
Committee Recommendation.............................. 11,625,914,000
Change from enacted level......................... +1,600,154,000
Change from budget request........................ +371,219,000
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 2021....................... $3,663,200,000
Budget request, fiscal year 2022...................... 4,210,672,000
Committee Recommendation.............................. 4,407,108,000
Change from enacted level......................... +743,908,000
Change from budget request........................ +196,436,000
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
$923,174,000, which is $60,525,000 more than the fiscal year
2021 enacted level and $23,187,000 more than the fiscal year
2022 budget request.
Youth Employment and Training Activities.--For Youth
Employment and Training Activities, the Committee recommends
$988,604,000, which is $67,474,000 more than the fiscal year
2021 enacted level and $24,767,000 more than the fiscal year
2022 budget request.
Dislocated Worker Employment and Training Activities.--For
Dislocated Worker Employment and Training Activities, the
Committee recommends $1,183,554,000, which is $122,001,000 more
than the fiscal year 2021 enacted level and $28,276,000 more
than the fiscal year 2022 budget request.
Dislocated Worker Assistance National Reserve.--The
Committee recommends $435,859,000 for the Dislocated Workers
National Reserve, an increase of $155,000,000 more than the
fiscal year 2021 enacted level and $55,000,000 over the fiscal
year 2022 budget request.
The Committee recommendation includes $100,000,000, an
increase of $55,000,000 over the fiscal year 2021 enacted level
and the fiscal year 2022 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 recommendation 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 $100,000,000 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 includes $10,000,000, the same as the fiscal
year 2021 enacted level, for grants to support national out-of-
school time organizations that serve youth and teens and place
an emphasis on age-appropriate workforce readiness programming
to expand job training and workforce pathways for youth and
disconnected youth, including soft skill development, career
exploration, job readiness and certification, summer jobs,
year-round job opportunities, and registered apprenticeships.
Funding will also support partnerships between workforce
investment boards and youth serving organizations.
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 includes $5,000,000 in fiscal year 2022 for a
demonstration program to provide fulltime, work-based learning
coordinators in underserved communities with an already proven
track record for secondary career and technical education.
Work-based learning coordinators will conduct outreach,
engagement, recruitment and coordination of work-based learning
activities, including, but not limited to, paid internships or
pre-apprenticeships for high school students, with local
community employers, especially with in-demand industries of
information technology, health sciences, and engineering. The
work-based learning coordinators may be employed by the local
education agency, local workforce development board or local
workforce development agency, a group of employers, or a
consortium of eligible entities. In making grant awards, the
Committee directs the Secretary to ensure to require a plan for
evaluations in each individual grant proposal, including types
of work-based learning opportunities completed, demographics of
participating students, and students' post-secondary career
plan, as well as to conduct a national assessment of all
grantee proposals once complete.
Native Americans.--For the Indian and Native American
programs, the Committee recommends $58,000,000, which is
$2,500,000 more than the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request.
Migrant and Seasonal Farmworkers.--For the National
Farmworker Jobs program, the Committee recommends $96,711,000,
which is $2,815,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request.
YouthBuild.--For the YouthBuild program, the Committee
recommends $145,000,000, which is $48,466,000 more than the
fiscal year 2021 enacted level and the same as the fiscal year
2022 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 $49,921,000 more than the
fiscal year 2021 enacted level and the same as the fiscal year
2022 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
or have been disproportionately impacted by the COVID-19
pandemic.
The Committee also continues the set-aside of $25,000,000
for competitive grants to national and regional intermediaries
for activities that prepare young adults with criminal legal
histories or who have been justice system-involved or who have
dropped out of school or other educational programs, with a
priority for projects serving high-crime, high-poverty areas.
The Committee directs the Department to consult data from the
Department of Education and prioritize grants in communities
where students of color have disproportionate rates of
expulsions and suspensions.
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
2023 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 $7,250,000 for the Workforce Data Quality
Initiative, which is $1,250,000 more than the fiscal year 2021
enacted level and the fiscal year 2022 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
$285,000,000 for the apprenticeship grants program, which is
$100,000,000 more than the fiscal year 2021 enacted level and
the same as the fiscal year 2022 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 is encouraged by the Administration's actions
to restore the Federal Government's role in ensuring high-
quality training opportunities by taking steps to rescind the
industry registered apprenticeship program. The national
apprenticeship program is in dramatic need of modernization
through expansion of registered apprenticeship, 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, beginning with cybersecurity workforce and 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 strongly supports efforts to expand
Registered Apprenticeships to traditionally underrepresented
communities and encourages the Department to explore the
feasibility and expansion of Registered Apprenticeship programs
within the arts, theater, film, and television industries.
Specifically, the Committee requests that the Department
explore expanding the Registered Apprenticeship model to create
career training strategies for all roles in the entertainment
industry such as creative, production, technical, marketing and
public relations roles.
In addition, the Committee notes that apprenticeships are
an important path to the middle-class. 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 is also concerned about shortages nationwide
of qualified drinking water and wastewater operation
professionals, especially in rural areas, and encourages the
Secretary to make funding available to address these
challenges. Further, the Committee directs the Department to
work with eligible community organizations to support the
creation of new training programs focused on filling identified
gaps in the maritime workforce.
The Committee also supports the use of apprenticeship
grants that provide worker education based on public-private
partnerships in in-demand fields, including first responders,
as well as in goods movement sectors such as global logistics,
rail and other freight-related employment.
The Committee encourages the Department to support
apprenticeship programs that increase the number of trained
workers in cybersecurity.
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
encourages 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.
National Youth Employment Program.--For the National Youth
Employment Program, the Committee recommends $50,000,000, which
is the same as the fiscal year 2022 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
$20,000,000, which is the same as the fiscal year 2022 budget
request. This new competitive grant program will prepare
veterans and their spouses for careers in clean energy.
Community Project Funding.--Within the funds included in
this account, $63,956,000 shall be used for the following
projects in the following amounts:
------------------------------------------------------------------------
Project Amount
------------------------------------------------------------------------
AIDS Service Center of Lower Manhattan, Inc. dba $1,000,000
Alliance for Positive Change, New York, NY for a
workforce development initiative....................
Anne Arundel County Government, Annapolis, MD for $500,000
Youthworks!.........................................
Arizona Opportunities Industrialization Center, $1,200,000
Phoenix, AZ for the provision of comprehensive
training courses and job placement in the
hospitality industry................................
Avivo, Minneapolis, MN for workforce training related $1,000,000
to clean energy and green building, including
equipment...........................................
Benedict College, Columbia, SC for workforce $2,000,000
development activities, including technology,
equipment, and supportive services..................
Beyond the Sanctuary, Inc., Rochester, NY for job $525,000
readiness program, including equipment and
supportive services.................................
Bristol County Chamber Foundation, Fall River, MA for $500,000
workforce development activities....................
Broward College, Ft. Lauderdale, FL for workforce $2,000,000
development initiative, including mobile training
units...............................................
Buffalo Sewer Authority, Buffalo, NY for a workforce $575,000
development initiative related to green
infrastructure, including equipment, stipends, and
supportive services.................................
California Mobility Center, Sacremento, CA for a $2,000,000
workforce development initiative, including
equipment...........................................
City of Boston, MA for short-term training programs, $1,000,000
including stipends..................................
City of East Providence, RI for a training program... $350,000
City of Greensboro, NC for a workforce development $1,600,000
initiative, including technology and supportive
services............................................
City of Houston, TX for a workforce development $750,000
initiative related to a solar initiative, including
job-placement, stipends, and supportive services....
City of Perris, CA for a workforce development $1,000,000
initiative..........................................
City of South San Francisco, CA, for workforce $500,000
development services, including career services and
job placement.......................................
Coalition for Responsible Community Development, Los $250,000
Angeles, CA for transitional employment and training
for formerly incarcerated adults, including
supportive services.................................
College of Eastern Idaho, Idaho Falls, ID for $100,000
workforce training program and equipment............
College of Lake County, Grayslake, IL for a workforce $900,000
development initiative related to manufacturing,
including equipment.................................
Colonial Farmhouse Restoration Society of Bellerose, $200,000
Inc., Floral Park, NY for a workforce training
initiative, including equipment.....................
Community Assistance Programs, Chicago, IL for job $100,000
training, job placement and supportive services.....
Comunidades Organizando el Poder y la Accion Latina $1,000,000
Education Fund, Minneapolis, MN for workforce
development activities, including equipment.........
Cornerstone Revitalization Foundation, Inc., $1,500,000
Birmingham, AL for workforce development activities,
including opprtunities to obtain a GED,
postsecondary credentials, and stipends.............
Council for Native Hawaiian Advancement, Kapolei, HI $1,200,000
for workforce training programs.....................
Covenant House Florida, Ft. Lauderdale, FL for work- $300,000
based learning and supportive services for homeless
youth...............................................
DC Central Kitchen, Washington, DC for culinary job $500,000
training, including stipends and equipment..........
Dream It Do It Western New York Inc., Jamestown, NY $250,000
for job training and placement......................
Eclectic Soul VOICES Corporation, Indianapolis, IN $100,000
for a job training program, including supportive
services and stipends...............................
Emerald Isle Immigration Center, Woodside, NY for $60,000
workforce development activities, including career
and supportive services.............................
Fairfax County Government, Fairfax, VA for a job $1,000,000
training program for pregnant and parenting teens
and non-parenting young adults, including equipment.
Fairfax County Government, Fairfax, VA for an $400,000
apprenticeship training program, including stipends.
Florida Endowment Foundation for Florida's Graduates, $1,500,000
Flagler Beach, FL for an at-risk youth jobs program.
Frederick County Government, Frederick, MD for a $250,000
mobile career center................................
Hire Heroes USA, Alpharetta, GA for job placement and $625,000
career services for veterans........................
iFoster, Inc., Las Vegas, NV for a workforce $150,000
development and readiness program...................
Jewish Family Service of Colorado, Denver, CO for $500,000
workforce development activities, including
technology and equipment............................
Kent State University at Tuscarawas, New $250,000
Philadelphia, OH for advanced manufacturing
equipment and training..............................
Kentucky Capital Development Corporation, Frankfort, $440,000
KY for cybersecurity/IT workforce development.......
La Colaborativa/Chelsea Collaborative, Chelsea, MA $300,000
for workforce development initiative................
Lansing Community College, Lansing, MI for mobile $400,000
skills laboratories, including equipment............
Living Classrooms Foundation, Baltimore, MD for $750,000
workforce development activities, including
technology..........................................
Macomb County, Clinton Township, MI for workforce $525,000
development and certification courses, including
technology and supportive services..................
Make the Road New York, Jackson Heights, NY for $400,000
workforce development, including adult education and
equipment...........................................
Mary's Mercy Center, Inc., San Bernadino, CA for a $300,000
training program and supportive services............
Mecklenburg County, Charlotte, NC for a training $1,000,000
program and supportive services.....................
Meristem, Inc., Fair Oaks, CA for a training program $450,000
for individuals with autism, including stipends.....
Mi Casa Resource Center, Denver, CO for a workforce $20,000
development program.................................
Milwaukee Metropolitan Sewerage District, Milwaukee, $1,000,000
WI for a workforce development initiative, including
equipment and stipends..............................
Montgomery County Office of Broadband Programs, $1,000,000
Rockville, MD for a technology job training pilot
program, including equipment and supportive services
Multi-Craft Apprenticeship Preparation Program, Inc., $200,000
Rochester, NY for workforce development initiative,
including stipends and equipment....................
National Institute for Medical Assistant Advancement, $450,000
Denver, CO for a training program, including
technology and equipment............................
Neighborhood House Incorporated, Seattle, WA for job $275,000
placement and career services.......................
Neighbors and Neighbors Association, Inc., Miami, FL $500,000
for work readiness and vocational training..........
New Century Careers, Pittsburgh, PA for pre- $500,000
apprenticeship and apprenticeship programs in
advanced manufacturing, including job placement
services............................................
New Jersey Chamber of Commerce Foundation, Trenton, $270,000
NJ for student training and equipment, including
information technology..............................
Newark Emergency Services for Families (NESF), $325,000
Newark, NJ for a workforce readiness program for
hard-to-serve target populations....................
Northern Maine Community College, Presque Isle, ME $1,000,000
for a mechanized logging operations training
program, including equipment........................
Opportunities Industrialization Center (d/b/a $575,000
Philadelphia OIC), Philadelphia, PA for a healthcare-
related job training program, including equipment...
Opportunity Village, Las Vegas, NV for workforce $525,000
development initiative for individuals with
intellectual and related disabilities...............
Para Los Ninos, Los Angeles, CA for a youth workforce $350,000
development initiative, including career and
supportive services.................................
Passaic County Community College, Patterson, NJ for $1,950,000
workforce training and career coaching, including
equipment...........................................
Path of Life Ministries, Riverside, CA for workforce $250,000
development activities, including supportive
services and stipends...............................
Philadelphia Works, Inc., Philadelphia, PA for $1,000,000
workforce development activities, including
transitional employment.............................
PIDC Community Capital, Philadelphia, PA for $525,000
workforce development activities, including
technology and stipends.............................
Presbyterian Villages of Michigan, Flint, MI for a $600,000
workforce development iniatitive, including a
certification program...............................
Prince George's County Office of Human Resources $2,000,000
Management, Largo, MD for a job training program....
Project QUEST, Inc., San Antonio, TX for an education $1,000,000
and training program, including supportive services.
Proyecto Del Barrio Inc., Arleta, CA for a job $300,000
training program....................................
Quad County Urban League, Inc., Aurora, IL for $425,000
education and skills training to enter
apprenticeships or positions in construction or TDL
industries, including equipment.....................
San Jose Conservation Corps & Charter School for $275,000
workforce development iniatitive for youth,
including stipends and technology...................
Second Harvest Food Bank of Central Florida, Orlando, $775,000
FL for a culinary workforce training program,
including internships, equipment, and supportive
services............................................
South Bay Workforce Investment Board, Hawthorne, CA $500,000
for workforce development activities, including
supportive services.................................
Southeast Michigan Community Alliance Inc., Taylor, $850,000
MI for a work-based learning program for at-risk in-
school youth age 14 or older, including stipends and
supportive services.................................
Southern California Regional Occupational Center, $1,000,000
Torrance, CA for a workforce development initiative.
Southern Maine Community College, South Portland, ME $1,000,000
for welding workforce training, including equipment.
State of Hawaii Workforce Development Council, State $975,000
of Hawaii Department of Labor and Industrial
Relations, Honolulu, HI for digital skills literacy
training............................................
Sunnyside Community Services, Sunnyside, NY for a $175,000
workforce development initiative....................
SUNY Maritime College, Bronx, NY for offshore wind $800,000
energy training program, including equipment........
The Corporate Source, Garden City, NY for IT training $125,000
and certification training program for people with
disabilities, including equipment and supportive
services............................................
The HOPE Program, Bronx, NY for a job training $800,000
program for green jobs to support justice-impacted
invididuals, including technology and equipment.....
Tri-Council Development Fund, Aurora, IL for a pre- $975,000
apprenticeship program, including equipment and
supportive services.................................
TXRX LABS, Houston, TX for employment and training $550,000
activities, an apprenticeship program, and a youth
STEM initiative.....................................
Uintah Basin Technical College, Roosevelt, UT for $515,000
electrical apprentice training program and the
purchase of equipment...............................
United Community Services for Working Families, $450,000
Reading, PA for job training for youth, including
stipends, technology, and supportive services.......
United Northeast Community Development Corporation, $600,000
Indianapolis, IN for a job training iniativie,
including supportive services.......................
United Way of Central Jersey, Milltown, NJ for $425,000
workforce development activities, including career
and supportive services.............................
United Way of Chester County, Exton, PA for job $100,000
training services...................................
United Way of Long Island, Deer Park, NY for a $700,000
YouthBuild program, including stipends..............
United Way of Miami-Dade Inc., Miami, FL for job $250,000
training activities and supportive services for
veterans and their families, including stipends,
technology, and supportive services.................
University of Rochester, Rochester, NY for youth $300,000
workforce development initiative for youth,
including technology and equipment..................
UPROSE, Brooklyn, NY for workforce development $175,000
initiative..........................................
Urban League of Hillsborough County, Inc., Tampa, FL $300,000
for preapprenticeships and paid internship programs,
including supportive services.......................
Vehicles for Change, Halethorpe, MD for a workforce $750,000
training initiative, including stipends and
equipment...........................................
Warren County Employment & Training Administration, $205,000
Glens Falls, NY for job recruitment and training
program, including the purchase of information
technology..........................................
Workforce Connections, Las Vegas, NV for a workforce $800,000
development initiative..............................
WorkSystems, Inc., Portland, OR for registered $1,000,000
apprenticeship opportunities in construction,
including supportive services.......................
WV Council for Community and Technical College $300,000
Education, Charleston, WV for aerospace training,
equipment, and curriculum...........................
------------------------------------------------------------------------
JOB CORPS
Appropriation, fiscal year 2021....................... $1,748,655,000
Budget request, fiscal year 2022...................... 1,754,759,000
Committee Recommendation.............................. 1,830,073,000
Change from enacted level......................... +81,418,000
Change from budget request........................ +75,314,000
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 $1,653,325,000, which is $50,000,000 more than the
fiscal year 2021 enacted level and $50,314,000 more than the
fiscal year 2022 budget request.
Construction, Rehabilitation, and Acquisition.--The
Committee recommends $138,000,000 for construction,
rehabilitation, and acquisition activities, which is
$25,000,000 more than the fiscal year 2021 enacted level and
the fiscal year 2022 budget request.
Administration.--The Committee recommends $38,748,000 for
the administrative expenses of the Job Corps program, which is
the same as the fiscal year 2021 enacted level and the same as
the fiscal year 2022 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.
In addition, the Committee is 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.
To better utilize Job Corps centers, the Committee directs
the Department to include an update in the fiscal year 2023
Congressional Budget Justification on Job Corps application and
enrollment data to evaluate the relative efficacy of different
investments in producing Job Corps-eligible applicants,
arrivals, and their families, including social media, national
television or radio buys, and local outreach efforts targeted
at eligible youth, guardians, and influencers.
As millions of disconnected youth struggle with housing,
food insecurity, and unemployment, the Committee supports the
efforts to resume operations at Job Corps centers as safely and
rapidly as possible. Like other schools across the country,
once Job Corps staff are vaccinated, the Committee encourages
full resumption of Job Corps operations. The Committee directs
the Department to include an update in the fiscal year 2023
Congressional Budget Justification on the requirements and
measures the Department will utilize to approve Job Corps
centers resuming operations at full capacity.
The Committee has previously expressed its concern that the
transition to fixed price Job Corps contracts may negatively
impact students and staff by prioritizing reducing costs over
improving student outcomes. The Committee encourages the
Department to ensure that Job Corps contracts offer competitive
wages and benefits. The Committee directs the Department to
include an update in the fiscal year 2023 Congressional Budget
Justification on the process by which the Department evaluates
cost-realism in bid evaluations, particularly with respect to
budgeting to pay prevailing wages, and data on the rate of
contract turnover over each of the last ten years.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriation, fiscal year 2021....................... $405,000,000
Budget request, fiscal year 2022...................... 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 2021 enacted level and
the fiscal year 2022 budget request.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriation, fiscal year 2021....................... $633,600,000
Budget request, fiscal year 2022...................... 551,000,000
Committee Recommendation.............................. 551,000,000
Change from enacted level......................... -82,600,000
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.
The authorization for this program is set to expire on July
1, 2022, and a sunsetting provision took effect on July 1,
2021, causing the program to revert to limited eligibility for
the program. The amount for fiscal year 2022 reflects this
reversion.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Appropriation, fiscal year 2021....................... $3,416,649,000
Budget request, fiscal year 2022...................... 4,121,761,000
Committee Recommendation.............................. 4,176,230,000
Change from enacted level......................... +759,581,000
Change from budget request........................ +54,469,000
The total includes $4,087,164,000 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
$3,125,214,000, which is $559,398,000 more than the fiscal year
2021 enacted level and the same as the fiscal year 2022 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 2022, for every
100,000 increase in the total average weekly insured
unemployment (AWIU) above 2,008,000, 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
$133,000,000 is made available pursuant to the Bipartisan
Budget Act of 2018 (P.L. 115-123), which is $50,000,000 more
than the fiscal year 2021 enacted level and equal to the fiscal
year 2022 budget request.
UI Integrity Center of Excellence (UIICE).--The
recommendation provides $9,000,000 for the continued support of
UIICE, including $6,000,000 for the benefit of States to the
entity operating the UIICE.
GAO Study on Unemployment Insurance Compensation.--The
Committee notes that the significant increase in Unemployment
Insurance (UI) Compensation claims during the COVID-19
pandemic, which Congress provided to address the corresponding
economic crisis, has strained the ability of state agencies
responsible for administering UI Compensation in a timely and
reliable manner. In a few short months, the unemployment rate
increased from 3.5 percent in February 2020 to 14.8 percent in
April 2020, requiring States to respond to unexpected
workloads. Moreover, fraudulent filing for, and receipt of, UI
Compensation, increased significantly as well. The Committee
directs GAO to study existing deficiencies in the
administration of UI Compensation, including but not limited to
the need for investment in technological improvements at the
state-level, and provide the Committees on Appropriations with
its findings and recommendations.
Pandemic Unemployment Assistance.--The Coronavirus Aid,
Relief, and Economic Security Act (CARES Act, P.L. 116-136)
established the Pandemic Unemployment Assistance (PUA) program,
which delivered billions of dollars in emergency assistance to
individuals who became unemployed due to the economic effects
of the COVID-19 public health emergency. Further, this program
sustained American families and provided needed economic
relief. The Committee notes that critical emergency assistance
during simultaneous public health and financial crises should
be targeted to individuals who are eligible for benefits. The
Department and States should ensure that proper safeguards--
including program integrity and fraud prevention tools and
procedures--are in place to identify any schemes to defraud
this emergency program. The Committee urges the Department to
work with the Office of the Inspector General on this matter
and to utilize the UIICE to assist States in efforts to ensure
benefits are delivered to individuals and families who qualify
for them.
Unemployment Compensation National Activities.--The
Committee recommends $118,108,000 for National Activities,
which is $100,108,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 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 urges the department to
develop a comprehensive long-term strategy for delivery of
assistance to state workforce agencies that would: develop an
open-systems approach and modular program of unemployment
management systems that can be adapted for state-by-state usage
plans; standardize employment and wage records reporting
requirements; incorporate 21st century accessibility standards;
develop enforcement and oversight methods so that states meet
established US DOL technology guidance such as Unemployment
Insurance Program Letter 2-1; avoid use of high-risk automated
decision-making and identity-proofing systems to deny claims;
standardize dashboard and claimant portal information; require
public dissemination of by-county demographic data on benefits
denials, delays, overpayments, and fraud determinations;
correct past inequities in benefits distribution by taking into
account user-experiences of historically disadvantaged groups;
conduct user testing and a full consultation with state-level
stakeholders, users, and worker organizations.
Employment Service.--The Committee recommends $748,862,000
for the Employment Service allotment to States, which is
$78,810,000 more than the fiscal year 2021 enacted level and
$50,000,000 more than the fiscal year 2022 budget request.
The Committee also recommends $22,318,000 for Employment
Service National Activities, which is the same as the fiscal
year 2021 enacted level and the fiscal year 2022 budget
request. Within the total, the Committee provides $2,500,000 to
reduce the processing backlog for the work opportunity tax
credit program and for assisting States in adopting or
modernizing information technology for processing of
certification requests, which may include training and
technical assistance to States.
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 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
$94,075,000 for the Foreign Labor Certification (FLC) program,
which is $16,265,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request. The
recommendation includes $67,793,000 for Federal administration,
an increase of $10,265,000 over the fiscal year 2021 enacted
level and the same as the fiscal year 2022 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 $6,000,000 over the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request.
H-2A Program.--Given the rapid growth of the H-2A program,
the role of farm labor contractors, and the troubling rate of
violations within the program, the Committee directs the
Secretary to submit a report to the Committee on Appropriations
on the Department's enforcement of farm labor contractors
(FLCs) within 180 days of enactment of this Act. The report
shall contain, at a minimum, the following information for each
of the last 5 years: an analysis of H-2A certifications for
fixed-site employers and FLCs; an analysis of the inspections,
audits, investigations, administrative complaints, and judicial
litigation regarding findings of violations by farm labor
contractors in the H-2A program, including remedies; and
recommendations to deter violations and improve compliance by
farm labor contractors in the H-2A program and how to ensure
that farmworkers obtain adequate relief for any violations. The
content of the final report shall be made publicly available on
the agency's website.
H-2B visa disbursements.--The Committee directs the
Department to include an update in its fiscal year 2023
Congressional Budget Justification on the number of labor
certifications granted through the H-2B non-immigrant visa
program. At a minimum, the report shall contain, but is not
limited to, the number of job openings published on
seasonaljobs.dol.gov each fiscal year, categorized by industry
and occupation.
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 2021 enacted level and the same as the fiscal year
2022 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 2021....................... $158,656,000
Budget request, fiscal year 2022...................... 211,503,000
Committee Recommendation.............................. 211,503,000
Change from enacted level......................... 52,847,000
Change from budget request........................ - - -
The recommendation includes $144,497,000 from the General
Fund of the Treasury and $67,006,000 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 encourages 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.
Long-term Unemployed.--The Committee notes the economic
challenges millions of individuals now face due to the
coronavirus pandemic and high-unemployment. Within a matter of
months, a nine-year period of sustained economic recovery and
growth was swept away by a wave of pathogen, shuttering
businesses and creating economic uncertainty. The Committee
also notes that the economic prospects for many individuals
unemployed prior to the start of the national emergency were
worsened as a result of COVID-19. Prior to the pandemic, these
individuals faced significant barriers to employment, having
been unemployed for 27 weeks or more. While it is essential
that the Department supports policies and practices that put
Americans back to work in a safe and sustainable way, the
Department must also ensure that the long-term unemployed do
not fall through the cracks of our economic recovery. To
advance this effort, the Committee encourages the Department to
support reemployment programs targeting long-term unemployed
workers.
Open Data Formats.--The Committee notes that Congress has
made a significant investment in our workforce development,
postsecondary, and career and technical education systems. As a
result of this investment, the number of credentials in the
U.S. continues to rise. However, the Committee is aware that
many workers and students may face challenges in navigating an
intricate network of diplomas, licenses, certifications, and
badges. Therefore, the Department is encouraged to require any
information publicly disclosed related to occupational and
professional licenses and certifications, as well as
credentials and competencies earned through apprenticeships,
whether directly or through contracts, be published using an
open source description language that is designed to allow for
public search and comparison of such data, including any such
data on credentials and competencies. Such information may be
published through open data formats such as the credential
transparency description language specifications or a
substantially similar approach. The Department is further
encouraged to provide a briefing to the Committees within 120
days of enactment of this Act, outlining a plan for providing
such data, including any challenges, barriers to
implementation, as well as anticipated costs.
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 Act 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.
Collaborations between manufacturers and educational
institutions.--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.
Justice Involved Workers.--The Committee supports the
Department'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 urges the Department 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 encourages the Department
to work with national nonprofit organizations that have proven
track records in this area, including organizations with
partnerships with the SNAP Employment and Training program.
Employee Benefits Security Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $181,000,000
Budget request, fiscal year 2022...................... 218,475,000
Committee Recommendation.............................. 218,475,000
Change from enacted level......................... +37,475,000
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 $218,475,000 for EBSA, which is
$37,475,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request.
Mental Health Parity and Addiction Equity Act (MHPAEA)
Compliance.--The Committee has included resources for 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.
These funds will enable EBSA to hire additional health
investigators who will focus exclusively on MHPAEA NQTL
compliance and contract with external consultants with
expertise in NQTL comparative analyses to assist and train
investigators. 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 2021....................... $465,289,000
Budget request, fiscal year 2022...................... 472,955,000
Committee Recommendation.............................. 472,955,000
Change from enacted level......................... +7,666,000
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 2021....................... $246,000,000
Budget request, fiscal year 2022...................... 276,500,000
Committee Recommendation.............................. 300,000,000
Change from enacted level......................... +54,000,000
Change from budget request........................ +23,500,000
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 $300,000,000 for WHD, which is
$54,000,000 above the fiscal year 2021 enacted level and
$23,500,000 above the fiscal year 2022 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.
Language Access.--In hiring investigators, the Committee
encourages WHD to focus on employing and retaining a greater
number of multilingual investigators. In the fiscal year 2023
Congressional Budget Justification, WHD is directed to include
information outlining the WHD's goals for meeting critical
language access needs through its investigator workforce.
Retaliation.--Because retaliation and the threat of
retaliation remain critical challenges 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 protect workers from retaliation in the
fiscal year 2023 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 identified. 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 be otherwise 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 2022 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.
Office of Labor-Management Standards
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $44,437,000
Budget request, fiscal year 2022...................... 51,554,000
Committee Recommendation.............................. 44,437,000
Change from enacted level......................... - - -
Change from budget request........................ -7,117,000
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 $44,437,000 for OLMS, which is the
same as the fiscal year 2021 enacted level and $7,117,000 below
the fiscal year 2022 budget request.
Office of Federal Contract Compliance Programs
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $105,976,000
Budget request, fiscal year 2022...................... 140,732,000
Committee Recommendation.............................. 140,732,000
Change from enacted level......................... +34,756,000
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 $140,732,000 for OFCCP, which is
$34,756,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 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 2021....................... $117,601,000
Budget request, fiscal year 2022...................... 140,809,000
Committee Recommendation.............................. 140,809,000
Change from enacted level......................... +23,208,000
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 $138,604,000 in
General Funds from the Treasury, which is $23,180,000 above the
fiscal year 2021 enacted level and the same as the fiscal year
2022 request, and $2,205,000 from the Special Fund established
by the Longshore and Harbor Workers' Compensation Act.
National Commission.--The Committee is concerned by an
ongoing and systematic decline in the adequacy of benefits
provided to injured workers under the State-based workers'
compensation system. Costs for disabling workplace injuries are
being shifted to Federal programs, such as Social Security
Disability Insurance, because of reduced coverage under State
laws. With the growth of the gig economy and misclassification
of workers as independent contractors, millions of workers are
falling through the cracks in State workers' compensation
systems. Given the impact to the Federal government, the
Committee believes that State workers' compensation programs
should be monitored on an ongoing basis. Following the issuance
of the report of the National Commission on State Workmen's
Compensation Laws in 1972, the Department prepared an annual
report on the operations of State workers' compensation
programs, but ceased doing so in 2004. Since then, there has
been no reporting or analysis as State legislatures have
passed, and governors have signed, significant legislation
affecting the availability and adequacy of workers'
compensation. The Committee requests that the Department,
through the Office of Workers' Compensation Programs, include
in the fiscal year 2023 Congressional Budget Justification an
assessment of the resources necessary to reinstate OWCP's
monitoring of State workers' compensation programs and
preparation of an annual report.
SPECIAL BENEFITS
Appropriation, fiscal year 2021....................... $239,000,000
Budget request, fiscal year 2022...................... 244,000,000
Committee Recommendation.............................. 244,000,000
Change from enacted level......................... +5,000,000
Change from budget request........................ - - -
These funds provide mandatory benefits under the Federal
Employees' Compensation Act.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriation, fiscal year 2021....................... $40,970,000
Budget request, fiscal year 2022...................... 32,970,000
Committee Recommendation.............................. 32,970,000
Change from enacted level......................... -8,000,000
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 $32,970,000 for Special Benefits
for Disabled Coal Miners. This amount is in addition to the
$14,000,000 appropriated in fiscal year 2021 as an advance for
the first quarter of fiscal year 2022. The total program level
recommendation is $8,000,000 less than the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request.
The Committee recommendation also provides $11,000,000 as
an advance appropriation for the first quarter of fiscal year
2023. These funds ensure uninterrupted payments to
beneficiaries.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS
COMPENSATION FUND
Appropriation, fiscal year 2021....................... $62,507,000
Budget request, fiscal year 2022...................... 63,428,000
Committee Recommendation.............................. 63,428,000
Change from enacted level......................... +921,000
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.
BLACK LUNG DISABILITY TRUST FUND
Appropriation, fiscal year 2021....................... $382,991,000
Budget request, fiscal year 2022...................... 331,505,000
Committee Recommendation.............................. 331,505,000
Change from enacted level......................... -51,486,000
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 that the
Secretary provide an update on the Department's efforts to
improve the speed and quality of its black lung claims
processing in the fiscal year 2023 Congressional Budget
Justification.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $591,787,000
Budget request, fiscal year 2022...................... 664,624,000
Committee Recommendation.............................. 691,787,000
Change from enacted level......................... +100,000,000
Change from budget request........................ +27,163,000
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 2022 Committee
------------------------------------------------------------------------
Safety and Health Standards......................... $28,450,000
Federal Enforcement.................................. 274,634,000
Whistleblower Programs............................... 30,000,000
State Programs....................................... 118,737,000
Technical Support.................................... 26,394,000
Federal Compliance Assistance........................ 86,175,000
State Consultation Grants............................ 63,500,000
Training Grants...................................... 14,787,000
Safety and Health Statistics......................... 39,479,000
Executive Direction and Administration............... 9,631,000
------------------------------------------------------------------------
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.
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 Smithfield and a JBS plant. For context, in 2019, JBS'
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 full penalties or a
penalty multiplier for serious violations in large businesses.
Whistleblower Protection Program.--The Committee is
concerned with 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 with three more added in the
past two years. OSHA's already-overburdened Whistleblower
Protection Program staff faced an unprecedented surge in
complaints during the COVID-19 pandemic. During the first four
months of the pandemic, the average number of whistleblower
complaints received per investigator increased by 30 percent--
39 percent of these were COVID-19 related. At the same time,
the Whistleblower Protection Program's FTEs decreased between
2019 to 2020 to only 120 investigators, causing an increase in
the number of cases handled by each investigator. 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
$10,936,000 above the fiscal year 2021 enacted level. This
increase will support OSHA's efforts to update its decades-old
Whistleblower database 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 Latino 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. In addition,
the Committee encourages OSHA to support grants for 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, like WHD, 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.
COVID-19 Testing for Meatpacking Workers.--The Committee is
supportive of workplace health and safety procedures that
include adequate COVID-19 testing for meatpacking workers. Even
before the pandemic, meatpacking, poultry, and agriculture have
been dangerous industries for workers. The pandemic exacerbated
these hazards, which are disproportionately felt by workers of
color.
OSHA Noise Standard.--The Committee is aware that the
National Institute for Occupational Safety and Health (NIOSH)
estimates that 22 million US 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 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 encourages 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.
Needlestick Safety.--The Committee recognizes the risks
posed by the COVID-19 pandemic to our nation's essential
healthcare workforce as they continue to ensure the
administration of FDA-approved COVID-19 vaccines. With the
increase in demand for syringe-administered vaccines comes the
increased risk of exposure not only to COVID-19, but also to
bloodborne pathogens including, but not limited to, hepatitis
B, hepatitis C and human immunodeficiency virus. OSHA should
continue to work with the Department of Health and Human
Services (HHS) to monitor the supply of safety-engineered
devices for COVID-19 vaccinations. If OSHA and HHS determine
that there is a shortage of these devices, the Committee
requests that OSHA include cost estimates that will ensure the
standards prescribed in the Needlestick Safety and Prevention
Act are enforced to the extent feasible in the fiscal year 2023
Congressional Budget Justification. The authorization includes
a standard which states that employers are required to
evaluate, select, and use engineering controls to eliminate or
minimize exposure to contaminated sharps.
Occupational Heat Stress Protection Standard.--The
Committee recognizes the urgency of developing a workplace
safety standard to protect workers from excessive heat, and is
aware that a standard has already proven to be feasible to
implement, and in light of rising temperatures urges OSHA to
take all necessary steps to issue a proposed occupational heat
stress protection standard by the end of fiscal year 2022. The
Secretary is directed to submit a schedule to the Committee
within 90 days of enactment of this Act on the action steps it
will be taking to promulgate an occupational heat stress
protection standard.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $379,816,000
Budget request, fiscal year 2022...................... 447,201,000
Committee Recommendation.............................. 404,816,000
Change from enacted level......................... +25,000,000
Change from budget request........................ -42,385,000
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.
Coal, Metal, and Non-metal Mines.--MSHA is directed to
include in the fiscal year 2023 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 2021....................... $655,000,000
Budget request, fiscal year 2022...................... 700,653,000
Committee Recommendation.............................. 700,653,000
Change from enacted level......................... + 45,653,000
Change from budget request........................ - - -
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 $632,653,000 from the
General Fund of the Treasury and $68,000,000 from the
Employment Security Administration Account in the Unemployment
Trust Fund. Within the total amount for BLS, the Committee
includes $28,470,000 to continue the relocation of the BLS
headquarters, which was initiated in fiscal year 2020.
Within the total for BLS, the Committee provides the
following amounts:
------------------------------------------------------------------------
FY 2022
Budget Activity Committee
------------------------------------------------------------------------
Employment and Unemployment Statistics............... $221,000,000
Labor Market Information............................. 68,000,000
Prices and Cost of Living............................ 233,033,000
Compensation and Working Conditions.................. 89,875,000
Productivity and Technology.......................... 12,375,000
Executive Direction and Staff Services............... 66,329,000
------------------------------------------------------------------------
National Longitudinal Survey of Youth (NLSY).--The
Committee is supportive of BLS' plan for the planning,
development, and implementation of a new NLSY cohort and
provides sufficient resources to implement this plan without
delay. Specifically, the Committee supports the Department's
plan to increase spending on the new NLSY cohort in fiscal year
2023 to $14,500,000 and requests an update on future spending
plans in the fiscal year 2023 Congressional Budget
Justification.
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 2021 full-time equivalent ceiling.
Artificial Intelligence.--The Committee is aware of the
development of artificial intelligence and encourages BLS to
examine this trend's impact on the economy.
Job Openings and Labor Turnover Survey (JOLTS).--The
Committee recognizes the need for enhancements to JOLTS to
better understand national labor market dynamics. Therefore,
the Committee requests for the Department to provide cost
estimates in the fiscal year 2023 Congressional Budget
Justification for expanding the JOLTS sample level and for
releasing JOLTS data monthly to improve timeliness.
Office of Disability Employment Policy
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $38,500,000
Budget request, fiscal year 2022...................... 42,711,000
Committee Recommendation.............................. 42,711,000
Change from enacted level......................... +4,211,000
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 $42,711,000, which
is $4,211,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request. The Committee is
supportive of the budget proposal for ODEP to invest in
research and demonstration projects related to testing
effective ways to promote greater labor force participation of
people with disabilities.
Departmental Management
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $349,364,000
Budget request, fiscal year 2022...................... 439,970,000
Committee Recommendation.............................. 457,219,000
Change from enacted level......................... +107,855,000
Change from budget request........................ +17,249,000
The Departmental Management appropriation provides funds
for the staff responsible for Departmental operations,
management, and policy development.
The Committee recommendation includes $456,911,000 from the
General Fund of the Treasury, $107,855,000 above the fiscal
year 2021 enacted level and $17,249,000 above the fiscal year
2022 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 2022 Committee
------------------------------------------------------------------------
Program Direction and Support........................ $35,023,000
Departmental Evaluation.............................. 10,040,000
Legal Services....................................... 154,629,000
International Labor Affairs.......................... 136,000,000
Administration and Management........................ 39,308,000
Adjudication......................................... 41,013,000
Women's Bureau....................................... 25,000,000
Civil Rights Activities.............................. 10,344,000
Chief Financial Officer.............................. 5,862,000
------------------------------------------------------------------------
International Labor Affairs Bureau (ILAB).--Of the
$136,000,000 recommended for the International Labor Affairs
Bureau (ILAB), the Committee directs the Secretary to allocate
not less than $40,175,000 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. The Committee directs
ILAB to use its fiscal year 2022 funding increase to place
additional labor attaches in strategic countries focused on
fundamental worker rights such as freedom of association,
collective bargaining, protection from sex discrimination, and
acceptable conditions of work. The Committee urges ILAB to
prioritize these additional attaches in areas of strategic
importance such as Honduras, Guatemala, Vietnam, and
Bangladesh.
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
2022 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 2023 Congressional Budget Justification,
ILAB is directed to include spending plans for resources
provided in the USMCA Implementation Act for fiscal years 2020
through 2023. Spending plans should include descriptions and
amounts for projects and staffing.
Sex Discrimination in Employment and the Workplace.--The
Committee recognizes the vital role ILAB plays in building the
capacity of other countries to enforce and improve labor
protections for workers and in enforcing the labor provisions
of U.S. trade agreements and preference programs; however, the
Committee is concerned that the issue of sex discrimination has
not received enough attention in the Bureau's capacity-
building, monitoring, and enforcement activities. It is
essential that workers around the world are protected from
pregnancy- and maternity-based discrimination, discriminatory
recruitment and hiring, and the manifestation of unconscious
bias in the workplace. Further, many female workers receive
unequal access to training opportunities and work schedules
that prevent them from acting as primary care givers and
accepting positions that would help them advance. In addition,
the Committee is concerned by the complete absence of gender
mainstreaming in labor inspections; lack of labor inspector
training on best practices for identifying and addressing sex
discrimination; and inadequate complaint mechanisms for women
to anonymously report sex discrimination in employment and the
workplace. Finally, the Committee believes workers should
receive equal pay for work of equal value. In response, the
Committee urges ILAB to prioritize these areas of concern
through its capacity-building, monitoring, and enforcement
efforts.
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 $25,000,000 appropriated to the
Women's Bureau, the Committee provides no less than $6,794,000
for the Women in Apprenticeship and Nontraditional Occupations
(WANTO) program, which is $5,000,000 above the fiscal year 2021
enacted level and the fiscal year 2022 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.
Women's Unemployment.--The Committee is concerned by the
dramatic increase in the unemployment rate for women as a
result of the COVID-19 pandemic. The Committee encourages the
Women's Bureau to make it an agency-wide priority to mitigate
and reverse this trend in fiscal year 2022. Additionally, the
Committee is supportive of the recommendations from GAO's
report on the gender pay gap in the federal workforce (GAO-21-
67) and is supportive of GAO's ongoing work to identify
improvements regarding measures taken by the Department of
Labor to mitigate women's unemployment, including the immediate
and long-term effects of COVID-19 on women's employment. The
Committee is interested in the impacts of COVID-19 on
unemployment rates for low-income women and women of color,
groups that have been disproportionately impacted by the
pandemic
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 2023
Congressional Budget Justification: Expenditures for fiscal
year 2021 and expected expenditures for fiscal years 2022 and
2023, 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.
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 2019, 2020 and 2021
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 2020
or 2021 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.
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 2023 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 2023
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 2023 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, 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 2023 Congressional Budget Justification.
Family-Friendly Workplaces Certification.--The Committee
recognizes the importance of promoting family-friendly
workplaces. The pandemic has placed an unexpected burden on
working parents, particularly working mothers who have left the
labor force in disproportionate numbers since March 2020.
Therefore, the Committee directs the Secretary to evaluate the
feasibility of establishing a certification program that
recognizes exemplary family-friendly businesses and
incentivizes businesses to adapt best practices that reflect
the challenges faced by working parents. Modeled off the
Environmental Protection Agency's Energy Star Program, this
Family-Friendly Workplaces Certification would evaluate
businesses based on a number of policies including; paid sick
days, paid family leave of at least 12 weeks per year,
childcare subsidies, lactation support, assistance paying for
or referring employees to fertility or adoption services, and
accommodations for pregnant workers. The Committee directs the
Secretary to submit this feasibility report within 270 days of
enactment of this Act.
VETERANS EMPLOYMENT AND TRAINING
Appropriation, fiscal year 2021....................... $316,341,000
Budget request, fiscal year 2022...................... 324,831,000
Committee Recommendation.............................. 334,841,000
Change from enacted level......................... +18,490,000
Change from budget request........................ +10,000,000
The recommendation includes $67,500,000 from the General
Fund of the Treasury and $267,331,000 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 2022 Committee
------------------------------------------------------------------------
State Administration Grants.......................... $180,000,000
Transition Assistance Program........................ 31,379,000
Federal Administration............................... 52,538,000
Veterans Employment and Training Institute........... 3,414,000
Homeless Veterans Reintegration Program.............. 67,500,000
------------------------------------------------------------------------
The Committee recommendation includes $31,379,000 for the
Transition Assistance Program, which is the same as the fiscal
year 2021 enacted level and the fiscal year 2022 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 $67,500,000 for the Homeless
Veterans Reintegration Program, which is $10,000,000 more than
the fiscal year 2021 enacted level and the fiscal year 2022
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 2021 enacted level and the fiscal year 2022 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
2021 enacted level 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
directs 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 2023 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.
Military Spouse Occupational License and Certification
Portability.--The Committee encourages the Department of Labor
to work with states to encourage them to implement occupational
license and certification portability measures for military
spouses through full license recognition. The current framework
for license and certification portability often poses a barrier
to employment, and this is particularly problematic for
military spouses as they frequently are required to relocate
due to the nature of their spouse's military employment. The
number of jobs that require a license has steeply risen from 5
percent in the 1950s to 30 percent today. The increase in
licensing requirements and frequent moves contribute to the
high unemployment rate of military spouses, currently at 24
percent. Addressing this issue demonstrates the Committee's
appreciation for the service of military members and the
sacrifices their families make on a daily basis.
Veterans' Pilot Program.--The Committee encourages the
Department to pilot an accelerated veteran transition program
in regions surrounding military installations in the United
States, inclusive of exiting soldiers and retired veterans. The
pilot program would utilize funding under this account for
direct services to support veterans and transitioning military
members into in-demand civilian occupations aligned with their
military training and experience. This project is needed as
available veteran resources do not fully pay for school,
transitional benefits (in terms of training), or target
regional career/trade demands. While transitioning soldiers
have access to available resources, those sources do not offer
the job-placement-centric approach that this program would
prioritize. Additionally, existing allocation from the
Workforce Innovation and Opportunity Act (WIOA) resources does
not fund certificate education in prospective targeted
occupations.
INFORMATION TECHNOLOGY MODERNIZATION
Appropriation, fiscal year 2021....................... $ 27,269,000
Budget request, fiscal year 2022...................... 37,269,000
Committee Recommendation.............................. 37,269,000
Change from enacted level......................... +10,000,000
Change from budget request........................ - - -
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 2021....................... $90,847,000
Budget request, fiscal year 2022...................... 95,398,000
Committee Recommendation.............................. 95,398,000
Change from enacted level......................... +4,551,000
Change from budget request........................ - - -
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 $89,738,000 from the General
Fund of the Treasury, which is $4,551,000 more than the fiscal
year 2021 enacted level and the same as the fiscal year 2022
budget request, and $5,660,000 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 Working Capital Fund.
Sec. 113. The Committee includes a new provision relating
to the Consolidated Appropriations Act, 2021 to clarify the
availability of funds provided under Section 118(a) of division
BB.
Sec. 114. The Committee includes a new provision relating
to the Wagner-Peyser Act Staffing Flexibility regulation.
Sec. 115. The Committee includes a new provision relating
to regulations pertaining to industry recognized apprenticeship
programs.
Sec. 116. The Committee includes a new provision relating
to processing of Applications for Temporary Employment
Certification for certain industries.
Sec. 117. The Committee includes a new provision relating
to the determination of prevailing wages.
Sec. 118. The Committee includes a new provision relating
to processing of Applications for Temporary Employment
Certification for employers with violations of labor laws.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Appropriation, fiscal year 2021....................... $7,207,234,000
Budget request, fiscal year 2022...................... 7,813,294,000
Committee Recommendation.............................. 8,723,922,000
Change from enacted level......................... +1,516,688,000
Change from budget request........................ +910,628,000
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
$8,723,922,000 in discretionary budget authority, $316,778,000
in mandatory funding and $16,200,000 in trust fund
appropriations for the Vaccine Injury Compensation Program
Trust Fund, and $5,000,000 for the Countermeasures Injury
Compensation Program.
PRIMARY HEALTH CARE
Appropriation, fiscal year 2021....................... $1,683,772,000
Budget request, fiscal year 2022...................... 1,733,772,000
Committee Recommendation.............................. 1,831,772,000
Change from enacted level......................... +148,000,000
Change from budget request........................ +98,000,000
Health Centers
The Committee recommends $1,830,772,000 for the Health
Centers program, $148,000,000 above the fiscal year 2021
enacted level and $98,000,000 above the fiscal year 2022 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,
school-based, and public housing health service grants.
In addition, the American Rescue Plan (P.L. 117-2) included
$7,600,000,000 in discretionary appropriations to support
Health Centers' response to the COVID-19 pandemic.
The Committee includes bill language providing up to
$120,000,000 for the Federal Tort Claims Act program, the same
as the fiscal year 2021 enacted level and the fiscal year 2022
budget request.
Alcee L. Hastings Program for Advanced Cancer Screening in
Underserved Communities.--The Committee is extremely concerned
about the disparity in cancer screening--and corresponding
higher levels of cancer incidence and adverse outcomes--in
medically underserved communities. Several studies have
demonstrated that this problem has only been made worse by the
pandemic. The Committee includes $25,000,000 to fund Health
Centers to increase access and address barriers to cancer
screening, including patient education, case management,
outreach, and other enabling services. Grantees must partner
and coordinate closely with NCI-designated cancer centers to
deploy cancer-center trained and supervised outreach
specialists and navigators to improve cancer screening and
referrals among vulnerable populations in their catchment
areas.
Ending the HIV Epidemic (EHE) Initiative.--The Committee
provides $152,250,000 within the Health Centers program for the
EHE Initiative, $50,000,000 above the fiscal year 2021 enacted
level and the same as the fiscal year 2022 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 Center Dental Services.--The Committee recognizes
the importance of Health Centers in providing comprehensive
primary and preventive health services to the nation's
underserved communities. Health Centers provide dental services
for many who would otherwise face barriers to dental care. The
Committee is aware that some Health Centers have partnered with
Community Dental Health Coordinators (CDHCs) to provide
patients with greater access to dental care. CDHCs provide
community-based prevention, care coordination, and patient
navigation to underserved populations in rural, urban, and
Native American communities. The Committee encourages HRSA to
work with Health Centers to expand their work in this area.
Health Center Mental Health Services for Children.--The
Committee is concerned about the many challenges faced by
children in need of mental health services because of the
COVID-19 pandemic. The pandemic has had serious impacts on
children's mental, psychological, and emotional well-being,
especially in low-income and minority communities. This impact
will likely last for an extended period. The Committee strongly
encourages HRSA to provide funding to Health Centers to support
vital mental health services for children.
School-Based Health Centers (SBHCs) and Health Center
Services at School-Based 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 a
total increase of $50,000,000 within the total for Health
Centers to support the delivery of health care services at
school-based sites. The Committee includes $25,000,000 to make
grants to establish new school-based health centers 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. The Committee also
includes $25,000,000, an increase of $20,000,000 above the
fiscal year 2021 enacted level, for awards to Health Centers
operating at school-based sites to increase their capacity to
meet the increasing demand for health services, including
mental health services. The Committee encourages HRSA to award
grants to applicants that previously submitted fundable
applications under HRSA-21-093 but that did not receive such
funding.
Health Center Controlled Networks.--Health Center
Controlled Networks (HCCNs) 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 strongly supports
the work of HCCNs.
HRSA Strategy to Address Intimate Partner Violence and
Project Catalyst.--The Committee includes no less than
$2,000,000 for the HRSA Strategy to Address Intimate Partner
Violence, an increase of $500,000 over the fiscal year 2021
enacted level and the fiscal year 2022 budget request. The
Committee encourages HRSA to support training, technical
assistance, and resource development to assist public health
and health care professionals to better serve individuals and
communities impacted by intimate partner violence.
Native Hawaiian Health Care Program.--The Committee
provides $22,000,000 within the total for Health Centers for
the Native Hawaiian Health Care Program, $1,500,000 above the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request. The Native Hawaiian Healthcare Systems help improve
the health status of Native Hawaiians by making health
education, health promotion, disease prevention, and Native
Hawaiian traditional healing services available.
The Committee understands the importance of ensuring that
indigenous people, including Native Hawaiians, have access to
health care. The Committee requests a report from the
Government Accountability Office (GAO) on the status of health
care accessibility and affordability for Native Hawaiians
living in Hawaii, to include the rural and medically
underserved islands.
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 2021 enacted level and the fiscal year 2022
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 2021....................... $1,224,006,000
Budget request, fiscal year 2022...................... 1,380,384,000
Committee Recommendation.............................. 1,564,876,000
Change from enacted level......................... +340,870,000
Change from budget request........................ +184,492,000
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.
In addition to the amounts above, the American Rescue Plan
(P.L. 117-2) included $1,000,000,000 in discretionary
appropriations to support health workforce programs in response
to the COVID-19 pandemic.
The Committee bill strikes language prohibiting HRSA funds
from being used to support alternative dental providers. 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.
National Health Service Corps (NHSC)
The Committee includes $185,000,000, an increase of
$65,000,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request, for NHSC to
support competitive awards to health care providers dedicated
to working in underserved communities in urban, rural, and
tribal areas.
In addition to the amounts above, the American Rescue Plan
(P.L. 117-2) included $900,000,000 in discretionary
appropriations to support NHSC in response to the COVID-19
pandemic.
Loan Repayment for Opioid and Substance Use Disorder (SUD)
Treatment.--The Committee includes $155,000,000, $25,000,000
below the fiscal year 2022 budget request, for loan repayment
for clinicians that provide opioid and substance use disorder
treatment. Within this total, the Committee includes
$15,000,000, the same as the fiscal year 2021 enacted level and
the fiscal year 2022 budget request, to support NHSC awards to
participating individuals that provide health services in IHS
facilities, Tribally-Operated Health Programs, and Urban Indian
Health Programs.
Maternity Care Target Areas (MCTAs).--The Committee
includes $5,000,000, an increase of $5,000,000 above the fiscal
year 2021 enacted level and the same as the fiscal year 2022
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.
National Health Service Corps Rural Demonstration
Program.--The Committee strongly supports the NHSC program for
improving access to quality care in rural and underserved
areas. 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 $25,000,000 within NHSC for a pilot program
to evaluate the benefit to patient access and practitioner
recruitment and retention of extending loan repayment for five
years and $200,000 for providers serving in rural areas that
are part of a Health Professional Shortage Area. The Committee
also directs HRSA to include an assessment of program
utilization and impact in the annual NHSC report to Congress
and to submit a final report after completion of the pilot.
Health Professions Education and Training
The Committee includes $565,404,000 for Health Professions
Education and Training Programs authorized under title VII of
the PHS Act, $125,870,000 above the fiscal year 2021 enacted
level and $37,992,000 above the fiscal year 2022 budget
request.
Addressing the Shortage of Behavioral Health
Professionals.--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 found that there will be a shortage
of 250,000 mental health professionals by 2025. The Committee
directs HRSA to submit a report addressing the scope of the
shortage of behavioral health professionals, barriers to
careers in behavioral health, Federal support available, and
recommendations to Congress to address the shortage within 180
days of enactment of this Act.
Social Work Reinvestment Commission.--The Committee is
aware that millions of Americans are not receiving the mental,
behavioral and social care services they need. The COVID-19
pandemic has increased the need for services. The nation's
700,000 social workers are the largest provider of these
services, so it is imperative that we ensure a robust social
work workforce. As such, the Committee directs HRSA in
collaboration with SAMHSA, ACF, OMH, and CMS, to conduct a
study and to report to Congress and the Secretary on policy
issues related to social work recruitment, retention, research
and reinvestment. Not later than 18 months after enactment of
this Act, HRSA shall submit its findings and recommendations
regarding recommendations and strategies to ensure a sufficient
and strong social work workforce.
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
$31,711,000 for COEs, $8,000,000 above the fiscal year 2021
enacted level and $5,000,000 above the fiscal year 2022 budget
request. 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. The
Committee notes that COEs educate a disproportionate share of
health professionals from minority and underserved backgrounds
and address the need for a diverse and culturally competent
American health care workforce.
Health Careers Opportunity Program (HCOP).--The Committee
includes $20,500,000 for HCOP, $5,500,000 above the fiscal year
2021 enacted level and $2,000,000 above the fiscal year 2022
budget request. The Committee notes that HCOPs assist students
from minority and economically disadvantaged backgrounds
navigate careers into 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 $2,310,000
for Faculty Loan Repayment, $1,120,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. 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 $61,970,000 for SDS, $10,500,000 above the
fiscal year 2021 enacted level and $10,000,000 above the fiscal
year 2022 budget request. This program provides grants to
health professions and nursing schools to provide scholarships
to students from disadvantaged background who have financial
need.
Within this total, the Committee includes $5,000,000, a
$2,500,000 increase over the fiscal year 2021 enacted level,
for grants to educate midwives to address the national shortage
of maternity care providers, and specifically the lack of
adequate diversity in the maternity care workforce. This amount
will double the number of five-year grants first made available
beginning in fiscal year 2020.
Primary Care Training and Enhancement
The Committee includes $49,924,000, an increase of
$1,000,000 above the fiscal year 2021 level and the fiscal year
2022 budget request, for Primary Care Training and Enhancement
programs, which support training and direct financial
assistance for future primary care clinicians, teachers, and
researchers.
Eating Disorders Screening, Brief Intervention, Referral,
and Treatment (SBIRT).--The COVID-19 pandemic worsened eating
disorders across the nation, with one study reporting up to 76
percent of respondents engaging in eating disorder behaviors.
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 National 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 (P.L. 114-255).
Oral Health Training
The Committee includes $42,673,000 for Oral Health
Training, $2,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 budget request. Within the total, the
Committee includes not less than $14,000,000 for Pediatric
Dentistry Programs, an increase of $2,000,000 above the fiscal
year 2021 enacted level. 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 2018 and 2021. The Committee directs HRSA to
initiate a new pre-doctoral grant cycle, and 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.
Interdisciplinary Community-Based Linkages
Area Health Education Centers (AHEC).--The Committee
includes $50,000,000 for the AHEC program, an increase of
$6,750,000 above the fiscal year 2021 level and the fiscal year
2022 budget request. This program links university health
science centers with community health service delivery systems
to provide education and training networks.
The Committee encourages HRSA to support AHEC oral health
projects that establish primary points of service and address
the need to help patients find treatment outside of hospital
emergency rooms. The Committee encourages HRSA to work with
programs that have already been initiated by some State dental
associations to refer emergency room patients to dental
networks.
Geriatrics Workforce Enhancement Program (GWEP).--The
Committee includes $52,737,000 for the GWEP program, an
increase of $10,000,000 above the fiscal year 2021 level and
$6,200,000 above the fiscal year 2022 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 $43,916,000 for Mental and Behavioral Health Programs,
an increase of $6,000,000 above the fiscal year 2021 level.
Graduate Psychology Education (GPE).--Within the total for
Mental and Behavioral Health Programs, the Committee includes
$25,000,000, $6,000,000 above the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request, 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 $181,000,000 for the BHWET
Program, $69,000,000 above the fiscal year 2021 enacted level
$43,874,000 below the fiscal year 2022 budget request. This
program establishes and expands internships or field placement
programs in behavioral health serving populations in rural and
medically underserved areas.
Adolescent Addiction Medicine and Addiction Psychiatry
Workforce.--The Committee applauds HRSA for issuing a funding
solicitation for the Addiction Medicine Fellowship (AMF)
program and the Mental and Substance Use Disorder Workforce
Training Demonstration, as both programs will build the
capacity of our nation's addiction medicine physician
workforce. However, 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 encourages HRSA to
support fellowship programs focused on increasing the number of
board certified pediatric and adolescent addiction medicine and
addiction psychiatry subspecialists.
Peer Support Specialists in the Opioid Use Disorder
Workforce.--Within the total for BHWET, the Committee includes
$15,000,000, an increase of $2,000,000 above the fiscal year
2021 enacted level and the fiscal year 2022 budget request, to
fund training, internships, and national certification for
mental health and substance abuse peer support specialists to
create an advanced peer workforce prepared to work in clinical
settings.
Substance Use Disorder Treatment and Recovery (STAR) Loan
Repayment Program.--The Committee includes $28,000,000 for this
program, $12,000,000 above the fiscal year 2021 enacted level
and the same as fiscal year 2022 budget request. 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.
An estimated 21 million Americans needed treatment for SUD
in 2017, but only four million received any form of treatment.
The Bureau of Labor Statistics data has cited tremendous
shortfalls in the SUD treatment profession. Without strategic
investments in the SUD workforce, this gap will not close and
more lives will be lost. Funding is now needed to increase the
ranks of a well-trained SUD workforce in communities across
America. Congress can save lives by equipping the frontline
professionals who prevent and treat addiction, provide recovery
support, and help reduce the negative consequences associated
with substance use. The Committee directs HRSA to provide a
report to the Committee on the progress and implementation of
this program within 180 days of enactment of this Act.
Mental and Substance Use Disorder Workforce Training
Demonstration.--The Committee includes $34,000,000 for the
Mental and Substance Use Disorder Workforce Training
Demonstration program, $4,300,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request. This program makes grants to institutions, including
but not limited to medical schools and Federally-Qualified
Health Centers (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.
National Center for Health Workforce Analysis (NCHWA)
The Committee includes $5,663,000, the same as the fiscal
year 2021 enacted level and the fiscal year 2022 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 $23,000,000 for Public Health and
Preventive Medicine Training Grant Programs, $6,000,000 above
the fiscal year 2021 enacted level and $5,000,000 above the
fiscal year 2022 budget request. Within this total, the
Committee provides an increase of $3,000,000 for the Preventive
Medicine Residency Training Program and an increase of
$3,000,000 for Public Health Training Centers.
Nursing Workforce Development
The Committee recommends $314,472,000 for Nursing Workforce
Development programs authorized under title VIII of the PHS
Act, $50,000,000 above the fiscal year 2021 enacted level and
$46,500,000 above the fiscal year 2022 budget request.
In addition to the amounts above, the American Rescue Plan
(P.L. 117-2) included $200,000,000 in discretionary
appropriations to support nursing workforce development in
response to the COVID-19 pandemic.
Impact of COVID-19 on the Rural Nursing Workforce.--The
Committee directs HRSA to submit a report within 180 days of
enactment of this Act on the impact of the current public
health emergency on the nursing workforce, especially in rural
areas, and summarize strategies to mitigate and address these
impacts.
Registered Nurse Shortages.--The Committee is concerned
about current and projected shortages of registered nurses
(RNs) in the U.S. As discussed in the HRSA publication ``Supply
and Demand Projections of the Nursing Workforce 2014-2030'',
California, New Jersey, South Carolina, and Texas are projected
to have a deficit of 10,000 or more full time equivalent RNs by
2030. The Committee directs HRSA to give priority in new
funding announcements to public entities for training of
additional RNs, specifically for acute care settings. In
addition, the Committee directs HRSA to give priority to
applicants in States listed by HRSA as having the greatest
shortages.
Advanced Nursing Education.--The Committee includes
$82,081,000 for Advanced Nursing Education, $6,500,000 above
the fiscal year 2021 enacted level and $1,500,000 above the
fiscal year 2022 budget request. This program supports
traineeships and faculty and curriculum development to increase
the number of qualified nurses in the primary care workforce.
Nursing Education, Practice, Quality, and Retention
(NEPQR).--The Committee includes $51,913,000 for NEPQR,
$5,000,000 above the fiscal year 2021 enacted level and the
fiscal year 2022 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 $15,000,000, an increase of $10,000,000
above the fiscal year 2021 enacted level and the fiscal year
2022 budget request, for grants to establish or expand
community-based nurse practitioner residency and fellowship
training programs that are accredited, or in the accreditation
process, for practicing postgraduate nurse practitioners (NPs)
in primary care or behavioral health, where supported education
and training specialties will include family, adult family,
adult-gerontology, pediatric, women's health care, nurse
midwife, and psychiatric-mental health. The Committee directs
HRSA to give preference to FQHCs, as defined by section
1861(aa)(4) of the Social Security Act. The Committee is
concerned the Nation is unprepared for health care provider
shortages and recognizes that postgraduate programs with this
focus, integrating primary care and behavioral health, will
help to address this problem. Patients need expert primary care
and behavioral health providers prepared to manage the social
and clinical complexities experienced in FQHCs. The program
provides residency training and fellowships to enable
postgraduate NPs to transition to an integrated model of care
consistent with current high standards of NP education and
practice meeting the needs of our nation's most vulnerable
populations. The events of 2020, from the global COVID-19
pandemic to national recognition of the severity of health
disparities and health inequities in our country, has made this
even more urgent.
Nursing Workforce Diversity.--The Committee includes
$26,343,000 for Nursing Workforce Diversity, $6,500,000 above
the fiscal year 2021 enacted level and $3,000,000 above the
fiscal year 2022 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 $108,635,000 for Nurse Corps, $20,000,000 above the
fiscal year 2021 enacted level and the fiscal year 2022 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.
In addition, the American Rescue Plan (P.L. 117-2) included
$200,000,000 in discretionary appropriations to support to
Nurse Corps in response to the COVID-19 pandemic.
Nursing Faculty Loan Program.--The Committee includes
$30,500,000 for the Nursing Faculty Loan Program, $2,000,000
above the fiscal year 2021 enacted level and the fiscal year
2022 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 $400,000,000 for the CHGME payment
program, $50,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 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 $75,000,000, $25,000,000 above the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request, to support colleges of medicine at public universities
located in the top quintile 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 recognizes that there are significant
shortages of pediatric subspecialists, child psychiatrists, and
other child mental health providers in underserved areas and
includes $25,000,000 for the Pediatric Subspecialty Loan
Repayment Program under section 775 of the PHS Act. The
Committee 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.
National Practitioner Data Bank (NPDB)
The Committee includes $18,814,000 for the NPDB, the same
as the fiscal year 2021 enacted level and the fiscal year 2022
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 2021....................... $975,284,000
Budget request, fiscal year 2022...................... 1,100,084,000
Committee Recommendation.............................. 1,188,784,000
Change from enacted level......................... +213,500,000
Change from budget request........................ +88,700,000
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.
Congenital Syphilis.--The Committee is concerned with the
rise in congenital syphilis as well as the need to expand
efforts to prevent this disease and reduce infant mortality. To
improve the quality of health care to mothers and their
children, the Committee encourages MCHB to support efforts to
increase prenatal screening for congenital syphilis and
postnatal follow-up for both mothers and babies to ensure that
congenital syphilis is detected at the earliest possible stage.
Maternal and Child Health (MCH) Block Grant
The Committee recommends $868,700,000 for the MCH Block
Grant, $156,000,000 above the fiscal year 2021 enacted level
and $46,000,000 above the fiscal year 2022 budget request.
States use the MCH Block Grant to improve access to care for
mothers, children, and their families; reduce infant mortality;
provide pre- and post-natal care; support screening and health
assessments for children; and provide systems of care for
children with special health care needs.
The Committee recommends that HRSA continue to support MCH
Block Grant partnerships with Federal and State partners to
address gaps in services to mothers, children, and their
families in all 50 States, the District of Columbia, and the
territories; including densely populated Medically Underserved
Areas and Medically Underserved Population designated Health
Professional Shortage Areas.
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 2022
Budget Activity Committee
------------------------------------------------------------------------
Set-aside for Oral Health............................ $5,250,000
Set-aside for Epilepsy............................... 3,642,000
Set-aside for Sickle Cell Disease.................... 10,000,000
Set-aside for Fetal Alcohol Syndrome................. 1,000,000
------------------------------------------------------------------------
State Oral Health Programs.--The Committee includes
$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 play a key
role in the design, monitoring, oversight, and implementation
of these projects.
Alliance for Maternal Health Safety Bundles.--The Committee
includes $14,300,000, an increase of $5,300,000 above the
fiscal year 2021 enacted level and the same as the fiscal year
2022 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.
Children's Health and Development.--There is increasing
evidence that experiences in early childhood have long-term
health consequences over the course of one's life. These
experiences are critical in all areas of children's
educational, social, and physical development and economic
well-being. Children living in persistently high poverty
experience more negative health outcomes. The Committee
includes $3,500,000 to build upon the work done to address
these challenges, and directs HRSA to fund projects bringing
systemic change, such as Statewide systems of early childhood
developmental screenings and interventions, in States with high
levels of or disparities in childhood poverty. The goal of the
program is to yield comprehensive and integrated models for
other States to utilize in improving child health and
development outcomes.
Early Childhood Development Expert Grants.--The Committee
includes $25,000,000, an increase of $25,000,000 above the
fiscal year 2021 level and $15,000,000 above the fiscal year
2022 budget request, to place early childhood development
experts in pediatrician offices that serve a population with a
high percentage of Medicaid and CHIP patients.
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.
Hereditary Hemorrhagic Telangiectasia (HHT) Centers of
Excellence.--The Committee includes $2,000,000 to establish a
new competitive grant program for HHT Centers of Excellence.
This funding will support 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.
Implicit Bias and Racism Training for Health Care
Professionals.--The Committee includes $5,000,000, an increase
of $5,000,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request, to make grants to
train health care providers on identifying and avoiding
implicit bias.
Infant-Toddler Court Teams.--The Committee includes
$25,000,000 to continue and expand research-based Infant-
Toddler Court Teams to change child welfare practices to
improve well-being for infants, toddlers, and their families.
The Committee expects this increase of $15,000,000 above the
fiscal year 2021 enacted level to: (1) build upon the work of
sites currently supported through the Infant-Toddler Court
Program provision of training technical assistance, and
additional support for Infant-Toddler Court teams' efforts
across the country, and (2) provide grants to plan and support
additional Infant-Toddler Court Teams.
Maternal Mental Health Hotline.--The Committee includes
$5,000,000, an increase of $2,000,000 above the fiscal year
2021 level and $1,000,000 above the fiscal year 2022 budget
request, to support a 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 shall provide 24 hours a day voice
and text support that is culturally and linguistically
appropriate. Funds provided shall also be used to raise public
awareness about maternal mental health issues and the hotline.
NASEM Study on Bias Recognition in Clinical Skills
Testing.--The Committee includes $1,000,000, $1,000,000 above
the fiscal year 2021 enacted level and the same as the fiscal
year 2022 budget request, to support a NASEM study that will
make recommendations for incorporating bias recognition in
clinical skills testing for accredited schools of allopathic
medicine and osteopathic medicine.
Pregnancy Medical Home Demonstration.--The Committee
includes $25,000,000, an increase of $25,000,000 above the
fiscal year 2021 level and the same as the fiscal year 2022
budget request, 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.
Regional Pediatric Pandemic Network.--The Committee
provides $13,000,000, an increase of $3,000,000 above the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request, within SPRANS to continue the work of the Regional
Pediatric Pandemic Network to prepare the pediatric community
for and coordinate timely research-informed responses to future
pandemics.
State Maternal Health Innovation Grants.--The Committee
includes $53,000,000, $30,000,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request, 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.
Sudden Infant Death Syndrome.--The Committee includes
$5,100,000, an increase of $4,000,000 above the fiscal year
2021 enacted level and the fiscal year 2022 budget request, for
the National Fetal, Infant, and Child Death Review (FIDCR)
program to expand support and technical assistance to States
and tribal communities and improve the availability of data on
sudden unexpected infant deaths (SUID). The Committee urges
HRSA to consider making grants to support families who have
experiences SUID by providing information, referrals, or peer
or follow-up support services.
Maternal and Child Health Programs
Sickle Cell Anemia Demonstration Program
The Committee includes $9,205,000 for this program, an
increase of $2,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 budget request. With the start of new
five-year grant awards in fiscal year 2022, the Committee is
interested in learning how the program is supporting the growth
of comprehensive Sickle Cell Disease (SCD) 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. The Committee directs HRSA to provide an update in
the fiscal year 2023 Congressional Budget Justification on its
plans to meet these goals.
Autism and Other Developmental Disorders
The Committee recommends $57,344,000 for Autism and Other
Developmental Disorders, $4,000,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request. These programs seek to improve the health and well-
being of children and adolescents with autism spectrum disorder
and other developmental disabilities and to advance best
practices for the early identification and treatment of autism
and related developmental disabilities.
Leadership Education in Neurodevelopmental and Related
Disabilities (LEND).--The Committee provides $38,245,000,
$2,000,000 above the fiscal year 2021 enacted level and
$856,000 above the fiscal year 2022 budget request, for the
LEND program to allow the existing 52 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 $25,883,000 for the Heritable
Disorders program, $7,000,000 above the fiscal year 2021
enacted level and the fiscal year 2022 budget request. This
program supports activities that strengthen the newborn
screening system to ensure infants born in every State receive
rapid identification, early intervention, and potentially life-
saving treatment.
Severe Combined Immune Deficiency (SCID).--Within the total
amount for Heritable Disorders, the Committee provides
$4,000,000, an increase of $1,000,000 above the fiscal year
2021 enacted level and the fiscal year 2022 budget request, to
support wider implementation, education, and awareness of
newborn screening and follow-up for SCID and other newborn
screening disorders. The Committee recognizes the progress that
has been made in screening for SCID at birth to enable early
interventions, including bone marrow transplantations and
emerging investigational gene therapies. This work has been
extremely beneficial to families who will soon have access to
additional support with the launch of a virtual, facilitated
caregiver support group this year. The Committee directs HRSA
to continue supporting this and related work that focuses on
helping families understand and navigate the process from
diagnosis to treatment and follow-up and to expand access to
these resources for providers and families of infants with SCID
and other newborn screening disorders with a focus on reaching
underserved populations.
Healthy Start
The Committee recommends $145,000,000 for the Healthy Start
program, $17,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 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.
Remote Blood Pressure Monitoring Initiative.--Preeclampsia/
eclampsia is the most dangerous form of hypertension that can
develop during pregnancy or the postpartum period, affecting as
many as one in twelve pregnancies and resulting in 15 percent
of premature infant deaths. While new preeclampsia diagnostics
are being evaluated by the Food and Drug Administration (FDA),
the Committee understands that medical providers continue to
rely on regular blood pressure monitoring to identify pregnant
and postpartum people at highest risk of developing
preeclampsia. The Committee also understands that preeclampsia
disproportionately affects racial and ethnic minorities and
those living in rural communities, and supports efforts to
improve blood pressure monitoring for people lacking access to
consistent prenatal care, particularly efforts to support
remote blood pressure monitoring of pregnant people through use
of blood pressure cuffs and easy-to-understand patient
information to identify the signs and symptoms of preeclampsia
and allow patients to proactively engage their health
providers. The Committee urges the Healthy Start Program to
work with States, health care providers, and nonprofit patient
organizations to design and support an initiative that will
strengthen remote blood pressure monitoring programs among
high-risk vulnerable populations and communities.
Maternal Mortality.--The Committee recognizes the rising
maternal mortality rate in the U.S. as a pressing public health
issue. Analysis of maternal mortality review committee data
indicates that over 60 percent of pregnancy-related deaths are
preventable. The Committee continues to provide no less than
$15,000,000, the same as the fiscal year 2021 enacted level and
the fiscal year 2022 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.
Clinical staff will provide direct access to well-woman care
and maternity care services to reduce barriers in access to
maternity care and help address maternal health disparities
among high-risk and underserved women, including those in rural
areas and maternal and infant care deserts. Clinical staff will
also support health educators by conducting training on
maternal early warning signs.
Universal Newborn Hearing Screening
The Committee includes $19,518,000 for the Universal
Newborn Hearing Screening program, an increase of $1,700,000
above the fiscal year 2021 enacted level and the fiscal year
2022 budget request. This program awards grants to 53 States
and territories to support Statewide systems of newborn hearing
screening and early intervention programs.
Emergency Medical Services for Children
The Committee includes $28,134,000 for Emergency Medical
Services for Children, an increase of $5,800,000 above the
fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. 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 $10,000,000 for the Screening and
Treatment of Maternal Depression and Related Behavioral
Disorders Program (MDRBD), an increase of $5,000,000 above the
fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. Maternal mental health (MMH) conditions
are the most common pregnancy and postpartum complication;
however, 75 percent of mothers go untreated. 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. 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. Grants shall
include culturally competent 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 $25,000,000 for Pediatric Mental
Health Access, an increase of $15,000,000 above the fiscal year
2021 enacted level and the fiscal year 2022 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.
Maternal, Infant, and Early Childhood Home Visiting Program
The Committee recognizes that good oral health is an
important component for improving the health and well-being of
children and families. The Committee encourages HRSA to explore
opportunities to facilitate linkages between the agency's Home
Visiting Program and Community Dental Health Coordinators,
where available. The Committee also encourages HRSA to work
with oral health initiatives such as Community Dental Health
Coordinators that have already been initiated by dental
organizations to provide dental education, community-based
prevention, care coordination, and patient navigation to
children and vulnerable families.
RYAN WHITE HIV/AIDS PROGRAM
Appropriation, fiscal year 2021....................... $2,423,781,000
Budget request, fiscal year 2022...................... 2,554,781,000
Committee Recommendation.............................. 2,654,781,000
Change from enacted level......................... +231,000,000
Change from budget request........................ +100,000,000
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:
------------------------------------------------------------------------
FY 2022
Budget Activity Committee
------------------------------------------------------------------------
Emergency Assistance................................. $700,876,000
Comprehensive Care Programs.......................... 1,387,005,000
AIDS Drug Assistance Program..................... 900,313,000
Early Intervention Program........................... 207,079,000
Children, Youth, Women, and Families................. 80,088,000
AIDS Dental Services................................. 15,122,000
Education and Training Centers....................... 44,611,000
Special Projects of National Significance............ 30,000,000
Ending the HIV Epidemic Initiative................... 190,000,000
------------------------------------------------------------------------
Ending the HIV Epidemic (EHE) Initiative.--The Committee
includes $190,000,000 within the Ryan White HIV/AIDS Program
for the EHE Initiative, an increase of $85,000,000 above the
fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. 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.
Ryan White Part A Formula Disparities.--The Committee
directs HRSA to take action to revise and improve the funding
formula disparities under Part A of the Ryan White HIV/AIDS
Program. Funding allocations utilized under the Ryan White HIV/
AIDS Treatment Extension Act of 2009 are largely based on a
formula which considers the place of residence of persons at
the time of initial diagnosis when making formula-based grants.
Under current law, if a person diagnosed with HIV in one area
of the country moves to another part of the country, the
funding for the case is not transferred to the new location.
Therefore, the Committee directs HRSA to develop methods for
calculating RWHAP formula funds to reflect the number of
persons living with HIV in eligible jurisdictions, as well as
other factors that reflect variability in funds and other
resources. Additionally, HRSA should review their methods for
awarding supplemental funds to effectively and accurately
address the need for RWHAP Part A funds among eligible
jurisdictions and report their findings back to the Committee
within 180 days of enactment of this Act.
HEALTH CARE SYSTEMS
Appropriation, fiscal year 2021....................... $129,093,000
Budget request, fiscal year 2022...................... 136,093,000
Committee Recommendation.............................. 147,093,000
Change from enacted level......................... +18,000,000
Change from budget request........................ +11,000,000
The Health Care 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; maintaining a national system
for the recruitment of bone marrow donors; operating the 340B
drug discount program; and operating a national toll-free
poison control hotline.
Organ Transplantation
The Committee includes $34,049,000 for the Organ
Transplantation program, $5,000,000 above the fiscal year 2021
enacted level and the fiscal year 2022 budget request.
Maximizing Deceased Donor Organ Recovery, Acceptance, and
Utilization.--The Committee supports swift implementation of
the CMS final rule for Organ Procurement Organizations (OPOs)
Conditions for Coverage (CMS-3380-F), including efforts to
decertify underperforming OPOs. OPO failures are
disproportionately borne by patients of color, which means OPO
reform is an urgent health equity issue. The Committee believes
swift and effective implementation of the Final Rule is a first
step toward ensuring OPOs perform their public duties to secure
more organs in an inclusive and equitable manner. The Committee
supports regulatory and enforcement efforts to minimize
excessive and frivolous expenses reimbursed by Medicare,
including the CMS proposed rule on Medicare reimbursement for
organ acquisition costs (CMS-1752-P). The Committee also
encourages HHS to make all efforts to promote competition for
the Organ Procurement and Transplantation Network (OPTN)
contract, and to use the announced movement of the Division of
Transplantation to the Office of the Assistant Secretary for
Health to facilitate coordinated organ donation reforms.
Reimbursement of Travel and Subsistence Expenses Toward
Living Organ Donation Program.--The Committee includes
$18,800,000, an increase of $12,800,000 above the fiscal year
2021 enacted level and $5,000,000 above the fiscal year 2022
budget request, for the Living Organ Donation Program. The
Committee supports the expansion of this program to reimburse a
comprehensive range of living donor expenses for the greatest
possible number of donors, including lost wages, childcare,
eldercare, similar expenses for donor caretakers, and removing
other disincentives to donation. 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.
National Cord Blood Inventory (NCBI)
The Committee includes $20,266,000 for the NCBI, an
increase of $2,000,000 above the fiscal year 2021 level and the
fiscal year 2022 budget request. The NCBI program supports cord
blood banks to build an inventory of the highest quality cord
blood units for transplantation. The National Cord Blood
Inventory program builds a genetically and ethnically diverse
inventory of high-quality umbilical cord blood for
transplantation. The Committee applauds HRSA for the growth of
the number of units collected and maintained under the NCBI.
C.W. Bill Young Cell Transplantation
The Committee includes $33,009,000 for the C.W. Bill Young
Cell Transplantation program, an increase of $2,000,000 above
the fiscal year 2021 level and the fiscal year 2022 budget
request. This program supports coordinating the procurement of
bone marrow and 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 has provided funding
above the budget request 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 donor. Eliminating these barriers would
allow therapies for patients to be delivered on time and to
provide equal and successful outcomes for all.
Office of Pharmacy Affairs (OPA)
The Committee includes $17,238,000 for OPA, $7,000,000
above the fiscal year 2021 enacted level and the same as the
fiscal year 2022 budget request. 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.
Funding will support implementation of 340B Program statutory
obligations, oversight of participating manufacturers and
covered entities, operational improvements, and increased
efficiencies using information technology.
340B Drug Discount Program.--The Committee recognizes that
the 340B program is a critical lifeline to safety net
providers, including Community Health Centers. Health Centers
are model stewards of the program and reinvest 340B savings to
``stretch scarce Federal resources as far as possible, reaching
more eligible patients and providing more comprehensive
services'', as Congress intended. The Committee is pleased that
HRSA sent letters to six pharmaceutical companies on May 17,
2021, determining that ongoing actions by the companies have
resulted in overcharges to 340B covered entities. Furthermore,
the Committee notes that HRSA articulated that continued
failure to provide the 340B price to covered entities utilizing
contract pharmacies may result in Civil Monetary Penalties, as
described in the final Civil Monetary Penalty rule. 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
directs HRSA to provide a report no later than 120 days after
enactment of this Act on actions taken to safeguard covered
entities' lawful access to discounted drugs.
The Committee is aware that in 2011, GAO issued a report
outlining five recommendations for HRSA to improve performance
and accountability within the 340B program. The Committee
commends HRSA for implementing three of those recommendations
and directs HRSA to report to the Committee within 120 days of
enactment of this Act on plans to implement the remaining two
recommendations, which focus on clarifying eligibility criteria
for 340B patients and providers. The Committee also directs GAO
to update the 2011 report on the performance of the 340B
program.
Poison Control Centers
The Committee includes $26,846,000 for Poison Control
Centers, an increase of $2,000,000 above the fiscal year 2021
enacted level and the fiscal year 2022 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.
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 2021 enacted levels and the amounts requested in
the fiscal year 2022 budget request. The programs support
inpatient, outpatient, long-term care, as well as training and
research in Baton Rouge, Louisiana; a residential facility at
Carville, Louisiana; 11 outpatient clinic sites in the
continental U.S. and Puerto Rico; repair and maintenance of
buildings at 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 2021....................... $329,519,000
Budget request, fiscal year 2022...................... 400,209,000
Committee Recommendation.............................. 400,209,000
Change from enacted level......................... +70,690,000
Change from budget request........................ - - -
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; for the
outreach and treatment of coal miners and others with
occupation-related respiratory and pulmonary impairments; and
for the expansion of telehealth services.
Rural Health Outreach Programs
The Committee includes $90,000,000 for Rural Health
Outreach Programs, an increase of $7,500,000 above the fiscal
year 2021 enacted level and the same as the fiscal year 2022
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 $10,400,000 for
RMOMS, an increase of $5,400,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request. 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 $11,576,000 for Rural Health
Research and Policy Development, an increase of $500,000 above
the fiscal year 2021 enacted level and the fiscal year 2022
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 Hospital Flexibility Grants
The Committee includes $79,009,000 for Rural Hospital
Flexibility Grants, $23,400,000 above the fiscal year 2021
enacted level and $21,500,000 above the fiscal year 2022 budget
request. These programs support States to assist small and
critical access rural hospitals to remain economically viable
and to provide high-quality care.
Small Rural Hospital Improvement Program (SHIP).--The
Committee recommendation includes $23,242,000 for SHIP, an
increase of $2,300,000 over the fiscal year 2021 enacted level
and the fiscal year 2022 budget request.
Rural Emergency Hospital Technical Assistance Program.--The
Committee includes $10,000,000 within the total for Rural
Hospital Flexibility Grants to establish the Rural Emergency
Hospital Technical Assistance Program. This program will
provide technical assistance from existing State Flexibility
Programs and other stakeholders to assist facilities in the
implementation of the new Rural Emergency Hospital model.
Rural Provider Modernization Technical Assistance
Program.--The Committee includes $5,000,000 within the total
for Rural Hospital Flexibility Grants to establish the Rural
Provider Modernization Technical Assistance Program. This
program will provide technical assistance to hospitals and
other health care providers to implement sustainable models of
care that address social determinants of health and health
equity.
Rural Provider Modernization Grants.--The Committee
includes $4,000,000 within the total for Rural Hospital
Flexibility Grants to establish the Rural Provider
Modernization Grants program. This program will make grants to
support hospitals, public health departments, clinics, and
community-based organizations to plan and implement emerging,
sustainable models of care.
State Offices of Rural Health
The Committee includes $13,000,000 for State Offices of
Rural Health, $500,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 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 $690,000 above the fiscal year 2021 enacted
level and the same as the fiscal year 2022 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 $900,000 above the fiscal year 2021 enacted level
and the same as the fiscal year 2022 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.
Telehealth
The Committee includes $39,000,000 for Telehealth, an
increase of $5,000,000 above the fiscal year 2021 enacted level
and $2,500,000 above the fiscal year 2022 budget request. 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.
Telehealth Centers of Excellence.--The Committee includes
$7,500,000 for Telehealth Centers of Excellence, an increase of
$1,000,000 above the fiscal year 2021 enacted level. Grantees
examine the efficacy of telehealth services in rural and urban
areas and serve as a national clearinghouse for telehealth
research and resources. The Centers of Excellence serve to
promote the adoption of telehealth programs across the country
by validating technology, establishing training protocols, and
by providing a comprehensive template for States to integrate
telehealth into their State health provider network. Additional
funding for the Centers of Excellence will support the
development of models of care and best practices for the
expansion of telemental health.
Urban Focused Telehealth Network Grant Program.--The
Committee believes that a fundamental element to ensuring our
health care system is prepared for pandemic events is the
development of robust telehealth services and integrated
systems that can provide a continuum of care across State and
regional lines. This is especially true in the nation's urban
areas, where a pandemic event has the potential to
disproportionately impact and overwhelm the health care and
delivery system. The Committee believes increased investments
in urban telehealth services could have a tremendous impact on
the health and well-being of the nation's most vulnerable
citizens and medically underserved populations, especially
during times of national public health emergencies. The
Committee encourages HRSA to establish a pilot program to
expand academic health system telehealth programs aimed at
addressing the health inequities of urban populations.
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 2021 enacted level and the same as the fiscal year 2022
budget request. This program funds physician residency training
programs that support physician workforce expansion in rural
areas.
The COVID-19 pandemic has exacerbated the challenges in
access to care faced by Americans in rural areas, particularly
when they require specialty care. The Committee commends the
Federal Office of Rural Health Policy for its 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 Tracks (RTTs). This
Committee encourages HRSA to expand the current program to
include RTTs in obstetrics and gynecology, as women in rural
communities are more likely to begin prenatal care late and are
more likely to experience maternal mortality and severe
maternal morbidity. The Committee requests a report in the
fiscal year 2023 Congressional Budget Justification on the
progress made to date and efforts to expand RTTs in obstetrics
and gynecology.
Rural Communities Opioids Response
The Committee includes $140,000,000 to continue the Rural
Communities Opioids Response program, an increase of
$30,000,000 above the fiscal year 2021 enacted level and
$25,000,000 below the fiscal year 2022 budget request. The
Committee recognizes the devastating impact the opioid epidemic
has had on rural communities and how the COVID-19 pandemic has
worsened the opioid crisis. The Committee expands funding to
support treatment for and prevention of substance use
disorders, including opioid abuse, focusing on rural
communities with the highest risk for substance use disorders.
Within the funding provided, the Committee includes $10,000,000
to continue the three Rural Centers of Excellence, as
established by Public Law 115-245 and continued in Public Law
116-94.
FAMILY PLANNING
Appropriation, fiscal year 2021....................... $286,479,000
Budget request, fiscal year 2022...................... 340,000,000
Committee Recommendation.............................. 400,000,000
Change from enacted level......................... +113,521,000
Change from budget request........................ +60,000,000
The Committee includes $400,000,000 for the Family Planning
program, $113,521,000 above the fiscal year 2021 enacted level
and $60,000,000 above the fiscal year 2022 budget request. In
addition, the American Rescue Plan (P.L. 117-2) included
$50,000,000 in funding to support emergency needs of the Family
Planning program due to the COVID-19 public health emergency.
The Family Planning program administers Title X of the
Public Health Service Act. This program plays a vital role not
only in ensuring access to affordable contraceptive education,
services, and supplies, but also in STD prevention, screening,
and treatment; cervical and breast cancer screenings; first-
line infertility services; and other community and health care
services.
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).
Telehealth Guidance.--The Committee recognizes that the
COVID-19 pandemic has increased the importance of access to
telehealth services across the health care system, including
for Title X providers and patients. The Committee urges the OPA
to release telehealth guidance and best practices for Title X
projects that reiterate the importance of telehealth in
providing quality family planning services.
Ensuring Health Equity.--The Committee recognizes that the
Title X program remains an important component of the health
care safety net and is essential to addressing health
inequities. Building a more inclusive Title X program requires
focusing on grantmaking that will continue this work.
Recommendations for Quality Family Planning Services.--The
Committee directs the Secretary to begin the process of
revising ``Providing Quality Family Planning Services,''
evidence-based recommendations from the CDC and OPA that were
last updated in 2017. Revisions should incorporate new evidence
and support holistic reproductive and sexual health needs. 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, reflecting the current estimated need for Title X services
and cost required to provide such updating the 2016 study
published in the American Journal of Public Health.
PROGRAM MANAGEMENT
Appropriation, fiscal year 2021....................... $155,300,000
Budget request, fiscal year 2022...................... 167,971,000
Committee Recommendation.............................. 536,407,000
Change from enacted level......................... +381,107,000
Change from budget request........................ +368,436,000
Program management supports 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 in House Report (116-450) to
have HRSA ensure that the Chief Dental Officer (CDO) is
functioning at an executive level authority with resources and
staff to oversee and lead all oral health programs and
initiatives across HRSA, no such authority has been delegated.
The Committee directs HRSA to restore the authority of HRSA CDO
with executive level authority and resources to oversee and
lead HRSA dental programs and initiatives as well as have a
role within oral health 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 2023 Congressional Budget Justification on how the
CDO is serving as the agency representative on oral health
issues to international, national, State and/or local
government agencies, universities, and oral health stakeholder
organizations.
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 (42 USC Section 256g) 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.
Oral Health Literacy.--The Committee includes $500,000 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 urges 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. The Committee directs HRSA to develop
and implement measures to increase the share of investments its
programs in persistent poverty counties, high-poverty areas,
and any other impoverished communities that HRSA determines to
be appropriate areas to target. The Committee appreciates the
report HRSA provided in response to the Committee's request in
House Report 116-450 and directs the Department to provide an
update to the Committee within 180 days of enactment of this
Act on how HRSA is carrying out this directive.
Community Project Funding
The Committee includes $367,415,000 for projects financing
the construction and renovation (including equipment) of health
care and other facilities and for one-time grants supporting
other health-related activities. The budget request does not
include funding for this purpose. The Committee includes
$4,000,000 within this total for agency administrative
expenses. The bill includes funding for the following projects
in the following amounts:
------------------------------------------------------------------------
Project Amount
------------------------------------------------------------------------
26Health, Orlando, FL for purchase of equipment...... $250,000
Advocate Health and Hospitals Corporation dba 150,000
Advocate Christ Medical Center, Oak Lawn, IL for
facilities and equipment............................
Advocate Illinois Masonic Medical Center, Chicago, IL 300,000
for facilities and equipment........................
Affinia Healthcare, Saint Louis, MO for facilities 2,000,000
and equipment.......................................
Aging in PACE Washington, Seattle, WA for facilities 700,000
and equipment.......................................
AIDS Care Group, Chester, PA for facilities and 1,000,000
equipment...........................................
Aleutians East Borough, Sand Point, AK for facilities 2,000,000
Alzheimer's Foundation of America, Amityville, NY for 100,000
education and training services.....................
Andy's Angels, Jackson, MI for facilities............ 300,000
Arc of the Ozarks, Springfield, MO for equipment and 800,000
autism diagnostic and treatment services............
Asian American Drug Abuse Prevention, Los Angeles, CA 250,000
for a health initiative.............................
Asian American Health Coalition of Greater Houston, d/ 1,000,000
b/a HOPE Clinic, Houston, TX for a health
initiative, including facilities and equipment......
Asian American Health Coalition of Greater Houston, d/ 2,000,000
b/a HOPE Clinic, Houston, TX for facilities and
equipment...........................................
Atlantic Health System, Morristown, NJ for facilities 750,000
and equipment at Atlantic Health System--Newton
Medical Center......................................
Aurora Community Mental Health Center, Aurora, CO for 1,000,000
facilities and equipment............................
Autism New Jersey, Robbinsville, NJ for facilities 200,000
and equipment and purchase of information technology
Avenidas, Palo Alto, CA for facilities and equipment 150,000
for the Avenidas Rose Kleiner Center................
Ballad Health, Johnson City, TN for facilities....... 450,000
BANJ Health Center Inc., Compton, CA for a health 50,000
initiative..........................................
Baptist Health Hardin, Elizabethtown, KY for 300,000
facilities and equipment............................
Battle Ground Healthcare, Battle Ground, WA for 320,000
facilities and equipment............................
Bay Area Community Health, Fremont, CA for an 1,000,000
electronic health records initiative................
Baylor College of Medicine, Houston, TX for 1,100,000
facilities and equipment............................
Beach Cities Health District, Redondo Beach, CA for 1,000,000
facilities and equipment for the Youth Wellness
Center..............................................
Benton County, Kennewick, WA for facilities.......... 2,000,000
Bethel School District #403, Spanaway, WA for 2,000,000
facilities and equipment for the School-Based Health
Clinic at Graham-Kapowsin High School...............
Bexar County Hospital District d/b/a University 300,000
Health, San Antonio, TX for a health initiative.....
Blood Bank of Hawaii, Honolulu, HI for facilities and 2,000,000
equipment...........................................
Bluefield State College, Bluefield, WV for facilities 300,000
Board of Trustees of the University of Illinois, 2,000,000
Urbana, IL for facilities...........................
Bon Secours Mercy Health Inc., Cincinnati, OH for 1,000,000
facilities and equipment............................
Bowling Green-Warren County Community Hospital 250,000
Corporation dba The Medical Center at Caverna, Horse
Cave, KY for facilities and equipment...............
Brooklyn Communities Collaborative, Inc., Brooklyn, 875,000
NY for a telehealth and electronic medical records
initiative..........................................
Brooklyn Hospital Center, Brooklyn, NY for facilities 2,000,000
and equipment.......................................
Broward Community and Family Health Centers, Inc., 225,000
Hollywood, FL for facilities and equipment..........
Brownsville Community Development Corporation dba BMS 1,000,000
Family Health and Wellness Centers, Brooklyn, NY for
facilities and equipment............................
Bucks County Department of Mental Health: 500,000
Developmental Programs, Doylestown, PA for
facilities..........................................
Burre Dental Center, Arcata, CA for facilities and 1,000,000
equipment...........................................
C.W. Williams Community Health Center, Charlotte, NC 1,150,000
for facilities and equipment........................
California State University, Dominguez Hills, Carson, 700,000
CA for facilities and equipment and an electronic
medical records initiative..........................
Camino Community Development Corp., Charlotte, NC for 200,000
facilities and equipment and an electronic health
records initiative..................................
Cape Cod Healthcare, Hyannis, MA for an electronic 1,500,000
health records initiative...........................
Capital Health System, Inc., Trenton, NJ for purchase 550,000
of equipment........................................
Capstone Rural Health Center, Parrish, AL for 725,000
facilities..........................................
Care Plus Bergen Inc. DBA Bergen New Bridge Medical 2,000,000
Center, Paramus, NJ for facilities and equipment....
CareSTL Health, Saint Louis, MO for facilities and 1,000,000
equipment...........................................
Caridad Center, Inc., Boynton Beach, FL for 1,150,000
facilities and equipment............................
Cedars-Sinai, Los Angeles, CA for facilities and 1,000,000
equipment...........................................
Center for African American Health, Denver, CO for 1,000,000
facilities and equipment............................
Central Michigan University College of Medicine, 370,000
Mount Pleasant, MI for telepsychiatry services,
equipment, and associated information technology....
Centre Volunteers in Medicine, State College, PA for 1,065,000
facilities and equipment............................
Centro De Salud Familiar La Fe, Inc., El Paso, TX for 925,000
facilities and equipment............................
Centro Las Americas, Inc., Worcester, MA for a 975,000
telehealth and electronic health records initiative,
including the purchase of equipment.................
Chestnut Health Systems, Bloomington, IL for 430,000
facilities and equipment............................
Child Focus, Inc., Cincinnati, OH for facilities and 1,000,000
equipment...........................................
Children's Health System of Texas, Dallas, TX for 850,000
facilities and equipment............................
Children's Hospital Colorado, Anschutz Medical 500,000
Campus, Aurora, CO for a health training initiative.
Children's Hospital Los Angeles, Los Angeles, CA for 550,000
equipment...........................................
Children's Hospital Los Angeles, Los Angeles, CA for 1,600,000
purchase of equipment...............................
Children's Hospital of Wisconsin, Inc., Wauwatosa, WI 400,000
for equipment.......................................
Children's National Hospital, Washington, DC for 2,000,000
facilities and equipment............................
Chiricahua Community Health Centers, Inc., Douglas, 625,000
AZ for facilities and equipment.....................
Christian Community Health Center, Chicago, IL for 20,000
purchase of equipment...............................
Church Health Center of Memphis, Memphis, TN for 350,000
facilities and equipment............................
City of Auburn, WA for facilities and equipment for 500,000
the Auburn Consolidated Resource Center.............
City of Baltimore, MD for facilities and equipment 2,325,000
and a telehealth initiative.........................
City of Brooklyn Center, MN for a health initiative.. 100,000
City of Hope Duarte Medical Center, Duarte, CA for 450,000
purchase of equipment...............................
City of Hope National Medical Center, Duarte, CA for 700,000
equipment...........................................
City of Hope National Medical Center, Duarte, CA for 1,200,000
equipment...........................................
City of Houston Fire Department, Houston, TX for 450,000
facilities and equipment............................
City of Houston Health Department, Houston, TX for 900,000
facilities and equipment............................
City of Long Branch, NJ for facilities and equipment 2,000,000
for the City of Long Branch Health Department.......
City of Morgantown, WV for facilities and equipment.. 100,000
City of Mount Sterling, KY for facilities and 1,000,000
equipment...........................................
City of Rochester Department of Recreation and Human 225,000
Services, Rochester, NY for facilities and equipment
City of West Wendover, NV for facilities and 320,000
equipment...........................................
Clinica Amistad, Tucson, AZ for a telehealth 185,000
initiative and purchase of equipment................
Clinicas de Salud del Pueblo, El Centro, CA for 1,000,000
facilities and equipment............................
Colorado Coalition for the Homeless, Denver, CO for 2,000,000
facilities and equipment............................
Columbus Neighborhood Health Center, Inc., dba 500,000
PrimaryOne Health (P1H), Columbus, OH for facilities
and equipment.......................................
Commonwealth Healthcare Corporation, Sapian, MP for 1,200,000
facilities and equipment............................
CommuniCare Health Centers, Davis, CA for facilities 400,000
and equipment.......................................
Community College District 502, Glen Elyn, IL for 500,000
purchase of equipment...............................
Community Health Access Network, Newmarket, NH for an 700,000
electronic medical records initiative...............
Community Health Centers of Pinellas, Inc., 2,000,000
Clearwater, FL for facilities and equipment.........
Compass Health, Everett, WA for facilities and 2,000,000
equipment...........................................
ComWell, Red Bud, IL for rural mental health and 250,000
psychiatric care....................................
Contra Costa Regional Medical Center, Martinez, CA 900,000
for a health training and electronic health records
initiative..........................................
Cooper University Health Care, Camden, NJ for 500,000
facilities and equipment............................
Cornerstone Care, Inc., Greensboro, PA for facilities 1,500,000
and equipment for a facility in Clairton, PA........
Cornerstone Services, Inc., Joliet, IL for facilites 1,050,000
and equipment.......................................
County of Alameda, Oakland, CA for facilities and 1,250,000
equipment for the West Oakland Health Council.......
County of Benton, Corvalis, OR for facilities and 1,000,000
equipment for the Benton County Crisis Respite
Center..............................................
County of Clear Creek, Georgetown, CO for facilities 1,000,000
and equipment for the Clear Creek County
Collaborative Care Center...........................
County of Contra Costa Health Services Department, 1,000,000
Behavioral Health Division, Martinez, CA for
facilities and equipment............................
County of Fairfax, Fairfax, VA for facilities and 2,000,000
equipment for the Merrifield Crisis Response Center.
County of Fairfax, VA for a health information 375,000
technology initiative, including purchase of
equipment...........................................
County of Fairfax, VA for a health IT initiative..... 800,000
County of Franklin, Columbus, OH for facilities and 500,000
equipment for the Franklin County Mental Health and
Addiction Crisis Center.............................
County of Henrico, Henrico, VA for facilities and 1,000,000
equipment...........................................
County of Lane, Eugene, OR for facilities and 1,500,000
equipment for a rural community health clinic in
Cottage Grove, OR...................................
County of Orange, Orlando, FL for a health workforce 300,000
initiative..........................................
County of Orange, Santa Ana, CA for facilities....... 2,000,000
County of Prince George's Department of Health, 4,000,000
Largo, MD, for a telehealth initiative, including
purchase of equipment...............................
County of Prince William, Prince William, VA for a 800,000
health initiative...................................
County of Santa Barbara, Santa Barbara, CA for 900,000
facilities and equipment for the Lompoc Health
Clinic..............................................
County of Santa Clara, San Jose, CA for a health 1,000,000
workforce initiative................................
County of Wayne, Honesdale, PA for facilities and 2,000,000
equipment...........................................
Dallas County Hospital District d/b/a Parkland Health 275,000
& Hospital System, Dallas, TX for facilities and
equipment...........................................
Day Kimball Hospital, Putnam, CT for facilities and 550,000
equipment...........................................
Delaware Division of Libraries, Dover, DE for a 275,000
telehealth initiative, including the purchase of
equipment...........................................
Delaware-Morrow Mental Health & Recovery Services 750,000
Board, Delaware, OH for facilities..................
Denver Health and Hospital Authority, Denver, CO for 1,200,000
facilities and equipment............................
Dientes Community Dental Care, Santa Cruz, CA for 1,050,000
facilities and equipment............................
Dimock Center, Inc. d/b/a The Dimock Center, Roxbury, 1,000,000
MA for facilities and equipment.....................
Doylestown Health Foundation, Doylestown, PA for 100,000
equipment and associated information technology.....
East Los Angeles College, Monterey Park, CA for a 925,000
health workforce initiative, including facilities
and equipment.......................................
Easterseals Midwest, St. Louis, MO for equipment, 200,000
information technology, and support services........
Easterseals of Southwest Florida, Sarasota, FL for 2,000,000
facilities..........................................
Edward M. Kennedy Community Health Center, Inc., 1,000,000
Worcester, MA for an interpreter services program...
El Centro de Corazon, Houston, TX for facilities and 225,000
equipment...........................................
El Paso County Hospital District/University Medical 1,200,000
Center of El Paso, El Paso, TX for purchase of
equipment...........................................
El Proyecto del Barrio, Inc., Winnetka, CA for 1,000,000
facilities and equipment............................
El Rio Santa Cruz Neighborhood Health Care, Inc., 1,450,000
Tucson, AZ for facilities and equipment.............
Equitas Health, Columbus, OH for purchase of 150,000
equipment...........................................
Erie County Health Department, Sandusky, OH for 2,000,000
facilities and equipment............................
Erie Neighborhood House, Chicago, IL for facilities 2,000,000
and equipment.......................................
Erlanger Health System, Chattanooga, TN for 2,000,000
facilities and equipment............................
EveryMind, Rockville, MD for telehealth.............. 325,000
Excela Health, Greensburg, PA for equipment.......... 125,000
Excela Health, Greensburg, PA for equipment.......... 650,000
Families Flourish Northeast, Lebanon, NH for 500,000
facilities and equipment............................
Family Services, Inc., Poughkeepsie, NY for 1,200,000
facilities and equipment............................
Jewish Family and Children's Service of Palm Beach 325,000
County, West Palm Beach, FL for an electronic health
records initiative..................................
Flanner House of Indianapolis, Inc., Indianapolis, IN 250,000
for facilities and equipment........................
Floating Hospital, Inc., Long Island City, NY for 925,000
facilities and equipment............................
Florida International University, Miami, FL for 2,000,000
facilities and equipment............................
Flushing Hospital and Medical Center, Flushing, NY 750,000
for facilities and equipment........................
Free Clinic of Meridian Inc., Meridian, MS for 315,000
facilities and equipment............................
Fresno City College, Fresno, CA for a health 475,000
workforce initiative................................
Friend Family Health Center, Chicago, IL for 250,000
facilities and equipment............................
Gardner Family Health Network, Inc., San Jose, CA for 900,000
facilities and equipment............................
Gateway Community Health Center, Inc., Laredo, TX for 2,000,000
facilities and equipment............................
Gavin Foundation, Inc., South Boston, MA for 1,000,000
facilities and equipment............................
George Mason University, Fairfax, VA for a health 1,150,000
workforce initiative................................
Glenbrook High School District 225, Glenview, IL for 250,000
facilities and equipment............................
God's Love We Deliver, Inc., New York, NY for a 775,000
health initiative...................................
GoochlandCares Inc., Goochland, VA for facilities and 15,000
equipment...........................................
Grandview Foundation, Dayton, OH for facilities...... 1,250,000
Great Lakes Recovery Centers, Ishpeming, MI for 680,000
facilities and equipment............................
Greater Bergen Community Action, Inc., Garfield, NJ 1,500,000
for facilities and equipment........................
Greater Lawrence Family Health Center, Methuen, MA 2,000,000
for facilities and equipment........................
Greater New Bedford Community Health Center, New 2,000,000
Bedford, MA for facilities and equipment............
Green County Human Services, Aging & Disability 200,000
Resource Center, Monroe, WI for a rural health
initiative, including the purchase of equipment.....
H. Lee Moffitt Cancer Center and Research Institute, 2,000,000
Inc., Tampa, FL for purchase of equipment...........
Habilitative Systems, Inc., Chicago, IL for 500,000
facilities and equipment and for an electronic
health records initiative...........................
Hackensack Meridian Health, Edison, NJ for purchase 775,000
of equipment........................................
Hackensack Meridian School of Medicine, Nutley, NJ 775,000
for facilities and equipment........................
Hana Health, Hana, HI for facilities and equipment... 1,000,000
Harbor Community Health Centers, San Pedro, CA for 1,000,000
facilities and equipment............................
Harbor Hospital, Inc., Baltimore, MD for a telehealth 875,000
initiative, including the purchase of equipment.....
Harry E. Davis Partnership for Children's Oral 650,000
Health, Yarmouth, ME for a telehealth initiative....
Health Care Coalition of Rural Missouri, Lexington, 2,000,000
MO for facilities and equipment.....................
HealthPoint, Renton, WA for facilities and equipment, 350,000
including telehealth equipment......................
Hennepin Healthcare System, Inc., Minneapolis, MN for 2,000,000
facilities and equipment............................
Henry Ford Wyandotte Hospital, Detroit, MI for 900,000
facilities and equipment, including telehealth
equipment...........................................
Henry Ford West Bloomfield Hospital, West Bloomfield, 1,150,000
MI for purchase of equipment........................
Henry Mayo Newhall Hospital, Valencia, CA for 610,000
equipment...........................................
Hepatitis B Foundation, Doylestown, PA for public 475,000
health programming..................................
Hill Country Mental Health and Developmental 2,000,000
Disabilities Centers, Kerrville, TX for facilities
and equipment.......................................
Hill Hospital, York, AL for facilities and equipment. 575,000
Hurley Medical Center, Flint, MI for purchase of 1,450,000
equipment...........................................
Illinois College of Optometry, Chicago, IL for 300,000
facilities and equipment............................
Independence Health & Therapy, Woodstock, IL for an 60,000
electronic medical records initiative...............
Ironbound Community Health Center, Newark, NJ for 550,000
purchase of equipment...............................
It Takes Philly, Inc. d/b/a/ Black Doctors COVID-19 2,000,000
Consortium, Jenkintown, PA for facilities and
equipment...........................................
Jackson County School District, Marianna, FL for 85,000
facilities..........................................
Jamaica Hospital Medical Center, Richmond Hill, NY 1,500,000
for facilities and equipment........................
Jessie Trice Community Health Systems Inc., Miami, FL 400,000
for facilities and equipment........................
Joseph P. Addabbo Family Health Center, Inc., 1,500,000
Arverne, NY for facilities and equipment............
JWCH Institute, Inc., Bell Gardens, CA for purchase 300,000
of equipment........................................
Kids First Health Care, Commerce City, CO for 800,000
facilities and equipment............................
Kokua Kalihi Valley Comprehensive Family Services, 1,050,000
Honolulu, HI for facilities and equipment...........
La Clinica Tepeyac, Inc., Denver, CO for facilities 2,000,000
and equipment.......................................
Lake County Health Department & Community Health 1,000,000
Center, Waukegan, IL for facilities and equipment...
Lakewood Community Services Corporation, Lakewood, NJ 400,000
for facilities......................................
Lebanon Valley College, Annville, PA for facilities.. 1,000,000
Legacy Community Health, Houston, TX for a health 20,000
initiative..........................................
LGBT Life Center, Norfolk, VA for facilities and 1,800,000
equipment...........................................
Linda Crnic Institute for Down Syndrome, Aurora, CO 950,000
for purchase of equipment...........................
Lions Eye Institute for Transplant and Research 2,000,000
Foundation Inc., Tampa, FL for facilities and
equipment...........................................
Loma Linda University Health, Loma Linda, CA for 1,000,000
facilities and equipment............................
Loma Linda University Medical Center--Murrieta, 600,000
Murrieta, CA for equipment..........................
Long Island FQHC, Inc., Westbury, NY for facilities 2,000,000
and equipment.......................................
Long Island FQHC, Inc., Westbury, NY for facilities 1,000,000
and equipment.......................................
Loretto Health and Rehabilitation Center, Syracuse, 260,000
NY for the purchase of equipment and software for a
medical records system..............................
Los Angeles LGBT Center, Los Angeles, CA for 775,000
facilities and equipment............................
Louisiana State University Health New Orleans, New 2,000,000
Orleans, LA for the purchase of equipment...........
Main St. Missions, Doylestown, PA for facilities..... 200,000
Manet Community Health Center, Quincy, MA for 500,000
facilities and equipment............................
Martin Luther King, Jr. Family Clinic, Dallas, TX for 100,000
a health workforce training initiative, including
equipment and technology............................
Mary Bird Perkins Cancer Center, Baton Rouge, LA for 775,000
equipment...........................................
Maverick County Hospital District, Eagle Pass, TX for 500,000
information technology and telehealth services......
McLaren Northern Michigan, Petoskey, MI for 500,000
facilities and equipment............................
McLaren Oakland Hospital, Pontiac, MI for purchase of 400,000
equipment...........................................
Medstar Southern Maryland Hospital Center, Clinton, 925,000
MD for facilities and equipment.....................
MedStar Washington Hospital Center, Washington, DC 800,000
for facilities and equipment and an electronic
medical records initiative..........................
Meharry Medical College, Nashville, TN for facilities 1,000,000
and equipment.......................................
Memorial Hospital at Gulfport Foundation, Inc., 2,000,000
Gulfport, MS for facilities and equipment...........
MemorialCare Health System, Long Beach, CA for 575,000
facilities and equipment and an electronic health
records initiative..................................
Mental Health Care, Inc., Tampa, FL for facilities 2,000,000
and equipment for the Mariposa Women's
Neuropsychiatric Hospital...........................
Methodist Health Services Corporation, Peoria, IL for 2,000,000
facilities..........................................
Metropolitan Family Health Network, Inc., Jersey 800,000
City, NJ for facilities and equipment...............
Miami SCI Wellness Inc., Miami, FL for equipment..... 440,000
Millikin University, Decatur, IL for facilities and 2,000,000
equipment...........................................
Minnesota State College Southeast, Red Wing, MN for 825,000
facilities and equipment............................
Mississippi State University, Mississippi State, MS 1,000,000
for facilities and equipment........................
Missouri Valley College, Marshall, MO for facilities 2,000,000
and equipment.......................................
Monongahela Valley Hospital Foundation, Monongahela, 455,000
PA for facilities...................................
Montefiore Medical Center, Bronx, NY for facilities 3,350,000
and equipment, including telehealth equipment.......
Montefiore St. Luke's Cornwall, Cornwall, NY for 2,000,000
facilities and equipment............................
Mount St. Mary's Hospital of Niagara Falls, Lewiston, 2,000,000
NY for facilities and equipment.....................
Muslim Community Center, Inc., Silver Spring, MD for 250,000
facilities and equipment............................
National Alliance on Mental Illness, Ohio Chapter, 2,000,000
Toledo, OH, for facilities and equipment............
Nemours Foundation, Jacksonville, FL for equipment 105,000
and information technology..........................
Nevada State College, Henderson, NV for facilities 35,000
and equipment.......................................
New Alternatives for Children, Inc., New York, NY for 500,000
purchase of equipment, including telehealth
equipment...........................................
New York City Health + Hospitals/Elmhurst, Queens, NY 800,000
for facilities and equipment........................
New York City Health + Hospitals/Elmhurst, Queens, NY 3,000,000
for facilities and equipment........................
New York City Health + Hospitals/Queens Hospital, 1,000,000
Jamaica, NY for facilities and equipment............
New York Community Hospital of Brooklyn, Inc., 975,000
Brooklyn, NY for facilities and equipment...........
Newark Community Health Centers, Inc., Newark, NJ for 760,000
facilities and equipment............................
Newark-Wayne Community Hospital, Newark, NY for 180,000
equipment...........................................
Night Ministry, Chicago, IL for facilities and 275,000
equipment...........................................
Norman Regional Hospital Authority, Norman, OK for 650,000
facilities and equipment............................
North Country Community College, Saranac Lake, NY for 1,000,000
facilities and equipment............................
North Oakland County Fire Authority, Holly, MI for 500,000
purchase of equipment...............................
North Shore Community College, Danvers, MA for 900,000
facilities and equipment............................
North Shore Community Health, Salem, MA for 1,000,000
facilities and equipment............................
Northern Dutchess Hospital/Nuvance Health, Rhinebeck, 300,000
NY for facilities and equipment.....................
Northern Nye County Hospital District, Tonopah, NV 2,000,000
for facilities and equipment........................
Northwell Health, New Hyde Park, NY for facilities 2,000,000
and equipment.......................................
Nursing Care Quality Assurance Commission, Tumwater, 1,000,000
WA for a health workforce training program..........
NYC Health + Hospitals/Coney Island, Brooklyn, NY for 2,000,000
equipment...........................................
Oakland LGBTQ Community Center, Oakland, CA for 350,000
facilities and equipment............................
Oklahoma Medical Research Foundation, Oklahoma City, 835,000
OK for facilities and equipment.....................
Oklahoma State University Center for Health Sciences, 2,000,000
Tulsa, OK for facilities............................
Olivet Nazarene University, Borubonnais, IL for 90,000
facilities and equipment............................
One Brooklyn Health System, Inc., Brooklyn, NY for an 425,000
electronic health records initiative................
One Brooklyn Health System, Inc., Brooklyn, NY for 1,000,000
purchase of equipment...............................
Oregon Health & Science University Northwest Native 800,000
American Center of Excellence, Portland, OR for a
health workforce initiative.........................
OSF St. Joseph Medical Center, Bloomington, IL for 700,000
facilities and equipment............................
Outer Cape Health Services, Harwich Port, MA for 250,000
facilities and equipment............................
Pace Center For Girls Inc., Jacksonville, FL for a 500,000
telehealth initiative, including the purchase of
equipment...........................................
Pace Center for Girls, Inc., Jacksonville, FL for 2,000,000
facilities..........................................
Palm Beach State College, Lake Worth, FL for 700,000
facilities and equipment............................
Palo Verde Hospital District, Blythe, CA, for 350,000
purchase of equipment...............................
Pascua Yaqui Tribe, Tucson, AZ for facilities and 900,000
equipment...........................................
Patrick County Economic Development Authority, 600,000
Stuart, VA for equipment............................
Penn State Health St. Joseph Medical Center, Reading, 500,000
PA, for a rural health initiative, including the
purchase of equipment...............................
Pennsylvania Organization for Women in Recovery, 1,500,000
Pittsburgh, PA for facilities and equipment.........
People Coordinated Services of Southern California, 600,000
Inc., Los Angeles, CA for facilities and equipment..
Petaluma Health Center, Inc., Petaluma, CA for 1,000,000
facilities and equipment............................
Petaluma Health Center, Petaluma, CA for facilities 1,600,000
and equipment.......................................
Phoebe Putney Health System, Inc., Albany, GA for 1,000,000
facilities and equipment............................
Piatt County Nursing Home, Monticello, IL for 215,000
facilities and equipment............................
Pierce Center for Arts & Technology, Tacoma, WA for 450,000
facilities and equipment............................
Pikeville Medical Center, Inc., Pikeville, KY for 675,000
facilities and equipment............................
Planned Parenthood Mar Monte, San Jose, CA for 1,000,000
facilities and equipment............................
Planned Parenthood Mar Monte, San Jose, CA for 1,000,000
facilities and equipment............................
Pomona Community Health Center dba ParkTree Community 775,000
Health Center, Pomona, CA for facilities and
equipment...........................................
Potomac Valley Hospital, Keyser, WV for facilities 750,000
and equipment.......................................
Preston Memorial Hospital, Kingwood, WV for 580,000
facilities and equipment............................
Primary Health Care, Inc., Des Moines, IA for 100,000
facilities and equipment............................
Primary Health Care, Inc., Des Moines, IA for 200,000
facilities and equipment............................
Providence Milwaukie Hospital , Milwaukie, OR for 800,000
facilities and equipment............................
Puerto Rican Organization to Motivate, Enlighten, and 825,000
Serve Addicts, Inc., Bronx, NY for facilities and
equipment...........................................
Queens College, The City of New York, Flushing, NY 1,850,000
for facilities and equipment........................
Refuah Health Center, Inc., Spring Valley, NY for 2,000,000
facilities and equipment............................
Regents of the University of California, Los Angeles, 600,000
CA for the purchase of equipment, including
telehealth equipment................................
Regents of the University of Washington, Seattle, WA 550,000
for purchase of equipment...........................
Regional One Health, Memphis, TN for purchase of 1,000,000
equipment...........................................
Research Institute at Nationwide Children's Hospital, 500,000
Columbus, OH for purchase of equipment..............
Richmond Medical Center of Staten Island, Staten 1,815,000
Island, NY for facilities and equipment.............
RIDOH Division of State Laboratories and Medical 900,000
Examiners, Providence, RI for purchase of equipment.
Rochester General Hospital, Rochester, NY for a 1,000,000
health workforce initiative.........................
Rockland County Pride Center, Nyack, NY, for 1,500,000
facilities and equipment............................
Roosevelt Special Hospital, Portales, NM for 600,000
facilities and equipment............................
Rosalynn Carter Institute for Caregivers, Americus, 1,100,000
GA for purchase of equipment........................
Roswell Park Comprehensive Cancer Center, Buffalo, NY 1,500,000
for purchase of equipment...........................
Rowan University/Rutgers-Camden Board of Governors, 500,000
Camden, NJ for facilities and equipment.............
SAC Health System, San Bernadino, CA for purchase of 375,000
equipment...........................................
Saint Francis University School of Health Sciences 500,000
and Education, Loretto, PA for facilities...........
Saint Joseph's Health, Paterson, NJ for facilities 1,000,000
and equipment.......................................
Saint Louis University, Saint Louis, MO for 500,000
facilities and equipment............................
San Antonio College, San Antonio, TX for facilities 1,050,000
and equipment.......................................
San Francisco Community Clinic Consortium, San 1,000,000
Francisco, CA for facilities and equipment,
including an electronic medical records initiative..
San Juan College, Farmington, NM for facilities and 1,100,000
equipment...........................................
San Juan County, Monticello, UT for cancer screening. 520,000
Savio House, Denver, CO for facilities and equipment. 300,000
Schenectady Family Health Services, Inc., D/B/A 750,000
Hometown Health Centers, Schenectady, NY for
facilities and equipment............................
Sharon Hospital, Sharon, CT for facilities and 400,000
equipment, including telehealth equipment...........
Shasta Community Health Center, Redding, CA for 750,000
facilities, equipment, and information technology...
Sixteenth Street Community Health Center, Milwaukee, 1,250,000
WI for facilities and equipment.....................
Snohomish Health District, Everett, WA for a 250,000
telehealth and electronic health records initiative,
including purchase of equipment.....................
Spectrum Health Lakeland, St. Joseph, MI for 505,000
facilities and equipment, including information
technology..........................................
Spokane County, Spokane, WA for equipment............ 1,125,000
St. Barnabas Hospital, Bronx, NY for facilities and 1,350,000
equipment...........................................
St. John's Episcopal Hospital, Far Rockaway, NY for 2,000,000
facilities and equipment for the Behavioral Health
Equity Renovation Project...........................
St. John's Episcopal Hospital, Far Rockaway, NY for 2,000,000
facilities and equipment for the Women and Newborns
Health Equity Renovation Project....................
St. John's University, Jamaica, NY for facilities and 1,250,000
equipment...........................................
St. Louis Center for Exceptional Children and Adults, 500,000
Chelsea, MI for facilities and equipment............
St. Luke's Hospital, New Bedford, MA for facilities 975,000
and equipment.......................................
St. Luke's Quakertown Hospital, Quakertown, PA for 400,000
facilities..........................................
St. Mary's University of San Antonio, San Antonio, TX 875,000
for facilities and equipment........................
St. Tammany Parish Hospital Service District No. 1, d/ 1,000,000
b/a St. Tammany Health System, Covington, LA for
equipment...........................................
Stanislaus County Behavioral Health and Recovery 2,000,000
Services, Modesto, CA for facilities and equipment..
Staten Island University Hospital, Staten Island, NY 2,000,000
for facilities and equipment........................
Stepping Stones Inc., Joliet, IL for facilities and 2,000,000
equipment...........................................
Stillman College, Tuscaloosa, AL for facilities and 800,000
equipment...........................................
STOP Inc., Virginia Beach, VA for a telehealth 250,000
initiative, including purchase of equipment.........
Summa Health, Akron, OH for facilities and equipment. 1,000,000
SUNY Downstate Health Sciences University, Brooklyn, 1,925,000
NY for facilities and equipment.....................
Terros, Inc.--DBA Terros Health, Phoenix, AZ for 600,000
facilities and equipment for Terros Health--Stapley
Health Center.......................................
Terros, Inc. DBA Terros Health, Phoenix, AZ for 900,000
facilities and equipment............................
Texas Southern University, Houston, TX for facilities 2,000,000
and equipment.......................................
Thresholds, Chicago, IL for facilities and equipment. 1,000,000
Tidalhealth Nanticoke, Seaford, DE for facilities and 350,000
equipment...........................................
Tillamook Bay Community College Foundation, 425,000
Tillamook, OR for a health workforce training
initiative, including purchase of equipment.........
Touro University California, Vallejo, CA for 1,000,000
facilities and equipment............................
Town of East Millinocket, ME for purchase of 300,000
equipment for the East Millinocket Rural Ambulance
Service.............................................
Town of Randolph, MA for facilities and equipment at 1,000,000
Randolph High School................................
Truman Medical Center Inc., Kansas City, MO for 2,000,000
facilities and equipment............................
Tulane University, New Orleans, LA for facilities and 1,000,000
equipment...........................................
United Way of Tarrant County, TX for a health 25,000
initiative..........................................
United Way of the Crossroads, Victoria, TX for a 40,000
rural health initiative.............................
Unity Care Northwest, Bellingham, WA for facilities 2,000,000
and equipment.......................................
Universal Community Health Center, Los Angeles, CA 300,000
for facilities and equipment........................
University at Albany, Albany, NY for purchase of 1,000,000
equipment...........................................
University Health System, Inc., Knoxville, TN for 2,000,000
facilities..........................................
University Health System, Inc., Knoxville, TN for 2,000,000
facilities and equipment............................
University Hospitals Cleveland Medical Center, Shaker 1,000,000
Heights, OH for facilities and equipment for the
University Hospitals Portage Medical Center.........
University of Alaska, Fairbanks, AK for facilities... 2,000,000
University of California San Diego, La Jolla, CA for 950,000
a telehealth initiative, including purchase of
equipment...........................................
University of California (San Francisco) Fresno 475,000
Regional Campus, Fresno, CA for facilities and
equipment...........................................
University of California, Davis Health, Sacramento, 1,700,000
CA for an electronic health record and telehealth
initiative..........................................
University of California-Davis, Davis, CA for a 1,000,000
health workforce initiative.........................
University of Cincinnati Medical Center, Cincinnati, 4,000,000
OH for facilities...................................
University of Colorado Anschutz Medical Campus, 1,000,000
Aurora, CO for a health workforce initiative........
University of Florida Health Jacksonville, 705,000
Jacksonville, FL for facilities and equipment.......
University of Hawaii System, Honolulu, HI for a rural 1,000,000
health initiative...................................
University of Illinois--Chicago, College of Dentistry 500,000
and Oral Health, Chicago, IL for facilities and
equipment...........................................
University of Kansas Medical Center, Kansas City, KS 1,000,000
for purchase of equipment for the Kansas University
Cancer Center.......................................
University of Massachusetts Boston, Boston, MA for 1,350,000
facilities and equipment............................
University of New Mexico, Albuquerque, NM for 1,500,000
facilities and equipment............................
University of Pittsburgh Medical Center Northwest, 100,000
Seneca, PA for facilities and equipment.............
University of Saint Francis--Crown Point Campus, Fort 225,000
Wayne, IN for facilities and equipment..............
University of Texas at Dallas, TX for facilities and 850,000
equipment and a telehealth initiative...............
University of Texas Southwestern Medical Center, 1,000,000
Dallas, TX for facilities and equipment.............
University of Texas Southwestern Medical Center, 800,000
Dallas, TX for facilities and equipment.............
University of Toledo Medical Center, Toledo, OH for 500,000
facilities and equipment............................
Urban Health Plan, Bronx, NY for facilities and 500,000
equipment...........................................
Urban Health Plan, Inc., Corona, NY for facilities 100,000
and equipment, including telehealth equipment.......
Veterans Transition House, New Bedford, MA for a 375,000
telehealth and electronic medical records
initiative, including the purchase of equipment.....
Via Care Community Health Center, Los Angeles, CA for 150,000
facilities and equipment............................
Village of Dwight, Dwight, IL for equipment.......... 250,000
Vinland National Center, Loretto, MN for facilities.. 500,000
Virginia Garcia Memorial Health Center, Hillsboro, OR 2,000,000
for facilities and equipment........................
Visiting Nurse Association of Central Jersey Freehold 700,000
Family Health Center, Freehold, NJ for facilities
and equipment.......................................
Visiting Nurse Association of Central Jersey Red Bank 400,000
Primary Care Center, Red Bank, NJ for facilities and
equipment...........................................
Washington Hospital Foundation, Washington, PA for 1,210,000
facilities and equipment............................
WEAVE INC., Sacramento, CA for facilities............ 275,000
Wenatchee Valley College, Omak, WA for facilities.... 2,000,000
West Central Alabama Area Health Education Center, 300,000
Demopolis, AL for a community health worker
initiative and purchase of equipment................
Westchester Public/Private Membership Fund for Aging 375,000
Services, Mount Vernon, NY for telehealth, including
telehealth equipment................................
Wheeling Health Right, Wheeling, WV for facilities 350,000
and equipment.......................................
White Memorial Medical Center, Los Angeles, CA for 1,200,000
facilities and equipment............................
Will-Grundy Medical Clinic Inc., Joliet, IL for 300,000
facilities and equipment............................
William F. Ryan Community Health Center, Inc., New 2,000,000
York, NY for facilities and equipment...............
WINGS Program Inc., Rolling Meadows, IL for 250,000
facilities and equipment............................
Winters Health Foundation, Winters, CA for facilities 500,000
and equipment.......................................
Wood River Health Services, Hope Valley, RI for 1,000,000
facilities and equipment............................
Young Men's Christian Association of Greater 2,000,000
Charlotte, Charlotte, NC for facilities and
equipment...........................................
Youthbuild Louisville , Louisville, KY for facilities 600,000
and equipment.......................................
------------------------------------------------------------------------
VACCINE INJURY COMPENSATION PROGRAM
Appropriation, fiscal year 2021....................... $11,200,000
Budget request, fiscal year 2022...................... 16,200,000
Committee Recommendation.............................. 16,200,000
Change from enacted level......................... +5,000
Change from budget request........................ - - -
The Committee includes $16,200,000 for administrative costs
associated with the Vaccine Injury Compensation Program, an
increase of $5,000,000 above the fiscal year 2021 enacted level
and the same as the fiscal year 2022 budget request. This
program provides compensation for individuals with vaccine-
associated injuries or deaths.
COVERED COUNTERMEASURES PROCESS FUND
Appropriation, fiscal year 2021....................... $0
Budget request, fiscal year 2022...................... 5,000,000
Committee Recommendation.............................. 5,000,000
Change from enacted level......................... +5,000,000
Change from budget request........................ - - -
The Committee includes $5,000,000 for administrative costs
associated with the Countermeasures Injury Compensation Program
(CICP), an increase of $5,000,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request. 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 2021....................... $7,874,804,000
Budget request, fiscal year 2022...................... 9,552,519,000
Committee Recommendation.............................. 10,571,419,000
Change from enacted level......................... +2,696,615,000
Change from budget request........................ +1,018,900,000
The Committee recommendation for the Centers for Disease
Control and Prevention (CDC) program level includes
$9,612,761,000 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 Americans 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 2021....................... $821,005,000
Budget request, fiscal year 2022...................... 945,930,000
Committee Recommendation.............................. 950,930,000
Change from enacted level......................... +129,925,000
Change from budget request........................ +5,000,000
The Committee recommendation includes $531,580,000 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:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Section 317 Immunization Program..................... $718,572,000
Acute Flaccid Myelitis............................... 6,000,000
Influenza Planning and Response...................... 226,358,000
------------------------------------------------------------------------
Adult Hepatitis B Vaccination.--The Committee is concerned
about the rate of adult hepatitis B vaccination, as low rates
of vaccine coverage among adults represent a missed
opportunity. The Committee urges CDC to develop a plan to
achieve adult hepatitis B vaccination goals.
Cost Estimates.--The Committee looks forward to reviewing
the fiscal year 2023 report on estimated funding needs of the
Section 317 Immunization Program and urges that the report be
updated and submitted not later than February 1, 2022. 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. The fiscal year 2023
report should 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 and influenza.
COVID-19 Antibody Testing.--The Committee is aware that
there is some concern that antibody or serologic testing has
been underutilized in the response to the COVID-19 pandemic and
that CDC guidance on the use of these tests may warrant further
review. The Food and Drug Administration has authorized
numerous antibody tests. These tests can be deployed to inform
seroprevalence surveys and to improve patient care. The
Committee encourages the use of antibody tests, where
appropriate, and requests an update on this topic in the fiscal
year 2023 Congressional Budget Justification.
Enhancing 317 Immunization Program.--The Committee includes
an increase of $99,925,000 to enhance adult immunization. The
COVID-19 pandemic illuminated a variety of gaps in our public
health capacity, including the need for a comprehensive adult
immunization program. This expansion holds the potential to
meet longstanding issues of inequity in protection from
vaccine-preventable diseases and to address vaccine hesitancy.
Immunization Rates.--The Committee is concerned about the
marked decline in routine childhood and adolescent vaccines as
a result of the pandemic. The Committee urges CDC to engage
providers, health care stakeholders, educators, community
organizations, and parents/guardians about the importance of
ensuring that children and adolescents visit their primary care
provider and receive their routinely recommended vaccinations,
including HPV vaccination. In addition, the Committee urges
that immunization reminder recall is prioritized. The Committee
requests a report within 90 days of enactment of this Act
regarding the strategy and plan for the public awareness
campaign to increase childhood and adult routine vaccination
rates and reduce barriers to routine vaccinations including,
but not limited to vaccine hesitancy. This report should
include information on immunization rates of all age groups and
provide disaggregated data on vaccines rates to determine
disparities across race, ethnicity, sex, age, and zip code, as
available, for both routine and COVID-19 vaccinations. In
addition, the report shall address actions taken and plans to
strengthen awareness, understanding, and trust in vaccines.
Improving Immunization Information System Infrastructure
and Data.--The Committee is concerned about the state of
interoperability across Immunization Information Systems (IIS),
especially as vaccine administration information becomes more
critical with respect to stopping the COVID-19 pandemic. It is
important that IIS across the country interoperate with each
other, are capable of transmitting information to public health
authorities, including CDC, and that each IIS has the capacity
to intake data and satisfy bidirectional queries. The Committee
includes $5,000,000 for CDC to consult with stakeholders to
outline the steps toward a more robust common core data set for
collection of vaccine administration information and to
initiate a national framework that includes the minimum
functional standards for IIS to interoperate.
Influenza Planning and Response.--The Committee includes an
increase of $25,000,000 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.
Respiratory Syncytial Virus.--The Committee applauds the
ongoing development of novel immunizations to provide
protection for all infants against Respiratory Syncytial Virus
(RSV) disease. Currently, there is no licensed immunization
that can protect all infants from RSV. The Committee encourages
CDC and the Advisory Committee on Immunization Practices (ACIP)
to review any novel immunization, including monoclonal
antibodies, that holds the promise of broad protection for all
infants and public health benefit to children, for inclusion on
the Child and Adolescent Immunization Schedule and in the
Vaccines for Children program.
Shared Clinical Decision Making.--The Committee encourages
CDC to work with health professional organizations to utilize
decision making support tools to promote recent changes made to
the Evaluation and Management office visit Current Procedural
Terminology codes which allow for the use of ``Total Time'' or
the use of ``Medical Decision Making'' as key contributing
factors, for the basis of payment for vaccination counseling
and administration. This will ensure that medical professionals
and patients are informed and have a clear understanding of and
continued access to the immunizations they should receive
across the life course.
Vulnerable Populations.--The Committee commends the CDC
ACIP recommendations and the Office of Civil Rights for its
continued vigilance regarding potential discrimination in
vulnerable populations during the COVID-19 pandemic and for
working collaboratively with States to ensure State guidelines
reflect best practices for serving individuals with
disabilities and the elderly.
HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND
TUBERCULOSIS PREVENTION
Appropriation, fiscal year 2021....................... $1,314,056,000
Budget request, fiscal year 2022...................... 1,420,556,000
Committee Recommendation.............................. 1,501,556,000
Change from enacted level......................... +187,500,000
Change from budget request........................ +81,000,000
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:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research............ $1,080,712,000
HIV Initiative................................... 275,000,000
School Health-HIV................................ 50,081,000
Viral Hepatitis...................................... 44,500,000
Sexually Transmitted Infections...................... 166,810,000
Tuberculosis......................................... 140,034,000
Infectious Diseases and the Opioid Epidemic.......... 69,500,000
------------------------------------------------------------------------
Congenital Syphilis.--The Committee is concerned about the
massive interruptions in sexually transmitted infection care
and preventative services due to the pandemic. The Committee
urges priority be given to jurisdictions experiencing the
highest prevalence of congenital syphilis (CS) cases. The
Committee urges CDC to prioritize CS programming and multi-
point testing of pregnant women in community organizations, and
STD and drug addiction clinics.
Hepatitis B.--The Committee urges CDC to maintain its
investment in hepatitis B grants to support community-based
organizations that are vital to serving disproportionately
impacted communities to help ensure these groups receive the
necessary testing and linkage to care. CDC is also urged to
expand the viral hepatitis disease tracking and surveillance
capabilities of the States to permit an effective targeting of
resources and evaluation of program effectiveness.
HIV Initiative.--The Committee includes an increase of
$100,000,000 for the third year of the Ending the HIV Epidemic
initiative to advance the four key strategies: diagnose, treat,
prevent, and respond. The Committee recognizes that sexually
transmitted diseases are associated with increased risk of HIV
acquisition. The Committee commends CDC for including dedicated
funding within this initiative for sexually transmitted
infection clinics.
Infectious Diseases and the Opioid Epidemic.--The Committee
includes an increase of $56,500,000 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
$16,000,000 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 $5,000,000 to address the high rates of sexually
transmitted infections (STIs). The Committee recognizes that
direct funding to State and local health departments is
critical to address STIs and other infectious diseases. In
addition, the Committee notes the investment of more than
$1,000,000,000 from the American Rescue Plan (P.L. 117-2) to
bolster support and enhance the disease intervention specialist
workforce nationwide to respond to COVID-19 and other
infectious diseases.
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 restore funding to 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.
Viral Hepatitis.--The Committee includes an increase of
$5,000,000 to enhance efforts to eliminate the public health
threat of viral hepatitis.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriation, fiscal year 2021....................... $648,272,000
Budget request, fiscal year 2022...................... 678,272,000
Committee Recommendation.............................. 726,272,000
Change from enacted level......................... +78,000,000
Change from budget request........................ +48,000,000
The Committee recommendation includes $674,272,000 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 2022 Committee
------------------------------------------------------------------------
Antibiotic Resistance Initiative..................... $177,000,000
Vector-borne Diseases................................ 57,603,000
Lyme Disease......................................... 21,000,000
Prion Disease........................................ 7,500,000
Chronic Fatigue Syndrome............................. 5,400,000
Food Safety.......................................... 75,000,000
Emerging Infectious Diseases......................... 194,997,000
National Health Care Safety Network.................. 26,000,000
Quarantine........................................... 72,772,000
Advanced Molecular Detection......................... 35,000,000
Epidemiology and Laboratory Capacity................. 40,000,000
Healthcare-Associated Infections..................... 12,000,000
Harmful Algal Blooms................................. 2,000,000
------------------------------------------------------------------------
Advanced Molecular Detection.--The Committee includes an
increase of $5,000,000 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. The
Committee is aware that at the start of the COVID-19 pandemic,
there were only a few public health laboratories capable of
performing the necessary advanced molecular detection tests.
The Committee requests a status update on the capabilities at
public health laboratories in the fiscal year 2023
Congressional Budget Justification.
Antibiotic Resistance.--The Committee includes an increase
of $5,000,000. The Committee recognizes the importance of
effectively combatting antibiotic resistant bacteria as part of
CDC's broader efforts to mitigate the clinical and public
health impacts of the COVID-19 outbreak. Furthermore, 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. The Committee encourages CDC
to competitively award research activities that address aspects
of antibiotic resistance related to ``One Health,'' including
global surveillance and research and development for new tools
to counter antibiotic resistance among entities, including
public academic medical centers, veterinary schools with
agriculture extension services, and public health departments
whose proposals are in line with CDC's strategy for addressing
antibiotic resistant bacteria.
Epidemiology and Laboratory Capacity Awards.--The Committee
urges CDC to work with States to prioritize funding to local
health departments based on factors such as population size,
disease burden, and other public health metrics to promote
equitable funding distribution.
Harmful Algal Blooms.--The Committee includes funding to
support monitoring and health reporting concerns related to
harmful algal blooms (HABs). The Committee urges CDC to
continue work to understand and prevent illnesses associated
with 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 such as the Harmful Algal Bloom and Hypoxia
Research and Control Act Interagency Working Group and the
Great Lakes Restoration Initiative. 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
encouraged to expand their work regionally to understand HABs
impact on our nation's largest fresh bodies of water.
Food Safety.--The Committee includes an increase of
$10,000,000 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.
Live Animal Imports.--The Committee is aware that
importation of live animals, particularly dogs, has increased
substantially during the COVID-19 pandemic and is concerned by
instances in which live animals have been held at ports of
entry for hours or days. The Committee emphasizes the
importance of prioritizing inspection of live cargo by CDC
personnel to ensure that all due standards of animal welfare
are maintained and urges CDC to adopt policies limiting the
maximum amount of time between the arrival of cargo containing
live animals and inspection to the shortest practicable period.
Lyme Disease.--The Committee includes an increase of
$5,000,000 to support efforts to develop improved diagnostics
with appropriate sensitivity and specificity for the detection
of subclinical or low-level infection for use in disease
eradication, and surveillance networks so that disease burden
can be more accurately determined; and to bolster critical
prevention and provider and public awareness efforts.
Furthermore, the Committee encourages CDC to reevaluate the
practice of utilizing the classification of States as high or
low incidence as surveillance criteria.
Mosquito-Borne Diseases.--The COVID-19 pandemic response
required many State and local health departments to redirect
staff from other vital tasks such as mosquito control-related
activities, resulting in less capacity to surveil and mitigate
potential mosquito-borne public health threats. The Committee
is concerned about the spread of mosquito-borne diseases, such
as Zika, 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.
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 2023 Congressional Budget
Justification on how this funding is being utilized.
National Healthcare Safety Network.--The Committee includes
an increase of $5,000,000 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.
Natural History Museums.--The Committee notes that the
nation's natural history museums provide an unparalleled
resource for studying zoonotic diseases such as COVID-19. These
museums hold millions of animal samples collected over decades
from across the globe, offer deep and broad scientific
expertise, and are uniquely positioned to assist in preparing
for and predicting the next pandemic-causing viruses. The
Committee encourages increased utilization and support of this
largely untapped resource.
One Health.--The Committee understands that despite
unprecedented efforts to address the COVID-19 pandemic, many
questions remain about the prevention of future pandemics,
especially those caused by zoonotic disease transmission. The
Committee supports a One Health approach that recognizes that
human, animal, and environmental health are fundamentally
interconnected.
Prion.--The Committee includes an increase of $1,000,000
and recognizes the critical work of the National Prion Disease
Pathology Surveillance Center. The workload related to chronic
wasting disease in deer and elk populations in the U.S. is in
addition to the Center's ongoing efforts related to human prion
diseases that includes research, surveillance, tissue banking,
and technical and supportive assistance to providers to
families.
Quarantine.--The Committee includes an increase of
$30,000,000 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 $15,000,000 to address the steady increase in the incidence
of vector-borne disease and to sustain the Regional Centers of
Excellence program, including State-level surveillance and
research being conducted by partners. The Committee encourages
CDC to examine options to provide greater coverage of the
Northwest region for vector-borne disease resources.
Wastewater Surveillance.--The Committee commends CDC's work
implementing the National Wastewater Surveillance System with
partners at State health labs and academic institutions to
better track COVID-19 and understands the important role
wastewater testing plays for our nation's biosecurity.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriation, fiscal year 2021....................... $1,276,664,000
Budget request, fiscal year 2022...................... 1,452,664,000
Committee Recommendation.............................. 1,557,064,000
Change from enacted level......................... +280,400,000
Change from budget request........................ +104,400,000
The Committee recommendation includes $1,302,114,000 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 2022 Committee
------------------------------------------------------------------------
Tobacco.............................................. $250,000,000
Nutrition, Physical Activity, and Obesity............ 56,920,000
High Obesity Rate Counties....................... 15,000,000
School Health........................................ 17,400,000
Health Promotion..................................... 47,500,000
Glaucoma......................................... 4,000,000
Vision and Eye Health............................ 1,000,000
Alzheimer's Disease.............................. 25,000,000
Inflammatory Bowel Diseases...................... 1,500,000
Interstitial Cystitis............................ 1,500,000
Excessive Alcohol Use............................ 5,000,000
Chronic Kidney Disease........................... 4,500,000
Chronic Disease Education and Awareness.......... 5,000,000
Prevention Research Centers.......................... 31,961,000
Heart Disease and Stroke............................. 148,105,000
Diabetes............................................. 153,129,000
National Diabetes Prevention Program................. 34,300,000
Cancer Prevention and Control........................ 385,799,000
Breast and Cervical Cancer....................... 230,000,000
WISEWOMAN.................................... 33,120,000
Breast Cancer Awareness for Young Women.......... 5,960,000
Cancer Registries................................ 51,440,000
Colorectal Cancer................................ 45,294,000
Comprehensive Cancer............................. 20,425,000
Johanna's Law.................................... 12,000,000
Ovarian Cancer................................... 14,000,000
Prostate Cancer.................................. 14,205,000
Skin Cancer...................................... 4,000,000
Cancer Survivorship Resource Center.............. 475,000
Oral Health.......................................... 21,500,000
Safe Motherhood/Infant Health........................ 119,000,000
Arthritis............................................ 12,500,000
Epilepsy............................................. 13,000,000
National Lupus Registry.............................. 10,500,000
Racial and Ethnic Approaches to Community Health..... 73,950,000
Good Health and Wellness in Indian Country....... 27,000,000
Social Determinants of Health........................ 153,000,000
Million Hearts....................................... 14,000,000
National Early Child Care Collaboratives............. 5,000,000
Hospitals Promoting Breastfeeding.................... 9,500,000
------------------------------------------------------------------------
Alzheimer's Disease.--The Committee includes an increase of
$4,500,000 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.
Arthritis.--The Committee includes an increase of
$1,500,000 to expand the number of State-based arthritis
programs, provide access to proven arthritis self-management
and physical activity programs, and improve data collection and
surveillance.
Breast and Cervical Cancer.--The National Breast and
Cervical Cancer Early Detection Program provides critical,
lifesaving breast cancer screening and diagnostic services to
uninsured and underinsured women. Patient navigation programs
have been proven to ensure people who are diagnosed with cancer
are able to access proper care. The Committee encourages
recipients to implement navigator programs to ensure patients
are followed from diagnosis to cure.
Breast Cancer Awareness for Young Women.--The Committee
includes an increase of $1,000,000 to expand awareness and
prevention efforts for young women.
Chronic Disease Education and Awareness.--The Committee
includes an increase of $3,500,000 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.
Chronic Kidney Disease.--The Committee includes an increase
of $2,000,000 for a public health approach to kidney disease
screening for early detection and treatment and prevalence
surveillance, so that the progression of kidney disease can be
slowed and complications can be reduced, which will
dramatically improve the quality of life of patients.
Colorectal Cancer.--The Committee includes an increase of
$2,000,000 to expand efforts to address disparities in
colorectal cancer screening rates and to improve access to
underserved populations.
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.
Early Child Care Collaboratives.--The Committee includes an
increase of $1,000,000 for the expansion of the core program to
at least one new State and to enhance efforts to address food
insecurity. The Committee is aware that COVID-19 escalated food
insecurity for children and families and recognizes the early
care and education setting is important for promoting healthy
habits in young children and ensuring that they have access to
nutritious food. The Committee includes funding for the
National Early Child Care Collaboratives Program to support
technical assistance to States for integrating best practices
into existing State and local systems for early care and
education, as well as direct provider-level training in
implementation of comprehensive programming to support healthy
eating and physical activity best practices. The Committee
encourages the program to serve a mix of rural, suburban and
urban areas, including areas with high childhood obesity rates.
Early Detection of Brain Aneurysms.--The Committee
recognizes that there are typically no warning signs or
symptoms unless brain aneurysms rupture. Even when an aneurysm
has ruptured, the symptoms are not widely known. The Committee
encourages CDC to capture and disseminate information about
best practices.
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 recognizes the opportunity to
advance public and provider awareness and improve care for the
epilepsy community through meaningful timely investment in
successful public health activities.
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.
Heart Disease and Stroke.--The Committee includes a total
increase of $20,000,000 to address cardiovascular diseases. The
Committee includes an increase of $5,000,000 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 and underserved communities, communities of color, those
communities with limited access to information about
cardiovascular health disease, and communities at risk for
delaying regular monitoring of cardiovascular health as a
result of the COVID-19 pandemic. The Committee supports CDC's
efforts to improve our understanding of the outcomes and health
effects of COVID-19 infection, including cardiovascular
disease. The Committee includes an increase of $5,000,000 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 $10,000,000 for the
Million Hearts initiative to increase education and outreach
about the importance of healthy behaviors, regular heart
screenings, and prevention measures.
Inflammatory Bowel Diseases.--The Committee includes an
increase of $500,000 to support an initial pilot education and
outreach program targeted toward healthcare providers,
inflammatory bowel disease (IBD) patients, and people with IBD-
type symptoms, including those from minority populations, and
focused on improving remission rates by reducing the time to
diagnosis and the start of effective treatments. Additionally,
the Committee encourages CDC to collaborate with organizations
that serve the IBD patient community in planning and executing
this pilot.
Interstitial Cystitis.--The Committee includes an increase
of $400,000 for interstitial cystitis activities.
Johanna's Law.--The Committee includes an increase of
$2,000,000 for CDC's Inside Knowledge Campaign that raises
awareness of the five main types of gynecological cancer:
cervical, ovarian, uterine, vaginal, and vulvar. This campaign
educates women of all ages, races, and ethnic groups, and
healthcare providers.
Lung Cancer.--The Committee remains concerned about the
high morbidity and mortality of lung cancer. Early detection
and treatment of lung cancer translates into higher survival
rates. The Committee encourages CDC to incorporate lung cancer
screening awareness and referral into its tobacco prevention
and control activities.
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 protect the health of Americans at
every stage of life by encouraging regular physical activity,
good nutrition, and preventing adult and childhood obesity. The
Committee is concerned that the eligibility for the High
Obesity Program is limited to communities with high obesity
rates solely among adults, without taking into account
childhood obesity rates. This exclusion represents a missed
opportunity to address the important public health problem of
childhood obesity, which can lead to high blood pressure, sleep
apnea, high cholesterol, fatty liver disease, psychological
problems and more. The Committee encourages CDC to consider
including high childhood obesity rates in its eligibility
criteria for the High Obesity Program.
Oral Health.--The Committee includes an increase of
$2,000,000 to expand support to State and territorial health
departments in their efforts to reduce oral disease and improve
oral health through effective interventions.
Ovarian Cancer.--The Committee includes an increase of
$2,000,000 to advance ovarian cancer prevention, early
detection, risk assessment, and access to the standard of care.
Prevention Research Centers.--The Committee includes an
increase of $5,000,000 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 supports CDC's efforts to
increase the public's 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.
Psoriatic Disease.--The Committee recognizes the value of
the Public Health Agenda for Psoriasis and Psoriatic Arthritis
and its impact in interventions to address psoriatic disease
over the past decade. Despite significant advancements in
research, treatment options, and care approaches for this
community, the Committee is concerned that many individuals,
especially people of color, remain undertreated and are not
achieving optimal health outcomes. The Committee encourages CDC
to develop an updated public health agenda and action plan to
be focused on addressing the systemic nature of the disease,
unmet needs, heterogeneity of disease and treatment response,
and diversity of diagnosis, care and outcomes.
Racial and Ethnic Approaches to Community Health.--The
Committee includes a total increase of $10,000,000 to continue
scaling this program to all States and territories, and support
grantees in building capacity for collaboration and
disseminating evidence-based strategies in communities. Racial
and Ethnic Approaches to Community Health (REACH) is a vital
initiative to help eliminate healthcare disparities in minority
communities. The Committee's recommended level includes an
increase of $5,000,000 for Good Health and Wellness in Indian
Country.
Safe Motherhood and Infant Health.--The Committee includes
a total increase of $56,000,000 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. Building on the commitment made in
FY 2021, the total funding allows for the expansion of Maternal
Mortality Review Committees (MMRCs) and Perinatal Quality
Collaboratives (PQCs) to all 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 encourages CDC
to help MMRCs build stronger data systems and improve data
collection at the State level to create consistency in data
collection, analysis, and reporting across State MMRCs. This
investment is necessary to provide accurate national statistics
on U.S. maternal mortality rates and will inform data-driven
actions to prevent these deaths. The Committee requests a
report within 90 days of enactment of this Act on barriers to
effective and consistent data collection and opportunities to
improve coordination among State MMRCs. PQCs improve maternal
and neonatal outcomes using known prevention strategies such as
reducing severe pregnancy complications associated with high
blood pressure and hemorrhage. PQCs help to address the high
incidence of maternal mortality, particularly among women of
color, maternal opioid use disorder and neonatal abstinence
syndrome as a result of the opioid crisis, which has been
exacerbated by the COVID-19 pandemic. The Committee requests an
update on the PQC program and challenges faced, including those
created by the COVID-19 pandemic, within 90 days of enactment
of this Act. Furthermore, little is known about the tragic,
sudden, and unexpected deaths of young children because of
variations in investigations and the way deaths are certified.
The Committee urges CDC to facilitate data and analysis,
including the expansion of the SUID and Sudden Death in the
Young Case Registry, to improve SUID prevention strategies.
Social Determinants of Health.--The Committee includes an
increase of $150,000,000 for investments in social determinants
of health (SDOH) to improve health equity. The Committee
includes funding to expand activities to address SDOH in
States, local, tribal and territorial jurisdictions to improve
outcomes among persons experiencing health disparities and
inequalities, including, but not limited to, expanding and
implementing Accelerator Plans, initiating a SDOH
implementation program, providing technical assistance to
communities and continuing to build the evidence base and
advance data collection to better understand health
disparities. Social Determinants Accelerator Plans should
include a description of the health and social outcome
objectives; identify 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 Social Determinants Accelerator Plans.
Tobacco.--The Committee includes an increase of $12,500,000
so that CDC and States can more robustly respond to the public
health threat caused by youth use of e-cigarettes, enhance
efforts to reduce tobacco use among disparate populations and
in areas with high tobacco use rates and tobacco-related
mortality, and expand education efforts to reach youth
influencers.
Vision and Eye Health.--The Committee is aware that vision
impairments and eye disease contribute to or complicate many
other serious and costly chronic health conditions, including
diabetes, cardiovascular disease, injuries and death related to
falling, depression, and cognitive decline. State and community
partnerships are essential in promoting messages of early
detection and coordinating access to treatment to prevent eye
disease from progressing to permanent vision loss.
BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES AND HEALTH
Appropriation, fiscal year 2021....................... $167,810,000
Budget request, fiscal year 2022...................... 172,810,000
Committee Recommendation.............................. 186,810,000
Change from enacted level......................... +19,000,000
Change from budget request........................ +14,000,000
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:
------------------------------------------------------------------------
FY 2022
Budget Activity Committee
------------------------------------------------------------------------
Child Health and Development......................... $66,800,000
Birth Defects.................................... 19,000,000
Fetal Death...................................... 900,000
Fetal Alcohol Syndrome........................... 12,000,000
Folic Acid....................................... 3,150,000
Infant Health.................................... 8,650,000
Autism........................................... 23,100,000
Health and Development for People with Disabilities.. 80,660,000
Disability & Health.............................. 41,000,000
Tourette Syndrome................................ 2,000,000
Early Hearing Detection and Intervention......... 10,760,000
Muscular Dystrophy............................... 8,000,000
Attention Deficit Hyperactivity Disorder......... 1,900,000
Fragile X........................................ 2,000,000
Spina Bifida..................................... 7,000,000
Congenital Heart................................. 8,000,000
Public Health Approach to Blood Disorders............ 11,400,000
Hemophilia Activities................................ 3,500,000
Hemophilia Treatment Centers......................... 5,100,000
Thalassemia.......................................... 2,100,000
Neonatal Abstinence Syndrome......................... 2,250,000
Surveillance for Emerging Threats to Mothers and 15,000,000
Babies..............................................
------------------------------------------------------------------------
Blood Disorders.--The Committee includes an increase of
$5,000,000 to expand sickle cell data collection efforts in
multiple States. The Committee urges an expansive sickle cell
surveillance program to better identify affected individuals,
understand their health outcomes and comorbidities, and
evaluate their utilization of the most effective and
appropriate treatments to prevent complications and risk
factors that affect individuals living with the disease.
Cerebral Palsy.--The Committee encourages CDC to explore
cross-divisional funding opportunities, networks, data sets and
systems to accelerate data-driven public health research to
improve Cerebral Palsy (CP) surveillance and develop increased
understanding of the mechanisms leading to earlier diagnosis
and improved outcomes to reduce the public health burden of CP.
The Committee also encourages CDC to conduct an updated study
from the 2003 report on the healthcare and societal costs of CP
in the U.S.
Congenital Heart Defects.--The Committee includes an
increase of $1,000,000 for grants or cooperative agreements to
provide technical assistance to State and local agencies to
complement intramural programs and to conduct applied research
related to screening, evaluation, diagnosis, results reporting,
data collection, surveillance, intervention programs, systems,
and follow-up of children identified through Critical
Congenital Heart Defects screening to better understand the
long-term outcomes and needs of this population.
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. The Committee is concerned about the
rising trend of prenatal alcohol consumption and increased
rates of fetal alcohol spectrum disorders (FASD). The Committee
urges CDC to increase support to: expand prevention efforts to
heighten awareness of FASD and the risks associated with
prenatal alcohol exposure; and strengthen existing national
community-based and professional FASD networks to expand access
to diagnostic, treatment, intervention, and other essential
services.
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 $5,000,000
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
$2,000,000 to enhance Muscular Dystrophy research and disease
surveillance initiatives, including the Duchenne Muscular
Dystrophy Care Considerations. The Committee directs CDC to
provide a report within 120 days of enactment of this Act
describing the allocation for specific activities in fiscal
years 2020 and 2021. The report should, to the extent
practicable, identify program priorities, including an
evaluation of the impact of the Duchenne Muscular Dystrophy
Care Considerations across the country on patient outcomes and
any remaining gaps, particularly in rural and underserved
areas. CDC should also address the following three areas of
unmet need: evaluating the differences in care and outcomes
between Certified Duchenne Care Centers (CDCC) and non-CDCC MD-
STARnet data and other data sources; the availability of
consistent and coordinated care for adults with Duchenne as
they transition from pediatric care settings to adult care
settings; and the impact of progressive disability on the
mental health of patients and their caregivers. The Committee
encourages CDC to partner with stakeholder organizations to
leverage additional knowledge and resources to advance this
work.
Prenatally and Postnatally Diagnosed Conditions Awareness
Act (P.L. 110-374).--As a response to the growth in prenatal
screening and testing, Congress passed this Act to ensure women
receive accurate information on genetic testing, community
support, and outcomes of care for their children when they
receive a prenatal or postnatal diagnosis for Down syndrome or
similar conditions. The Committee requests an update on the
efforts to implement the Act in the fiscal year 2023
Congressional Budget Justification.
Spina Bifida.--The Committee is aware of a growing
incidence of sudden death in the adult spina bifida population,
and understands that there is a significant need to study this
issue and to address the transitional and adult care needs of
the growing, aging spina bifida community. Therefore, the
Committee encourages CDC to use funding for the National Spina
Bifida Program to support the continuation of the Spina Bifida
Clinical Care Monitoring and Tracking Program, which works with
the National Spina Bifida Registry, to guide the health care
community in best treatment options for people living with
spina bifida; and to expand and modernize data collection,
including the National Spina Bifida Patient Registry and
surveillance activities to allow for data collection from more
clinics and individuals with spina bifida.
PUBLIC HEALTH SCIENTIFIC SERVICES
Appropriation, fiscal year 2021....................... $591,997,000
Budget request, fiscal year 2022...................... 741,997,000
Committee Recommendation.............................. 756,997,000
Change from enacted level......................... +165,000,000
Change from budget request........................ +15,000,000
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:
------------------------------------------------------------------------
FY 2022
Budget Activity Committee
------------------------------------------------------------------------
Health Statistics.................................... $190,397,000
Surveillance, Epidemiology, and Informatics.......... 460,600,000
Public Health Workforce.............................. 106,000,000
------------------------------------------------------------------------
Artificial Intelligence Recruitment.--The Committee
recognizes that there are many challenges in recruiting the
public health workforce and encourages the consideration of
human resource technology augmented by cloud-agnostic,
commercial off-the-shelf automated machine learning decision
assistance software, while preserving fairness throughout the
human resource processes.
Community Health Workers.--The Committee commends CDC for
integrating community health workers into care teams,
community-based organizations, and coordinated public health-
led actions to manage COVID-19 among priority populations
within communities. The Committee urges CDC to continue this
critical investment by supporting, promoting and expanding
State investments in the community health worker workforce in
the COVID-19 response and long-term efforts to address the
social determinants of health and achieve health equity in
partnership with community health worker professional
organizations.
Disability Data.--The Committee encourages CDC to ensure
disability data is included as a core demographic component
across surveys and surveillance systems administered by the
National Center for Health Statistics. The Committee encourages
CDC to support and fund research focused on the community of
people with disabilities as a whole.
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.--The Committee
includes an increase of $15,000,000 for the National Center for
Health Statistics, a component of our nation's public health
infrastructure, to monitor the health of the American people
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.
Overdose and Suicide Data Collection.--The Committee
recognizes the importance of timely and accurate data to
understand the incidence and prevalence of health outcomes to
effectively respond to emerging trends, especially drug
overdoses and suicides. Data on fatal overdoses and suicide
become publicly available six months to over a year after they
occur. These delays hinder the ability of communities to
respond quickly to preventable deaths. The Committee directs
CDC to evaluate its current process for fatal overdose, non-
fatal overdose, suicide, and suicide attempts/self-harm data
collection. The Committee further directs the CDC to develop
recommendations to reduce reporting lags while maintaining data
accuracy, and to submit these recommendations to the Committee
within 180 days of enactment of this Act.
Primary Immunodeficiencies.--The Committee includes funding
to continue the existing program of education and awareness
related to primary immunodeficiencies and to expand allowable
use of funding to include genetic sequencing surveillance. This
program has proven effective in identifying undiagnosed
patients and linking them to centers of care.
Public Health Data Modernization Initiative.--The Committee
initiated the funding for the Data Modernization Initiative
(DMI) to create modern, integrated, and real-time public health
surveillance with CDC, State, territorial, local and tribal
partners in fiscal year 2020 and provided significant resources
through annual and supplemental appropriations, including
$500,000,000 in the American Rescue Plan (P.L. 117-2). The
Committee directs CDC to create a standards-based,
interoperable public health infrastructure where systems can
communicate and share data seamlessly; advance standards so
that information can be stored and shared across systems and
facilitate complete and timely reporting so that our public
health system has essential data on race, ethnicity, pregnancy
status, treatments, and co-morbidities that are critical for
achieving equity in public health responses. The Committee
urges CDC to consider innovative mechanisms to ensure States
and local jurisdictions, where appropriate, have access to this
funding to modernize their vital records data systems in
accordance with the goals of the initiative. The Committee
reiterates that the National Center for Health Statistics is to
be fully integrated in the DMI. The Committee acknowledges the
need for sustained funding for this public health
infrastructure and thus, includes $150,000,000, an increase of
$100,000,000, 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.
Public Health Workforce.--The Committee includes an
increase of $50,000,000 to aid in the rebuilding of the public
health workforce. At this funding level, CDC will double the
number of Epidemic Intelligence Service and Laboratory
Leadership Service Fellows, ensuring the opportunity for
placement of a fellow in every State. The Committee recognizes
that a robust and well-trained public health workforce is
critical to maintaining a highly effective public health
infrastructure.
Vital Statistics Reporting.--The Committee encourages CDC
to engage with the National Academies of Science, Engineering,
and Medicine to improve vital statistics and death reporting.
ENVIRONMENTAL HEALTH
Appropriation, fiscal year 2021....................... $222,850,000
Budget request, fiscal year 2022...................... 332,850,000
Committee Recommendation.............................. 343,350,000
Change from enacted level......................... +120,500,000
Change from budget request........................ +10,500,000
The Committee recommendation includes $326,350,000 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 2022
Budget Activity Committee
------------------------------------------------------------------------
Environmental Health Laboratory....................... $72,750,000
Newborn Screening Quality Assurance Program....... 23,000,000
Newborn Screening /Severe Combined 1,250,000
Immunodeficiency Diseases........................
Environmental Health Activities....................... 17,000,000
Safe Water............................................ 8,600,000
Amyotrophic Lateral Sclerosis (ALS) Registry.......... 10,000,000
Climate and Health.................................... 110,000,000
Trevor's Law.......................................... 2,000,000
Environmental and Health Outcome Tracking Network..... 34,000,000
Asthma................................................ 34,000,000
Childhood Lead Poisoning.............................. 50,000,000
Lead Exposure Registry................................ 5,000,000
------------------------------------------------------------------------
Amyotrophic Lateral Sclerosis Registry.--The Committee
directs CDC to present a plan to the Committee within 90 days
of enactment of this Act to enhance the oversight and advisory
process for the National ALS Registry to increase transparency
and better reflect the needs of the ALS community. This plan
should consider ways to translate Registry findings to human
application that can lower the risks and disease burden of ALS,
make disease reporting more representative, more accurate, and
more inclusive, and include a range of estimates rather than
point estimates of ALS prevalence. Equally important are
updates to the survey process to ensure the data they collect
are impactful and respectful of participant burden. Finally,
the plan should ensure that the ALS community can view as much
Registry information as possible without compromising the
privacy of participants.
Asthma.--The Committee includes an increase of $4,000,000
for the National Asthma Control Program to increase the number
of States carrying out programmatic activities. The Committee
recognizes that millions of people in the U.S. suffer from
asthma, and that it disproportionately affects African American
children.
Childhood Lead Poisoning.--The Committee includes an
increase of $11,000,000 to support the expansion of direct CDC
assistance and funding to additional State and local public
health departments. The Committee believes that CDC's expertise
and technical assistance can be a valuable asset. The Committee
directs CDC to provide a report within 90 days of enactment of
this Act on plans to make direct assistance and funding
available to additional State and local programs. 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
$100,000,000 to expand the Climate and Health program to all
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.
Improving Pediatric Reference Intervals.--The Committee
encourages CDC to initiate efforts to improve the accuracy of
pediatric reference intervals.
Lead Exposure Registry.--The Committee includes an increase
of $500,000 for the Flint, Michigan Lead Exposure Registry.
Newborn Screening.--The Committee includes an increase of
$5,000,000 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 urges 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.
Tuberous Sclerosis Complex.--The Committee encourages CDC
to take into consideration Tuberous Sclerosis Complex (TSC) as
a possible cause of autism, epilepsy, and cardiac rhabdomyomas
in surveillance. The Committee encourages CDC to counsel
researchers and other stakeholders to facilitate development of
a viable newborn screening assay for TSC.
INJURY PREVENTION AND CONTROL
Appropriation, fiscal year 2021....................... $682,879,000
Budget request, fiscal year 2022...................... 1,103,169,000
Committee Recommendation.............................. 1,064,169,000
Change from enacted level......................... +381,290,000
Change from budget request........................ -39,000,000
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 2022
Budget Activity Committee
------------------------------------------------------------------------
Domestic Violence and Sexual Violence................ $40,200,000
Child Maltreatment............................... 7,250,000
Child Sexual Abuse Prevention.................... 2,500,000
Community and Youth Violence Prevention.............. 115,100,000
Domestic Violence Community Projects................. 10,500,000
Rape Prevention...................................... 101,750,000
Suicide Prevention................................... 14,000,000
Adverse Childhood Experiences........................ 7,000,000
National Violent Death Reporting System.............. 34,500,000
Traumatic Brain Injury............................... 8,750,000
Elderly Falls........................................ 2,050,000
Drowning............................................. 2,000,000
Injury Prevention Activities......................... 28,950,000
Opioid Overdose Prevention and Surveillance.......... 663,369,000
Injury Control Research Centers...................... 11,000,000
Firearm Injury and Mortality Prevention Research..... 25,000,000
------------------------------------------------------------------------
Adverse Childhood Experiences.--The Committee includes an
increase of $2,000,000 to expand efforts including technical
assistance to States to analyze data and burden. The Committee
requests a report within 120 days of enactment of this Act on
the viability and utility of a Positive Childhood Experience
Surveillance System that measures resilience factors in a State
or community.
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 $100,000,000 for a new evidence-based
community violence intervention, which aims to prevent
intentional violence, such as mass casualty violence or gang
violence. The Committee encourages CDC to fund a broad range of
interventions, including programs to provide de-escalation and
conflict mitigation skills.
Domestic Violence and Sexual Violence.--The Committee
includes an increase of $5,000,000 for domestic violence and
sexual violence. The Committee notes the importance of the
collection, reporting, and sharing of data on domestic violence
and sexual violence. In addition, the Committee recognizes that
the fiscal year 2022 appropriation invests in efforts to end
gender-based violence across multiple Federal agencies. The
Committee notes that the United Nations urged countries to
adopt national action plans to combat gender-based violence and
violence against women, including domestic violence. The
Committee directs CDC to work in coordination with the
Administration for Children and Families, the Office of the
Surgeon General, and the Department of Justice to create a
National Domestic Violence Prevention Action Plan to expand,
intensify, and coordinate domestic violence prevention efforts
among Federal, State, local, and tribal government agencies and
with other relevant stakeholders to ensure a whole-of-
government, goal-oriented, community-informed, forward looking
approach in addressing domestic violence prevention in the U.S.
and report the plan to the Committee no later than one year
after enactment of this Act.
Domestic Violence Community Projects.--The Committee
includes an increase of $5,000,000 to expand the reach of the
Domestic Violence Prevention Enhancement and Leadership Through
Alliances (DELTA) program.
Drowning.--The Committee includes new dedicated funding to
scale proven drowning prevention programs, including programs
working with underserved youth, and to support State drowning
surveillance efforts and a national plan on water safety. The
Committee is concerned that protocols for proper lifeguard
positioning at pools are not based on scientific testing, and
therefore, lifeguards are often positioned so that they cannot
identify a patron in distress before drowning leads to serious
injury or death. The Committee urges CDC to identify gaps in
scientific evidence for lifeguard positioning to support the
Model Aquatic Health Code provisions, specifically as it
relates to Zone of Patron Surveillance requirements.
Furthermore, the Committee is concerned about drowning rate of
children with autism. The Committee urges CDC to work with
State and local organizations to identify subgroups of the
populations at greater risk for drowning, including autistic
children and specific racial/ethnic groups, and to develop
initiatives aimed at preventing drowning among these
populations.
Drug Use Surveillance.--The Committee notes that trends in
drug use change quickly and vary significantly geographically.
The Committee encourages CDC to develop a strategy to expand
the use of the National Wastewater Surveillance System for drug
use surveillance to quickly detect emerging drug-use trends to
more effectively implement public health interventions.
Firearm Injury and Mortality Data.--The Committee urges CDC
to collaborate with the National Institute of Justice to
compile, share, and improve gun violence data. Such data should
include the Uniform Crime Report and include data from
hospitals treating victims of nonfatal gunshot wounds.
Firearm Injury and Mortality Prevention Research.--The
Committee includes an increase of $12,500,000 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. The Committee directs CDC to focus on
activities that will have the greatest potential public health
impact. 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.
Injury Control Research Centers.--The Committee includes an
increase of $2,000,000 to award additional grants.
National Violent Death Reporting System.--The Committee
includes an increase of $10,000,000 to collect data on gender
identity and sexual orientation. This data will increase our
understanding of violent deaths among disproportionately
affected groups and inform efforts towards decreasing the
number of deaths across groups.
Opioid Abuse and Overdose Prevention.--The Committee
includes an increase of $187,790,000 and appreciates efforts by
CDC to ensure that funding for opioid and stimulant abuse and
overdose prevention reaches local communities to advance local
understanding of the opioid overdose epidemic and to scale-up
prevention and response activities, as intended by Congress.
The Committee encourages CDC to consider community member
naloxone education as a criterion when distributing overdose
prevention funds. In addition, the Committee directs that CDC
report on the results of the investments in local cities,
counties, and communities and ensure that traditionally
underrepresented communities, including rural and tribal
communities, receive equitable access to funds in the fiscal
year 2023 Congressional Budget Justification. In addition, the
Committee notes that chronic pain is a disabling and costly
health condition; who is affected, the extent of resulting
disability, the nature and accessibility of effective pain
management, and related costs all remain largely unknown. The
Committee directs CDC to conduct the collection, analysis, and
publication of population research data using questions from
the National Health Interview Survey and other nationally
representative population-based samples to describe those with
chronic pain by patient age, comorbidities, part of body
affected, socio-economic status, geographic location by State,
county and city, payor source, race, and gender. The Committee
further directs CDC to analyze and report data from the Medical
Expenditure Panel Survey regarding the use of and associated
direct healthcare costs related to pain management treatments
and services as well as indirect costs related to pain.
Finally, the Committee directs CDC to report on the status of
these activities in the fiscal year 2023 Congressional Budget
Justification.
Public Health Approach to Violence.--The Committee notes
House Report 116-450 directed CDC to provide a report under
this heading. The Committee is still awaiting this report and
looks forward to its submission.
Rape Prevention.--The Committee includes an increase of
$50,000,000 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.
Traumatic Brain Injury.--The Committee provides an increase
of $2,000,000 to begin to address concussion surveillance,
particularly among children and youth.
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
Appropriation, fiscal year 2021....................... $345,300,000
Budget request, fiscal year 2022...................... 345,300,000
Committee Recommendation.............................. 360,300,000
Change from enacted level......................... +15,000,000
Change from budget request........................ +15,000,000
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:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
National Occupational Research Agenda................ $123,000,000
Agricultural, Forestry, and Fishing.............. 28,500,000
Education and Research Centers....................... 32,000,000
Personal Protective Technology....................... 23,000,000
Mining Research...................................... 61,500,000
National Mesothelioma Registry and Tissue Bank....... 1,200,000
Firefighter Cancer Registry.......................... 2,500,000
Other Occupational Safety and Health Research........ 117,100,000
------------------------------------------------------------------------
Agricultural, 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.
Assessment of the Extent of COVID-19 Infections and Deaths
Among Workers.--The Committee is aware that many groups of
essential workers faced higher rates of COVID-19 infections and
death during the pandemic, such as those employed in health
care, first responders, meat and poultry, corrections, grocery,
corrections, and transit industries. Many of these are low wage
workers of color, whose jobs required them to report to work in
person throughout the pandemic. In order to fully assess the
extent and impact of the COVID-19 pandemic on workers and to
protect them from unnecessary future exposure and infection,
the Committee directs CDC to prepare: (1.) A study quantifying
COVID-19 deaths by occupation and industry based upon an
analysis of death certificates. Such report shall compare the
higher risk occupations and the rate of COVID-19 deaths in the
general population. Such report shall be provided to the
Committee on Appropriations and the public 180 days from the
date of enactment of this Act; and (2.) A report on the extent
of COVID-19 infections among working populations by occupation,
the factors that contribute to this increased risk, and a
description of disparate impacts by race and ethnicity. The
report should include an assessment of the adequacy of
reporting and data collection of COVID-19 infections, outbreaks
and deaths among workers, and recommendations and a
professional budget justification for improvements in data
collection and reporting by employers, localities, States and
the Federal government for COVID-19 and future epidemics. Such
report shall be provided to the Committee on Appropriations and
the public within 180 days of enactment of this Act.
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.
Mining Program.--The Committee commends CDC for the
progress outlined in the 2019-2023 mining program strategic
plan to reduce overexposure to hazardous airborne contaminants
in the mining environment by conducting studies to: (1) improve
measurement of exposures to hazardous dusts, and to better
understand the risks for respiratory diseases among mine
workers; (2) develop and assess the effectiveness of
interventions and technologies to prevent overexposure to
hazardous dusts; and (3) to improve the adoption of control
interventions and technologies.
Personal Protective Technologies.--The Committee recognizes
the important role that CDC continues to provide regarding
personal protective technologies in response to the COVID-19
pandemic and to protect workers every day and includes an
increase of $3,000,000 to support these efforts. The Committee
directs CDC to review and report back to the Committee within
180 days of enactment of this Act, a consideration of how
technology, including voice-activated technology, could save
PPE and clinicians' lives. This review should include specific
analysis of the impact on nurses employed in acute care
hospitals.
Total Worker Health.--The Committee includes an increase of
$4,000,000 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.
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM
Appropriation, fiscal year 2021....................... $55,358,000
Budget request, fiscal year 2022...................... 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 2021....................... $592,843,000
Budget request, fiscal year 2022...................... 697,843,000
Committee Recommendation.............................. 842,843,000
Change from enacted level......................... +250,000,000
Change from budget request........................ +145,000,000
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.
In addition, the American Rescue Plan (P.L. 117-2) included
$750,000,000 for global disease detection and emergency
response.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Global AIDS Program.................................. $128,421,000
Global Tuberculosis.................................. 9,222,000
Global Immunization Program.......................... 226,000,000
Polio Eradication................................ 176,000,000
Other Global/Measles............................. 50,000,000
Parasitic Diseases and Malaria....................... 31,000,000
Global Public Health Protection...................... 448,200,000
------------------------------------------------------------------------
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. Emerging infectious diseases such as COVID-19 and Zika
and the global threat of spread of known diseases such as
Ebola, represent profound challenges to our health system. The
Committee supports CDC's continued work on 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. The Committee requests an update in the fiscal
year 2023 Congressional Budget Justification on how CDC is
working with FDA, BARDA, and NIH to jointly coordinate global
health research activities with specific measurable metrics
used to track progress and collaboration toward agreed upon
health goals.
Global Public Health Protection.--The Committee includes an
increase of $245,000,000 to support and enhance 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, including by providing support of
program implementation and scientific and technical experts in
Atlanta and in the field with concentrated efforts on
countries, populations, and programs where resources will have
the greatest public health impact. In addition, the Committee
requests an update in the fiscal year 2023 Congressional Budget
Justification on wastewater-based epidemiology and surveillance
global detection efforts in the global response to COVID-19,
including a professional judgement on the necessary budget and
infrastructure requirements to fully operationalize these
programs.
Global Water Strategy.--The Committee recognizes CDC's work
to provide sustainable Water, Sanitation, & Hygiene (WASH) in
healthcare facilities, aligned with the 2017 U.S. Global Water
Strategy, and to support WASH efforts to contribute to the
elimination of cholera as a public health threat as outlined by
Ending Cholera--A Global Roadmap to 2030. The Committee urges
CDC to increase its WASH efforts in areas where Neglected
Tropical Diseases are endemic.
Parasitic Disease and Malaria.--The Committee provides an
increase of $5,000,000 recognizing the important role CDC plays
in the fight against malaria and parasitic disease. CDC
provides crucial monitoring and surveillance of transmission,
evaluation of interventions for effectiveness and impact,
development of key diagnostics, and testing of tools in a real
world setting that are critical to ensuring that our global
health investments are smarter, better, and not wasteful.
Therefore, the Committee encourages CDC to continue to
research, monitor, and evaluate efforts for malaria and
parasitic disease in collaboration across the agency and with
other agencies.
Population-based Surveillance Platforms.--The Committee
directs at least $5,000,000 to be used 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.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriation, fiscal year 2021....................... $842,200,000
Budget request, fiscal year 2022...................... 842,200,000
Committee Recommendation.............................. 862,200,000
Change from enacted level......................... +20,000,000
Change from budget request........................ +20,000,000
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:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Public Health Emergency Preparedness Cooperative $715,000,000
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 they are conducting tailored and robust
outreach efforts to LEP communities. In addition, the Committee
requests a State distribution table in the fiscal year 2023
Congressional Budget Justification, 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 2021....................... $30,000,000
Budget request, fiscal year 2022...................... 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 2021....................... $283,570,000
Budget request, fiscal year 2022...................... 708,570,000
Committee Recommendation.............................. 1,308,570,000
Change from enacted level......................... +1,025,000,000
Change from budget request........................ +600,000,000
This account supports public health leadership and support
activities at CDC.
The Committee recommendation includes $1,148,570,000 in
discretionary funds and $160,000,000 in transfers from the PPH
Fund.
In addition, the American Rescue Plan (P.L. 117-2) provided
significant supplemental funding for the COVID-19 response,
including $7,500,000,000 for vaccination efforts and
$1,000,000,000 for vaccine confidence activities.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Preventive Health and Health Services Block Grant.... $160,000,000
Public Health Leadership and Support................. 113,570,000
Infectious Diseases Rapid Response Reserve Fund...... 35,000,000
Public Health Infrastructure and Capacity............ 1,000,000,000
------------------------------------------------------------------------
Infectious Diseases Rapid Response Reserve Fund.--The
Committee includes an increase of $25,000,000. 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 that endangers American
lives. Funds are available until expended.
Local Health Departments.--The Committee recognizes that
COVID-19 has raised awareness of the importance of the role of
local health departments in our nation's governmental public
health partnership to protect the public's health. However,
Federal funding intended for both State and local health
departments does not consistently reach local health
departments beyond those directly-funded. The Committee
encourages CDC to require States to fund local health
departments when programmatically appropriate.
National SARS-CoV-2 Genomic Surveillance Program.--The
Committee recognizes that new SARS-CoV-2 variants continue to
emerge across the globe, including variants that may have
increased transmissibility and potential to evade vaccines.
This dire situation demonstrates the need for a comprehensive
genomic sequencing and surveillance program to discover and
track the spread of these variants and devise appropriate
public health countermeasures. The Committee directs NIH and
CDC, in coordination with other HHS agencies as appropriate, to
continue to expand national genomic surveillance to rapidly
scale up sequencing of viral samples and dissemination of SARS-
CoV-2 genomic data.
Prevention and Public Health Fund.--The Committee
encourages the fiscal year 2023 Congressional Budget
Justification to request Prevention and Public Health funds for
programs it was intended to assist, such as cardiovascular/
stroke prevention through Million Hearts.
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 $1,000,000,000 for this new funding line to invest in
core public health infrastructure and capacity nationwide. The
COVID-19 pandemic exposed the inadequacies of the current
public health ecosystem and the message from the Subcommittee
hearing on Public Health Infrastructure on February 24, 2021
was clear: flexible, sustainable investments in public health
are critical. 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
Committee provides this new, annual funding to turn the tide on
the nation's public health infrastructure by providing a stable
source of disease-agnostic funding so that nation's State,
local, territorial, and Federal public health agencies are
better equipped to coordinate together to save lives. Each
year, CDC awards nearly 75 percent of its budget through
grants, cooperative agreements, and contracts to accomplish its
mission; the Committee directs no less than 75 percent of this
funding to be awarded to State, local, and territorial health
departments.
Rural Health.--The Committee recognizes the unique
challenges present in rural areas and encourages CDC to
consider the importance of reaching those in rural areas.
Vaccine Outreach with Community Health Workers.--The
Committee directs CDC to ensure funding made available through
COVID-19 emergency supplemental appropriations supports a
vaccine outreach program in partnership with community health
workers to increase vaccine access in hardest-hit communities
including Hispanic, Black, Asian, and Native American
populations. In addition, the Committee requests a report
within 120 days of enactment of this Act outlining best
practices for increasing vaccine access in the aforementioned
communities.
National Institutes of Health
Appropriation, fiscal year 2021....................... $42,934,000,000
Budget request, fiscal year 2022...................... 51,732,713,000
Committee Recommendation.............................. 49,434,000,000
Change from enacted level......................... +6,500,000,000
Change from budget request........................ -2,298,713,000
The Committee recommendation for the National Institutes of
Health (NIH) program level includes $48,162,495,000 in
discretionary appropriations and $1,271,505,000 in Public
Health Service Act section 241 evaluation set-aside transfers.
Within the total appropriation, the Committee recommendation
includes $496,000,000 in budget authority authorized in the
21st Century Cures Act (P.L.114-255).
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, including a total of
$194,000,000 for the Cancer Moonshot Initiative; $541,000,000
for the ``All of Us'' precision medicine initiative (including
$150,000,000 from the Cures Act); and $612,000,000 for the
Brain Research through Application of Innovative
Neurotechnologies (BRAIN) Initiative (including $152,000,000
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 2021....................... $6,559,852,000
Budget request, fiscal year 2022...................... 6,733,302,000
Committee Recommendation.............................. 6,992,056,000
Change from enacted level......................... +432,204,000
Change from budget request........................ +258,754,000
Mission.--NCI leads, conducts, and supports cancer research
across the nation to advance scientific knowledge and help all
people live longer, healthier lives.
Cancer Data Sharing.--The Committee applauds NIH for
creating the National COVID Collaborative (N3C), a commercial
solution leveraged to create a centralized and secure database
that researchers in academic institutions can use to study
COVID-19 and identify potential treatments. The Committee
encourages NIH to continue pursuing similar approaches to other
critical areas of research, including cancer, where data
sharing continues to be a barrier to progress. The Committee
commends NCI's data sharing efforts through the Cancer
Moonshot, the Childhood Cancer Data Initiative, and other
programs, and requests an update in the fiscal year 2023
Congressional Budget Justification on NCI's continued progress
toward adopting a centralized, secure, national platform to
share cancer research data to drive new insights and speed
research efforts across the country.
Cancer Immunotherapy.--The Committee recognizes that NCI-
supported research exploring cancer immunology, cancer
immunotherapy, and cancer vaccines that started years before
the emergence of COVID-19 contributed to the rapid development
of COVID-19 treatments and vaccines. Applying lessons learned
from COVID-19 therapeutic development to cancer immunotherapy
clinical trials has the potential to greatly improve treatment
options and outcomes for cancer patients. The Committee
encourages NCI to accelerate the translation of discoveries in
cancer immunotherapy by means of the same innovations used to
develop COVID-19 treatments and vaccines. This should include
expediting consideration and support for potential high-impact
cancer immunotherapy clinical trials, and for correlative
science based on planned and ongoing clinical trials.
Cancer Moonshot.--The Committee directs NIH to transfer
$194,000,000 from the NIH Innovation Account to NCI to support
the Cancer Moonshot initiative. These funds were authorized in
the 21st Century Cures Act (P.L. 114-255).
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 due to the fact that these
vaccines were built on messenger RNA technology, or mRNA, an
approach that had been initiated for cancer research. While
most traditional vaccines use inactivated viruses to stimulate
an immune response, a complicated process that can take several
years, mRNA vaccines use the body's own genetic material, and
can be developed much more quickly. 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. The
Committee commends the work of NCI, which is currently
supporting multiple research projects focusing on the use of
mRNA vaccines, and encourages its continued commitment to
moving the field forward for mRNA vaccines as an approach for
cancer immunotherapy treatment and prevention. To better
understand NCI's progress to date and the potential of new
breakthroughs with mRNA, the Committee requests an update in
the fiscal year 2023 Congressional Budget Justification on
NCI's work on mRNA vaccines, noting existing barriers or
challenges, if any.
Childhood Cancer Data Initiative (CCDI).--The Committee
includes $50,000,000 for the second year of the CCDI, as
proposed in the fiscal year 2022 budget request. The
development of new therapies is important to finding a cure for
childhood cancers, many of which have not seen new therapies in
decades. The Committee commends NCI for its support of the
establishment of the National Childhood Cancer Registry as a
part of the Childhood Cancer Data Initiative. Data sets for
childhood cancers are often small and spread out across
institutions or aggregated into State-wide or Federal
registries where the particulars of incidence rate by cancer
are lost. Traditional disease registries such as the Federally-
supported Surveillance Epidemiology and End Results Program
(SEER) and the CDC's National Program for Cancer Registries
(NPCR) aggregated into the U.S. Cancer Statistics (USCS) do not
yet include all of the data relevant to cutting-edge pediatric
cancer research, such as the molecular characteristics of each
child's cancer. The Committee urges NCI to use available
resources to ensure all relevant data needed to assist
childhood cancer researchers in developing innovative
treatments for childhood cancer are made available through the
National Childhood Cancer Registry and other integrated CCDI
programs. The Committee requests an update on the progress made
to increase available childhood cancer data in the fiscal year
2023 Congressional Budget Justification.
Childhood Cancer STAR Act.--The Committee includes no less
than $30,000,000, the same as the fiscal year 2021 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.
Funding provided this year will allow NCI to continue to
conduct and support childhood cancer survivorship research as
authorized in the STAR Act.
Colorectal Cancer Disparities.--Given the impact that
screening can have on reducing mortality and morbidity in
colorectal cancer, the Committee encourages NIH to study the
impact of the COVID-19 pandemic on the incidence of colorectal
cancer in minority communities. The Committee is hopeful that
such information will provide policymakers with a better
understanding of the effects on minority communities and help
develop strategies to address barriers to screening and reduce
health inequities and cancer deaths.
Deadliest Cancers.--The Recalcitrant Cancer Research Act
(RCRA) of 2012 (P.L. 112-239) focuses on cancers with a five-
year survival rate below 50 percent, which account for 44
percent of all U.S. cancer deaths. While advances in some
cancers have made it possible to reduce the overall rate of
cancer deaths over the last two decades, there has been limited
progress reducing mortality for these diseases. For fiscal year
2020, Congress directed NCI to develop a scientific framework
using the process outlined in the RCRA for stomach and
esophageal cancers. The Committee notes that in addition to the
ongoing framework development, NCI has also developed and
received approval from its Board of Scientific Advisors to
launch a Program in Origins of Gastroesophageal Cancers.
Alongside the research and advocacy communities, the Committee
appreciates NCI's efforts to keep the Committee apprised of
continued research progress informed by the pancreatic, lung,
glioblastoma, esophageal, and stomach cancer frameworks. The
Committee encourages NCI to consider a similar process, as
appropriate, for primary liver cancer, including
cholangiocarcinoma. Given the toll all recalcitrant cancers
exact on society and the lack of diagnostic and treatment
resources currently available to help patients, the Committee
also requests an update in the fiscal year 2023 Congressional
Budget Justification on research goals to advance progress for
the deadliest cancers (brain, esophagus, liver, lung, ovary,
pancreas, stomach and mesothelioma).
Germline RUNX1 Mutations.--The Committee commends NCI for
supporting NHGRI in running a natural history study of patients
with germline RUNX1 mutations and their families. These
mutations frequently lead to blood cancers, especially acute
myeloid leukemia; more research on how this occurs could
ultimately lead to treatments that would prevent malignancy.
Interest in this field has grown significantly in recent years,
and the Committee strongly urges NCI to initiate funding
opportunities for NIH intramural and extramural researchers.
Priority areas of research should include the role of
inflammation and the immune system on cancer transformation,
pharmacological approaches to regulating RUNX1 activity, gene
editing strategies, and support for an extramural clinical
consortium dedicated to national patient data collection,
analysis and specimen storage for collaborative research.
Glioblastoma (GBM).--The Committee commends NCI for its
establishment and initial implementation of the GBM
Therapeutics Network (GTN). The GTN's cross-cutting teams'
capability of preclinical and early-phase clinical trials
necessary to rapidly evaluate potential treatments, including
but not limited to 87 drugs, biologics, radiation, and devices,
is what is needed to continue to advance toward cures and
improved quality of life. The Committee urges NCI to continue
to implement the GTN 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. Therefore, the Committee urges NCI to expand the
number of programs, projects, 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 2023 Congressional
Budget Justification, including specific grants and strategies
where the intent is to overcome these racial disparities in
gynecologic cancers outcomes, including the underrepresentation
of minority women in gynecologic cancer clinical trials.
HPV-Associated Cancers.--The Committee encourages NCI to
expand research related to HPV-associated cancers.
Liver Cancer.--The Committee notes that liver cancer is the
second deadliest cancer, with a five-year survival rate of only
20 percent. The number of liver cancer cases in the U.S. has
increased by over 250 percent since 2000 and continues to
increase. Since early detection of cancer in general and liver
cancer in particular is the most effective way to reduce cancer
mortality, the Committee urges NCI to support the research
needed to develop a liver cancer screening test using the blood
and saliva samples from widespread national COVID testing. This
extensive and growing inventory of saliva and blood samples
offers a unique opportunity to develop a liver cancer screening
test that can soon reach over 100 million citizens, a number
that will grow as COVID testing is expanded.
Melanoma.--As UV radiation is established as the primary
carcinogen for melanoma, the Committee urges NCI 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 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
support multicenter trials that will determine whether shorter
courses of therapy will decrease toxicity and costs while
maintaining benefit, the role of adjuvant therapy and whether
patients with earlier disease should receive adjuvant therapy
and that further determine the role of adjuvant therapy in both
treatment and drug development.
The Committee encourages NCI to support research on novel
targets, especially for rare subtypes, and support development
of registries where populations are not adequate for randomized
trials. The Committee requests an update on these requests and
a status of NCI-funded melanoma research in NCI's fiscal year
2023 Congressional Budget Justification.
Metastatic Breast Cancer.--The Committee is aware that
clinical research is of utmost importance to those living with
metastatic breast cancer (MBC), which is breast cancer that has
spread to other organs and become incurable. An estimated
168,000 Americans live with MBC, and nearly all of the more
than 43,000 deaths from breast cancer are attributed to this
late stage of disease. Given the mortality associated with MBC
and the lack of treatment options, research offers the best
possibility of therapeutic advances and extended life for these
patients. MBC is also associated with startling health
disparities, since breast cancer mortality is about 40 percent
higher for Black women in the U.S. than White women, and breast
cancer is the second most common cause of death by cancer for
Black women. The Committee believes that a renewed emphasis by
NCI on research for MBC, especially in communities of color, is
needed to discover better treatments and a cure for MBC and to
address health disparities in this population. The Committee
requests an update on NCI's activities regarding MBC in the
fiscal year 2023 Congressional Budget Justification, including
progress made with respect to inclusion of people of color in
NCI-funded clinical trials in this area.
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 provide subject
matter expertise as appropriate as DoD continues to implement
recommendations from the report aimed at achieving
representation of the demographics 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.
Pancreatic Cancer.--Pancreatic cancer is the third leading
cause of cancer-related death in the U.S. In 2020, over 60,000
Americans will be diagnosed with pancreatic cancer; more
Americans than ever before. The five-year survival rate for
pancreatic cancer remains at just over ten percent. The
Committee appreciates that NCI has adhered to and completed all
reporting requirements of the Recalcitrant Cancer Research Act
of 2012 (RCRA) as it pertains to the Pancreatic Cancer
Scientific Framework. The Committee looks forward to updates
and progress made on the action items identified in the
pancreatic cancer focus areas. The Committee is encouraged to
hear that NCI is building upon the RCRA's Strategic Framework
and taking steps to integrate research efforts across the NCI,
and that several NCI-supported consortia focused on early
detection have formed the Alliance of Pancreatic Cancer
Consortia as a virtual network of researchers, clinicians, and
advocacies to provide a platform and coordinate resources to
discover and validate biomarkers and imaging methods for early
detection. The Committee applauds this effort and requests an
update in the fiscal year 2023 Congressional Budget
Justification on progress made within the Alliance since its
inaugural meeting in December 2016.
Pediatric Cancer Expertise.--The Committee recognizes that
the Childhood Cancer STAR Act (P.L. 115-180) calls on NCI to
ensure that all applicable study sections, committees, advisory
groups, and panels at NCI include one or more qualified
pediatric oncologists, as appropriate. The Committee requests
an update in the fiscal year 2023 Congressional Budget
Justification on the actions NCI has taken to ensure
appropriate pediatric cancer expertise is included in such
groups.
Prioritizing Underserved Populations in Cancer Clinical
Trials.--The Committee remains concerned about the lack of
equity and access to cancer clinical trials across the country.
Groups that are generally underrepresented in clinical trials
include racial and ethnic minorities and older and lower-income
individuals as well as those from rural communities. To better
identify and address these disparities, the Committee
encourages NCI to continue to develop and prioritize trial
recruitment strategies that consider socioeconomic status,
race/ethnicity, or location and to prioritize grant
applications that aim to recruit and enroll diverse patient
cohorts when appropriate. The Committee urges NCI to continue
collecting and publicly reporting research data on race/
ethnicity, and to encourage the collection of data, when
appropriate, on sexual orientation, gender identity, and other
variables that are known to influence clinical outcomes.
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.
Research on Cancer Disparities.--The Committee encourages
NCI to continue its commitment to support the NCI Community
Oncology Research Program and the activities of the Center to
Reduce Cancer Health Disparities, two key efforts that
contribute to building a cadre of community stakeholders and
medical researchers prepared to engage in transdisciplinary
approaches to address cancer, including its disparate impact on
some communities nationwide. Although there have been
significant advances in the prevention and treatment of cancer,
evidence shows persistent differences in cancer incidence,
late-stage diagnosis, and mortality in many States depending on
socioeconomic status, geography, race, ethnicity, and other
factors. The Committee encourages NCI to continue to prioritize
research and training programs aimed at reducing health
disparities in cancer, including through NCI's continued
support of its integrated training, education, and outreach
networks between communities and medical research centers. The
Committee encourages NCI to prioritize partnerships with
community groups and other stakeholders to explore the issues
associated with cancer disparities as identified by local
communities and include activities to develop curriculum to
inform health professions education to reduce medical mistrust
in targeted groups and to highlight relevant research questions
to address cancer disparities. Additionally, NCI efforts should
support the development of a cancer research infrastructure to
identify relevant research questions related to disparities and
to develop integrated and sustainable approaches to reducing
cancer disparities, including examining social determinants of
health and their impacts on such disparities.
Skin Cancer in Communities of Color.--Research has shown
that skin cancer in patients with skin of color is often
diagnosed in its later stages, making treatment more difficult
and decreasing the chances for survival. The Committee requests
an update in the fiscal year 2023 Congressional Budget
Justification regarding research that assesses factors
contributing to later diagnoses of skin cancer among patients
with skin of color, as well as research focused on measures to
raise awareness of risk factors for skin cancer and to
encourage activities that promote prevention and early
detection of skin cancers among patients with skin of color and
other underserved populations.
Telehealth-Based Services for Vulnerable Patients.--The
COVID-19 pandemic significantly exacerbated the physical,
emotional, and mental toll on cancer patients and families.
Providing clinical and psychosocial services to address these
challenges is an essential component of comprehensive cancer
care across a patient's lifespan. Cancer centers across the
U.S. quickly pivoted to providing patient support and related
health services by telehealth, although the extent to which all
patients and families had equitable access to these services
and the impact for those who have attended them is unknown. For
example, both rural and urban underserved areas
disproportionately lack reliable home-based Internet service,
creating barriers for patients to access telehealth-based
clinical and psychosocial support services. To overcome this,
many cancer centers provided technical assistance to patients
during the pandemic to support their use of telehealth. The
Committee urges NCI to increase its support of research on the
delivery and evaluation of telehealth-based clinical and
psychosocial services, particularly among vulnerable patients
and disadvantaged communities. This enhanced research would
lead to evidence-based best practices, so that all patients can
benefit from the most effective cancer care at all stages of
the disease.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)
Appropriation, fiscal year 2021....................... $3,664,811,000
Budget request, fiscal year 2022...................... 3,845,681,000
Committee Recommendation.............................. 3,866,828,000
Change from enacted level......................... +202,017,000
Change from budget request........................ +21,147,000
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.
Alzheimer's Disease and Vascular Dementia.--Well-
characterized, longitudinal, population-based cohort studies
provide value in bringing to light more information about the
risk factors related to dementia. By studying participants over
time, much can be learned about cognitive decline and early
biomarkers; however, mature cohorts naturally dwindle as
participants pass away, requiring that the research mission be
adjusted to continue to leverage the previous science and build
upon it. The Committee urges NHLBI to fund research into next
generation cohorts, with a focus on understanding the
development and progression of risk factors and detection of
early signs of cognitive decline. Funded cohorts should be
racially and ethnically diverse with broad geographic
representation.
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 mention someone's sexual orientation, and
rather focus on risk factors that might expose a potential
donor to blood-borne illness. The Committee strongly recommends
that NHLBI work with the FDA and remove or replace the
recommended deferment of blood for men who have had sex with
men in the last 12 months.
Community Engagement Alliance Against COVID-19 Disparities
(CEAL) Initiative.--The Committee includes $30,000,000 for the
new CEAL initiative, the same as the fiscal year 2022 budget
request. This initiative will connect researchers with
community organizations and leaders to conduct outreach and
increase participation of people from underrepresented
communities in clinical trials for COVID-19 treatments and
vaccines.
COVID-19-Associated Illnesses.--The Committee recognizes
the growing burden of COVID-associated critical illnesses,
including sepsis and pneumonia. The Committee encourages NHLBI
to accelerate research into sepsis, pneumonia, and acute lung
injury.
Duchenne Muscular Dystrophy.--In light of improvements in
care leading to patients living into their third decade, the
leading cause of death in Duchenne Muscular Dystrophy patients
is heart failure. The Committee urges NHLBI to support research
that characterizes cardiomyopathy in Duchenne and Becker
Muscular Dystrophy. There is a gap in the ability to develop
novel cardiac therapeutics for Duchenne Muscular Dystrophy due
to a lack of accepted cardiac outcome measures. The Committee
encourages NHLBI to convene a workshop with research, clinical,
and patient organization leaders to work towards establishing
viable cardiac outcome measures for the development of
therapeutic agents to combat cardiomyopathy.
Health Disparities Research.--The COVID-19 pandemic has
highlighted and exacerbated health disparities in the U.S. The
Committee includes an increase of $50,000,000 for NHLBI to
support research related to identifying and reducing health
disparities, the same as the fiscal year 2022 budget request.
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 ``long haul'' health
conditions, including serious respiratory diseases such as
acute respiratory distress syndrome and pulmonary fibrosis. The
Committee urges NHLBI to prioritize research into the
understanding, treatment and prevention of ``long haul'' post-
COVID respiratory conditions, particularly among minority
populations disproportionately impacted by COVID-19.
Lymphedema (LE).--LE is a chronic, debilitating, and
incurable swelling that can be a result of damage to the
lymphatic system due to surgery, cancer treatment, or injury,
and that can also be inherited. An estimated 10,000,000
Americans suffer from LE. Additional research is necessary to
improve our understanding of this condition and expand the
treatment options available. The Committee directs NHLBI to
increase support for research on LE and to establish a Research
Condition Disease Categorization category for research related
to lymphedema.
Mitral Valve Prolapse (MVP) Workshop.--MVP is a common
valve disease that has an estimated 2.4 percent prevalence.
Though most cases are thought to be benign, reported
complications such as severe mitral regurgitation and
arrythmias can result in sudden cardiac death (SCD). Medical
research has found an association between MVP and SCD.
Predictors of this outcome, however, are not readily available,
underlying mechanisms are poorly understood, and indicators of
high-risk individuals are lacking. Despite several studies,
there is not sufficient data to generate guidelines for care of
patients with valvular heart disease, including MVP. The
Committee encourages NHLBI to convene a workshop of subject
matter experts to identify research needs and opportunities
with the goal of informing guidelines for treatment of patients
with MVP.
National Commission on Lymphatic Diseases.--The Committee
directs NIH to establish a National Commission on Lymphatic
Diseases and to engage with relevant Institutes, Centers, and
external stakeholders in establishing this Commission. The
Committee directs NIH to provide an update on progress to
establish the Commission within 60 days of the enactment of
this Act.
National Chronic Obstructive Pulmonary Disease (COPD)
Action Plan.--The Committee notes NHLBI's role in crafting the
National COPD Action Plan. NHLBI is encouraged to continue this
important work by supporting additional research activities and
collaborating with other Public Health Service agencies to
facilitate implementation of the plan's recommendations.
Polycystic Kidney Disease.--The Committee commends NIDDK
for its continued commitment to Polycystic Kidney Disease
Research and Translation Centers and the Pediatric Centers of
Excellence in Nephrology, which improve our understanding of
the causes of autosomal dominant polycystic kidney disease and
autosomal recessive polycystic kidney disease. The Committee
encourages NIDDK to ensure that funds previously committed for
polycystic kidney disease research centers remain dedicated to
funding other PKD research efforts.
Pulmonary Fibrosis (PF).--The Committee recognizes that PF
is a family of more than 200 different lung diseases that all
look very much alike despite having a variety of causes. This
heterogeneity presents significant challenges for diagnosis and
treatment. The Committee commends NHLBI for its recent efforts
to apply the principles of precision medicine to PF research,
especially by funding a major new study that will evaluate a
promising treatment for a subset of patients with a particular
gene variant. This study, known as PRECISIONS, also aims to
identify genetic variants that play a role in certain forms of
PF. The Committee urges NHLBI to prioritize basic research on
PF, particularly to better understand the causes and process of
scarring and the varying impacts on patients.
Sickle Cell Disease (SCD) Research.--The Committee commends
NIH for its ongoing support of clinical research for SCD, which
imposes major morbidity on an estimated 90,000 to 100,000
individuals in the U.S., with three million Americans carrying
the sickle cell trait. The Committee encourages NIH to support
clinical trials for prenatal and postnatal treatment of SCD,
which includes multiple promising approaches to eradicate this
disease, save lives, and reduce dramatically the substantial
health care costs associated with SCD for children and adults.
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.
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 the NHLBI to robustly fund The Heart Truth
program.
Thalassemia.--Recent studies have shown that the length of
time between when blood is donated and transfused does not
impact outcomes for patients in need of an emergency blood
transfusion, such as in cases of trauma or acute events.
However, these studies do not determine the impact on
chronically transfused patients, such as those with
thalassemia, in which an administration of older red cells may
exacerbate iron loading in the heart and other internal organs
and contribute to worse outcomes for patients. The Committee
urges NHLBI to establish research initiatives to address
current gaps in clinical understanding in this area.
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.
Additionally, the Committee supports efforts by NIH to convene
a workshop of subject matter experts to identify research needs
and opportunities with the goal of informing guidelines for
treatment of patients with valvular heart disease.
Vascular Dementia.--A growing number of Americans are
developing severe forms of vascular dementia, conditions
resulting from many years of living with chronic diseases such
as hypertension and cardiovascular disease. This prevalence is
especially high in areas with high rates of hypertension,
obesity, and lack of access to regular health care.
Epidemiological studies and human pathology studies have
demonstrated association of vascular risk factors, vascular
diseases, and pathology with dementia. Research in animal
models could further investigate causal relationships,
understand mechanisms, and test novel interventions (including
repurposing existing drugs). Study of the mechanisms of
vascular dementia can help researchers to understand causation,
develop new treatment therapies and study how to repurpose
existing drugs to delay or halt disease progression. The
Committee encourages NHLBI to continue its support for
investigating potential relationship between vascular disease
and risk factors for vascular dementia, leveraging the work of
well-established longitudinal cohort studies of dementia and
cardiovascular disease and experimental models well
characterized phenotypes and mechanisms. The Committee
encourages NHLBI to coordinate this research with NIA and NINDS
to ensure that the continuum of research from basic science to
observational cohort to clinical trial to implementation is
maintained.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH (NIDCR)
Appropriation, fiscal year 2021....................... $484,867,000
Budget request, fiscal year 2022...................... 516,197,000
Committee Recommendation.............................. 519,010,000
Change from enacted level......................... +34,143,000
Change from budget request........................ +2,813,000
Mission.--The mission of NIDCR is to improve dental, oral,
and craniofacial health through research, research training,
and the dissemination of health information.
Dental Restorative Materials.--To help address one of the
U.S. commitments under the Minamata Convention on Mercury, the
Committee encourages NIDCR to conduct additional research on
durable mercury-free dental restorative materials.
Opioids and Pain/Pain Management Research.--The Committee
includes an increase of $18,000,000 for NIDCR to support
research related to opioids, pain, and pain management, as
requested in the fiscal year 2022 budget.
Oral Microbiome.--The Committee appreciates NIDCR's
leadership in microbiome research, including its support of the
Human Oral Microbiome Database. The Committee encourages NIDCR
to build upon its microbiome research to discover and better
understand the microbiome's connection to overall health,
including its influence on preventing and treating illness and
disease.
SARS-CoV-2.--The Committee thanks NIDCR for its commitment
to prioritizing research to answer critical research questions
related to the novel coronavirus. The Institute's research into
high-impact areas such as transmission risk in dental
environments is critical for the nation to continue fighting
COVID-19 and to ensure everyone is as safe as possible.
Report on Oral Health in America.--The Committee greatly
appreciates NIDCR's leadership on the upcoming Report ``Oral
Health in America: Advances and Challenges''. The Committee
anticipates the final release of the report and encourages
NIDCR to utilize the findings of the 2021 Report to identify
research gaps across dental, oral, and craniofacial research
and to pursue research opportunities to fill those gaps.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
(NIDDK)
Appropriation, fiscal year 2021....................... $2,131,975,000
Budget request, fiscal year 2022...................... 2,219,298,000
Committee Recommendation.............................. 2,237,625,000
Change from enacted level......................... +105,650,000
Change from budget request........................ +18,327,000
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.
End-Stage Renal Disease (ESRD).--The Committee continues to
note the important work in supporting critical kidney research
that NIDDK has accomplished on ESRD. The Committee encourages
NIDDK to work with stakeholders to facilitate new opportunities
for research in related conditions.
Glomerular Disease.--The Committee continues to support the
important work that the Cure Glomeruloneuropathy (CureGN)
initiative has accomplished, which has led to breakthroughs for
critical clinical trials. The Committee encourages NIDDK to
continue supporting research on related conditions such as
minimal change disease.
Inflammatory Bowel Diseases (IBD).--The Committee
encourages NIDDK to continue pursuing bedside-to-bench research
in IBD with a focus on biological and clinical drivers of
patient remission and relapse in Crohn's disease and ulcerative
colitis, including mucosal healing as well as environmental
triggers such as nutrition and psychological stress. The
Committee recognizes the importance of having common data
elements (CDE), standardizing the clinical categorization of
IBD patients, to facilitate the sharing, validation, and
comparison of results across research studies, and commends the
work many Institutes and Centers have done to support
development of CDEs for a number of diseases and disorders. To
effectively support bedside-to-bench research in IBD, the
Committee encourages the Institute to support the development
of CDEs and to collaborate with other IBD researchers and
organizations.
Interstitial Cystitis.--The Committee notes the progress of
interstitial cystitis research through the Multidisciplinary
Approach to the Study of Chronic Pelvic Pain (MAPP) Program and
encourages NIDDK and stakeholders to continue collaboration on
a comprehensive state of the science conference to examine
mechanisms for scientific opportunity. The Committee requests
an update on the progress of the conference in the fiscal year
2023 Congressional Budget Justification.
Liver Disease and Health Disparities.--The Committee notes
the relationship between health disparities and a variety of
conditions of the liver, such as nonalcoholic steatohepatitis
(NASH) and nonalcoholic fatty liver disease (NAFLD). The
Committee encourages NIDDK to continue to work with NIMHD and
other Institutes and Centers to advance liver disease research
in a comprehensive and impactful way.
Opioids and Pain/Pain Management Research.--The Committee
includes an increase of $20,000,000 for NIDDK to support
research related to opioids, pain, and pain management, as
requested in the fiscal year 2022 budget.
Pediatric Nephrology Workforce Diversification.--The
Committee recognizes that the COVID-19 pandemic caused
unprecedented disruption in biomedical research, delaying
awards and dissuading applications for pediatric nephrology
research. The Committee is concerned that these disruptions
have disproportionately impacted researchers from traditionally
underrepresented groups, resulting in even fewer researchers
from communities of color. Pediatric nephrology studies
continue to suffer from low enrollment, due in part to the
disproportionate impact of kidney disease on children of color
and longstanding challenges of clinical trial recruitment
within those communities. Because children and families of
color are more likely to enroll in studies where the research
team is from the same community, the diversity of pediatric
nephrology biomedical workforce is paramount to the success of
this research. The Committee requests that NIDDK consult with
stakeholder groups to identify barriers to increasing the
diversity of the pediatric nephrology workforce and identify
ways to incentivize researchers from traditionally
underrepresented groups to enter this field. The Committee
requests that NIDDK include information in the fiscal year 2023
Congressional Budget Justification on the progress made to
bolster the diversity of the pediatric nephrology biomedical
research workforce.
Prostate Cancer Disparities.--Nearly 250,000 men will be
diagnosed with and 34,000 men will die from prostate cancer in
2021. Incidence of prostate cancer is almost 80 percent higher
in non-Hispanic Black men, and prostate cancer mortality among
Black men is more than double that of men in every other racial
or ethnic group, representing a stark example of health
inequity in cancer outcomes. The Committee supports NCI and
NIMHD research on Prostate Cancer in Men of African American
Ancestry: Defining the Roles of Genetics Tumor Markers, and
Social Stress (RESPOND) Study, intended to identify the
underlying causes of disparities in prostate cancer incidence
and mortality. The Committee requests an update on the study in
the fiscal year 2023 Congressional Budget Justification.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (NINDS)
Appropriation, fiscal year 2021....................... $2,513,393,000
Budget request, fiscal year 2022...................... 2,783,300,000
Committee Recommendation.............................. 2,799,515,000
Change from enacted level......................... +286,122,000
Change from budget request........................ +16,215,000
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.
BRAIN Initiative.--The Committee directs NIH to transfer
$76,000,000 from the NIH Innovation Account to NINDS to support
the BRAIN Initiative. These funds were authorized in the 21st
Century Cures Act (P.L. 114-255). 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 (CP) Research.--The Committee commends NIH
for supporting research on mechanisms leading to CP, health
outcomes for those affected, biomarkers that may aid in
diagnosis or treatment selection, and interventions for
treatment and prevention of CP. The Committee strongly
encourages NIH to strengthen, accelerate, and coordinate
cerebral palsy research priorities across the lifespan
identified in the 2017 NINDS/NICHD Strategic Plan for CP
Research, such as basic and translational discoveries,
including neuroprotective, regenerative medicine and mechanisms
of neuroplasticity, as well as implementation and clinical
studies aimed at early detection and intervention, comparative
effectiveness, and functional outcomes. The Committee
encourages that a follow-up workshop be held in 2022 in
conjunction with key stakeholders to provide updates on
promising research performed to date, with the goal to further
refine or expand the opportunities that were identified in the
five to 10 year NIH strategic plan, including early detection
and intervention.
Duchenne Muscular Dystrophy.--While the expression of the
dystrophin protein in the brain is recognized, our
understanding of the link between the absence of dystrophin and
related neurobehavioral/cognitive diagnosis is not well
understood. The Committee urges NINDS to support research to
characterize the role of dystrophin in the brain and to further
define the relationships between mutation and neurobehavioral
and cognitive diagnosis.
Dystonia.--The Committee continues to urge NINDS to
implement the recommendations from the NINDS workshop
``Defining Emergent Opportunities in Dystonia Research'' and
engage with other Institutes and stakeholders on advancing
translational research that may lead to more treatment options
for those affected by dystonia.
Expanded Access to ALS Treatments.--The Committee supports
efforts to expand access for neurodegenerative diseases with no
disease modifying treatments. The Committee encourages NINDS to
collaborate with stakeholders to expand access for patients
unable to access treatment through clinical trials.
Headache Disorders.--Migraine is a leading cause of
disability, affecting more than 17 percent of people in the
U.S. The statutory language providing authority for Helping End
Addiction Long-Term (HEAL) Initiative cites the necessity of
attending to disease burden in prioritizing HEAL research
programs (42 U.S. Code Sec. 284q 1). The Committee encourages
NIH to consider HEAL Initiative support of fundamental,
translational, clinical, and social science research on
headache disorders, as appropriate to the mission of the HEAL
initiative, to provide lasting scientific solutions to the
opioid crisis. HEAL has invested in resources and
infrastructure developed to support pain research across all
pain conditions and should continue to encourage application
submissions on headache disorders, as well as those on pain
conditions for which opioid use and prescribing is highly
prevalent. Headache disorders research supported through the
HEAL initiative should supplement, not supplant, current
funding for headache disorders research at NIH, which has
contributed to many of the effective non-opioid treatments for
headache.
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 and Stimulant Research.--The Committee includes
$405,400,000 million within NINDS for the Helping to End
Addiction Long-Term (HEAL) Initiative, $135,105,000 above the
fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. The HEAL Initiative is a trans-NIH effort
to accelerate scientific discovery related to prevention and
treatment of opioid use disorder and developing nonaddictive
alternatives for pain management. The Committee also includes
an additional $43,000,000 in NINDS to support basic research
related to opioids and pain, as requested in the fiscal year
2022 budget.
Parkinson's Disease (PD).--The Committee commends NINDS for
taking critical steps in identifying priority recommendations
to advance research on PD, which impacts between 500,000 and
1,500,000 people in the U.S. and is the second most prevalent
neurodegenerative disease in this country. 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 of
its progress on implementing these recommendations in the
fiscal year 2023 Congressional Budget Justification.
Sleep Disorders.--The Committee notes the leadership of
NINDS in advancing research into underrepresented sleep
disorders, such as narcolepsy, restless legs syndrome, and
Kleine Levin Syndrome. The Committee encourages NINDS to
bolster these activities and review the state of the science
around sleep disorders to better advance initiatives that
advance scientific understanding of specific sleep disorders
impacting patients.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)
Appropriation, fiscal year 2021....................... $6,069,619,000
Budget request, fiscal year 2022...................... 6,245,926,000
Committee Recommendation.............................. 6,557,803,000
Change from enacted level......................... +488,184,000
Change from budget request........................ +311,877,000
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.
Antiviral Drugs and Pandemic Preparedness.--The Committee
strongly encourages NIAID efforts to establish a public-private
partnership focused on global pandemic preparedness and
antiviral drug discovery, in coordination with BARDA. Such a
partnership could leverage the best of academia and
pharmaceutical manufacturers to develop broad-spectrum
antiviral drugs to address rapidly emerging public health
threats, helping our nation be better prepared for the next
global pandemic. The Committee directs NIAID to provide an
update on this and any related efforts in the fiscal year 2023
Congressional Budget Justification.
Celiac Disease.--The Committee encourages NIH to devote
focused research to the study of celiac disease, including the
autoimmune causation underpinning the affliction. 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. Therefore, the Committee urges NIAID to support
new research on celiac disease, to better coordinate existing
research, and to focus new research towards diagnosing and
effectively treating this condition. The Committee also
strongly encourages NIH to establish a Research Condition,
Disease Categorization (RCDC) for celiac disease and a Notice
of Special Interest to spur additional research.
Centers for AIDS Research.--As part of the Ending the HIV
Epidemic initiative, the Committee includes $71,000,000 for the
Centers for AIDS Research, an increase of $10,000,000 above the
estimated fiscal year 2021 enacted level and the same as the
fiscal year 2022 budget request. These Centers offer evidence-
based practices on prevention and treatment to initiative
partners and support for evaluating the initiative.
Combating Antibiotic-Resistant Bacteria.--The Committee
supports NIAID's efforts related to combating antibiotic-
resistant bacteria. These funds enable NIAID to support
research on antimicrobial (drug) resistance, including basic
research on how microbes develop resistance, new and faster
diagnostics, and clinical trials designed to find new vaccines
and treatments effective against drug-resistant microbes.
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 $12,200,000, an increase of $6,100,000,
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.
Emerging Diseases.--The Committee supports the work of
NIAID in researching emerging coronaviruses, and urges NIAID to
fund basic science on a host of deadly viruses, including SARS-
CoV-2, Ebola, Marburg, and Nipah viruses. The Committee notes
the importance of using high containment BSL-3 and BSL-4 labs
in this effort. The Committee is aware of the success of non-
animal approaches to identify how viral proteins interact with
host proteins and their pathways. The Committee notes the
success of these approaches with SARS-CoV-2 to identify new
therapeutic approaches. The Committee encourages NIAID to
support research into viruses, including Ebola, Marburg, and
Nipah viruses, to help identify small molecule drugs to block
infection by a host of deadly viruses.
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 the
commitment to the HAE research at this critical time.
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 of the first safe and effective
microbicide for women and supporting an active ARV-based
microbicide pipeline to produce additional solutions to prevent
HIV and to help end the epidemic.
Rapid Vaccine Development Platforms for Emerging Infectious
Disease.--The Committee recognizes the importance of being able
to quickly, efficiently, and safely develop and manufacture
vaccines against emerging infectious diseases. Vaccines play a
pivotal role in host protection against infectious diseases and
have significantly reduced mortality worldwide. Older methods
of developing vaccines are no match for a host of emerging and
reemerging pathogens that call for a tailored and speedy
response, such as the developing coronavirus variants. Today,
innovations in how vaccines are developed enable faster
production of platforms capable of making and initially testing
a new vaccine in less than 120 days that then are tailored to
specific pathogens as manufacturing begins, based on science
and data, not speculation. Such rapid vaccine platform
technologies can vastly decrease the time it takes to develop,
manufacture and distribute vaccines. Therefore, the Committee
includes $50,000,000 to support research and development of
rapid vaccine platform technologies and requests a briefing on
these efforts within 180 days of enactment of this Act.
Regional Biocontainment Laboratories (RBLs).--The Committee
commends NIAID for issuing a Request for Applications (RFA) to
support the RBLs through the RFA for Facility and Building
System Upgrades Support for the RBLs. The Committee encourages
NIAID to continue supporting meritorious research applications
from investigators conducting research through the RBLs on
efforts to prevent, prepare for, and respond to infectious
disease outbreaks, including, but not limited to: (1)
conducting research on developing testing for antiviral
compounds, new vaccines, and point of care tests; (2)
conducting research on validating methods for identifying
suitable prophylactic methods to prevent infections; and (3)
training new researchers in biosafety level 3 practices.
Universal Influenza Vaccine.--The Committee includes no
less than $250,000,000, an increase of $30,000,000 over the
fiscal year 2021 level and the fiscal year 2022 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.
Valley Fever.--The Committee is encouraged by NIAID's
recent announcement to establish collaborative
coccidioidomycosis (Valley Fever) research centers. To guide
this continuing work, the Committee requests, within 180 days
of enactment of this Act, a 10-year strategic plan from NIH
with the objective of producing a Valley Fever vaccine by 2031.
This plan should include, but not be limited to: (1) a
statement of science on Valley Fever, including disease burden
in the U.S.; (2) identifiable and achievable benchmarks for
Valley Fever vaccine development, including vaccine market
viability; (3) identifying or developing funding priorities and
opportunities that actively support the development of a Valley
Fever vaccine; and (4) any recommendations to Congress on
policy reforms designed to help develop a Valley Fever vaccine.
Furthermore, the Committee directs NIAID to convene a
stakeholder and researchers conference in an endemic region to
help guide the strategic plan's development. The Committee
requests an update in the fiscal year 2023 Congressional Budget
Justification on progress towards achieving goals in this
strategic plan.
Viral Vector Platforms.--The Committee notes that viral
vector platforms have a proven track record for successfully
producing vaccines against infectious diseases for many decades
and believes well-established viral vectors with a robust
safety record for use in children, pregnant women, or other
high-risk populations should be continuously developed and
adjusted to potential emerging infections in the future. The
Committee encourages investments in vaccine centers with long-
term experience in the development of viral vectors covering
multiple virus-based vaccine platforms, with particular
emphasis on entities that have established collaborations with
high-security facilities (BSL-4) for preclinical studies.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)
Appropriation, fiscal year 2021....................... $2,991,417,000
Budget request, fiscal year 2022...................... 3,096,103,000
Committee Recommendation.............................. 3,139,656,000
Change from enacted level......................... +148,239,000
Change from budget request........................ +43,553,000
Mission.--NIGMS supports basic research that increases our
understanding of biological processes and lays the foundation
for advances in disease diagnosis, treatment, and prevention.
Increasing Diversity in Biomedical Research.--The Committee
has long sought to promote opportunities for the Nation's next
generation of researchers and enhance diversity in biomedical
research. Early-stage researchers, particularly women and
racial and ethnic minorities, spend longer periods of time in
postdoctoral positions with lower salaries, receive inadequate
mentorship, and are offered fewer opportunities for
professional advancement, resulting in lower retention rates
for these groups. Even with these obstacles, many early-stage
researchers tackle riskier projects and have seen positive
outcomes for the benefit of society. Grant programs offering
support and opportunities for researchers at key career
transition points requiring little or no preliminary data, are
critical to ensuring innovative scientists from diverse
backgrounds succeed in biomedical research. The Committee
provides an increase of $20,000,000 for NIGMS for programs,
including but not limited to the Maximizing Opportunities for
Scientific and Academic Independent Careers (MOSAIC), Minority
Access to Research Careers (MARC), Bridges to the
Baccalaureate, and Undergraduate Research Training Initiative
for Student Enhancement (U RISE) programs, that train the next
generation of scientists while enhancing the diversity of the
biomedical research workforce and enabling promising scientists
to pursue high-risk, high-reward research.
Institutional Development Awards (IDeA).--The Committee
provides $415,000,000 for IDeA, $18,427,000 above the fiscal
year 2021 enacted level. IDeA supports high-quality research
and investigators throughout the country in States in which the
success rate for NIH grants has been historically low.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT (NICHD)
Appropriation, fiscal year 2021....................... $1,590,337,000
Budget request, fiscal year 2022...................... 1,942,117,000
Committee Recommendation.............................. 1,689,786,000
Change from enacted level......................... +99,449,000
Change from budget request........................ -252,331,000
Mission.--NICHD investigates human development throughout
the entire life process, with a focus on understanding
disabilities and important events that occur during pregnancy.
The Committee commends the important role that NICHD has
historically served to support research in the areas of
behavioral health, cognition, development of young children,
language, learning differences, and school readiness. The COVID
pandemic has only increased the importance of research in these
areas, such as the long-term consequences of social isolation
or emotional development after a year of inconsistent in-person
school attendance. Accordingly, the Committee encourages NICHD
to prioritize ongoing investment in these areas.
Endometriosis Research.--The Committee urges NICHD to
expand funding for basic, clinical, and translational research
into the mechanics of endometriosis, identify early diagnostic
markets, and develop new treatment methods.
Human Milk Research.--The Committee encourages NICHD to
continue to support human milk research through peer-reviewed
scientific research and graduate and postdoctoral fellowships.
The Committee encourages NICHD to connect at least four, but
not more than 10, centers for human milk research to establish
a research center network to support shared resources and
facilities for human milk research and any required
infrastructure.
Impact of COVID-19 on Children.--The Committee includes an
increase of $15,000,000, as requested in the fiscal year 2022
budget, for NICHD to support additional research into
multisystem inflammatory syndrome in children (MIS-C) and other
ways in which COVID-19 affects children. The Committee looks
forward to receiving NIH's SARS-CoV-2 pediatric research agenda
and asks NIH to continue identifying research needs focused on
the novel coronavirus impacts on children and adolescents,
exploring how pediatric patients have been included in current
NIH SARS-CoV-2 research and clinical trials, investigating any
disparities that have emerged in how children of different
communities have been affected, assessing the risk and
protective factors children may produce against COVID-19
antigens, investigating longer-term impacts of SARS-CoV-2 on
child health, and pursuing research focused on treatments and
prevention methods for SARS-CoV-2 focused on children and
adolescents when carrying out this agenda.
Learning Disabilities Research Centers and Learning
Disabilities Innovation Hubs.--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
the only 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 supports research to
identify new proteins and sperm structures that are necessary
for normal sperm function and, consequently, for fertility and
healthy embryo development.
Maternal Health Research.--The Committee includes an
increase of $30,000,000 for the Implementing a Maternal Health
and Pregnancy Outcomes Vision for Everyone (IMPROVE)
Initiative, as requested in the fiscal year 2022 budget.
Maternal mortality in the U.S. is higher than in other
industrialized nations, and there are disparities in maternal
outcomes across the country. For example, Black women
experience maternal mortality at nearly four times the rate of
White women. 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. The initiative uses an integrated approach to
understand biological, behavioral, sociocultural, and
structural factors that affect severe maternal mortality and
maternal mortality (SMM/MM) by building an evidence base for
improved care and outcomes in specific regions of the country.
IMPROVE will target health disparities associated with SMM/MM
by (1) implementing and evaluating community-based
interventions for disproportionately affected women (e.g.,
African American, American Indian/Alaska Native, advanced
maternal age, low socioeconomic status, and rural populations),
and (2) identifying risk factors and the underlying biological
mechanisms associated with leading causes of SMM/MM, including
cardiovascular disease, infection and immunity, and mental
health.
Population Research.--The Committee applauds NICHD for
supporting many of the Nation's most used prospective,
population-representative longitudinal studies, including the
Fragile Families and Child Wellbeing Study, Panel Study of
Income Dynamics Child Supplement Survey, and National
Longitudinal Survey of Youth, and also for supporting research
and research training through the NICHD Population Dynamics
Centers Research Infrastructure Program. Given the dearth of
data being collected regarding the short and long-term social,
economic, developmental, and health effects of the COVID
pandemic on children and families, the Committee urges NICHD to
consider expanding data collection and research through these
existing surveys and the Centers Program. Further, the
Committee encourages NICHD to explore the use of existing and
new mechanisms to enhance research regarding the effect of
COVID on fertility trends and reproductive health overall.
Finally, the Committee urges NICHD to expand data collection
and research regarding maternal, infant, child, and adolescent
mortality. The Committee asks that NICHD report on its progress
to enhance and expand these research and survey activities
within 90 days of enactment of this Act.
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
(PRGLAC) 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
NICHD, along with other relevant Institutes and Centers, CDC,
and FDA, to continue to implement PRGLAC recommendations to the
extent appropriate and feasible under the legal authorities
available to the Secretary.
Additionally, The Committee includes $1,500,000 within
NICHD to contract with the National Academies of Science,
Education, and Medicine (NASEM) to convene a panel with
specific legal, ethical, regulatory, and policy expertise to
develop a framework for addressing medicolegal and liability
issues when planning or conducting research specific to
pregnant people and lactating people. Specifically, this panel
should include individuals with ethical and legal expertise in
clinical trials and research; regulatory expertise; plaintiffs'
attorneys; pharmaceutical representatives with tort liability
and research expertise; insurance industry representatives;
Federally funded researchers who work with pregnant and
lactating women; representatives of institutional review boards
(IRBs); and health policy experts.
Uterine Fibroids.--Nationally, an estimated 26,000,000
individuals ages 15 to 50 have diagnosed uterine fibroids.
Uterine fibroids are the most common gynecological condition,
but individuals are frequently unaware that the symptoms of
this condition, including heavy menstrual bleeding, pain, and
frequent urination during periods, are abnormal. Fibroids
contribute to significant negative health outcomes including
chronic pain, iron deficiency and anemia, miscarriage, and/or
infertility. The Committee strongly urges the NICHD to
prioritize funding to expand basic, clinical, and translational
research into the mechanics of fibroids, identification of
early diagnostic methods, and fertility-preserving treatments.
Research focusing on understanding the significant health
disparities among individuals with fibroids should also be
prioritized, given that Black women are at increased risk for
fibroids, tend to develop symptoms at a younger age, and suffer
more severe symptoms.
NATIONAL EYE INSTITUTE (NEI)
Appropriation, fiscal year 2021....................... $835,714,000
Budget request, fiscal year 2022...................... 858,535,000
Committee Recommendation.............................. 877,129,000
Change from enacted level......................... +41,415,000
Change from budget request........................ +18,594,000
Mission.--NEI conducts and supports basic and clinical
research, research training, and other programs with respect to
blinding eye diseases, visual disorders, and mechanisms of
visual function, preservation of sight, and the special health
problems and needs of individuals who are visually-impaired or
blind.
Blepharospasm.--The Committee notes the work of NEI in
expanding research into blepharospasm, a form of dystonia, and
requests an update on collaboration amongst stakeholders and
other Institutes and Centers.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)
Appropriation, fiscal year 2021....................... $814,675,000
Budget request, fiscal year 2022...................... 937,107,000
Committee Recommendation.............................. 941,799,000
Change from enacted level......................... +127,124,000
Change from budget request........................ +4,692,000
Mission.--NIEHS's mission is to discover how the
environment affects people in order to promote healthier lives.
Climate Change Research.--The Committee includes an
increase of $100,000,000, the same as the fiscal year 2022
budget request, for NIEHS to support research on the impact of
climate change on human health.
Harmful Algal Blooms Research.--The Committee recognizes
the value of the NIEHS mission and the NIEHS NSF jointly-funded
Oceans and Human Health Program as a means to increase
scientific knowledge about short-term and long-term human
health effects potentially associated with acute and chronic
exposures to toxins produced by harmful algal blooms (HABs).
The Committee recognizes the increasing relevance of this
scientific research to communities directly affected by HABs,
including Florida, where a 16-month bloom one of the longest
documented HABs in the State's history occurred from late 2017
through early 2019. The Committee encourages NIEHS to continue
investing in this research area using its competitive, peer-
reviewed grantmaking processes. In particular, the Committee
notes growing scientific interest in the use of
multidisciplinary approaches to investigate respiratory
irritation or illness associated with inhalation of aerosolized
HAB toxins and with neurotoxic shellfish poisoning arising from
ingestion of contaminated seafood. 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.
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 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 2023 Congressional Budget Justification.
NATIONAL INSTITUTE ON AGING (NIA)
Appropriation, fiscal year 2021....................... $3,899,227,000
Budget request, fiscal year 2022...................... 4,035,591,000
Committee Recommendation.............................. 4,258,049,000
Change from enacted level......................... +358,822,000
Change from budget request........................ +222,458,000
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.--In recognition
that Alzheimer's disease poses a serious threat to the nation's
long-term health and economic stability, the Committee
recommends a total of no less than $3,394,000,000 for
Alzheimer's disease and related dementias research,
$200,000,000 above the estimated fiscal year 2021 level and the
fiscal year 2022 budget request.
Center on Exposome Studies in Alzheimer's Disease and
Related Dementias (ADRD).--The Committee recognizes the
importance of mechanistic research to address ADRD disparities,
including the social and contextual factors that contribute to
increased risk for disease. The Committee directs NIA to
establish research infrastructure in the form of a Center(s) on
Exposome Studies in ADRD, which would enable the linkage of
community and health system-level factors to biological
outcomes including cellular and molecular mechanisms that lead
to disease. This includes linking social and biological factors
via characterization of the exposome, the measure of all the
exposures of an individual over the life course (e.g. physical,
chemical, environmental, social), characterized through a
mechanistic disparities lens. The Committee includes
$15,000,000 to facilitate these efforts to provide a
cornerstone of health disparities operations to advance
solutions, innovations, and cures.
Diversity in Alzheimer's Disease Research.--The Committee
commends NIA for its leadership in supporting longitudinal,
population-based cohort studies into the causes of dementia.
Since rural, poor, and minority populations may be at greater
risk for dementia, the value and application of these studies
are enhanced when they include individuals from various
geographic, ethnic, socioeconomic, and generational
backgrounds. The Committee urges NIA to continue to support
diversity in its cohort studies, with the specific goal of
better understanding disease burden and biomarkers by race and
geographic region, as well as the underlying pathologies which
may differ by race.
Elder Abuse.--The Committee commends NIA for its research
on developing linguistically and culturally appropriate tools
to combat elder abuse and financial exploitation and improve
the identification and reporting of elder abuse. The Committee
is pleased by efforts to facilitate cross-Institute
collaborations, such as the 2015 Workshop on Multiple
Approaches to Understanding and Preventing Elder Abuse and
Mistreatment. The Committee urges NIH to utilize innovative
means such as inter-institute workshops, improved cross-agency
coordination, or the Project ECHO telementoring model with
aging professionals and housing providers to translate and
disseminate information to combat elder abuse in diverse
populations.
Opioids and Pain/Pain Management Research.--The Committee
includes an increase of $29,000,000 for NIA to support research
related to opioids, pain, and pain management, as requested in
the fiscal year 2022 budget.
Overactive Bladder and Cognitive Impairment Treatment.--The
Committee is concerned that anticholinergic medications
commonly prescribed to treat overactive bladder, a condition
that affects one in three older Americans, have been shown in
recent studies to increase the risk of developing ADRD. The
Committee believes that further research of anticholinergic
medications as well as on alternatives to these treatments is
urgently needed to establish certainty regarding the safety of
these medications as a treatment option for overactive bladder
in older adults. The Committee urges NIA to prioritize research
grants and contracts that study the long-term use of
anticholinergic medications and the risk of cognitive
impairment and ADRD. The Committee requests an update on this
issue and on research activities to advance safe and effective
alternative treatments for overactive bladder in the fiscal
year 2023 Congressional Budget Justification.
Population Research.--The Committee praises NIA for
supporting a scientifically innovative population aging
research portfolio that reflects some of the Institute's, and
Nation's, highest scientific priorities, including Alzheimer's
disease and social inequality in health and the aging process.
More research, however, is needed to understand the short and
long-term social, behavioral, and economic health consequences
of COVID-19 on older people and their families, which NIA is
uniquely positioned to foster and support. Existing large-
scale, longitudinal and panel surveys, such as the Health and
Retirement Study, the National Health and Aging Trends Study,
and Understanding America Study, should be enhanced to
facilitate scientific research on the complex, multifaceted
effects of the pandemic on older, diverse populations. Further,
the Committee encourages NIA to support the further development
of data infrastructure to promote research on racial, ethnic,
gender, and socioeconomic disparities in health and well-being
in later life and the long-term effects of early life
experiences. The Committee asks that NIA to report on its
progress to enhance and expand these research and survey
activities within 90 days of enactment of this Act.
Prion Diseases.--The Committee encourages NIH to continue
funding research proposals on prion diseases that could be
relevant for 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.
Thalassemia.--Thanks to significant advances in medical
science, 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. Among these are female and male
reproductive issues, the impact of non-disease related
medicines, the relationship to diseases of aging such as ADRD,
Parkinson's, arthritis, osteoporosis, and more. The Committee
requests that NIA develop a plan to research comorbidities in
thalassemia and other rare disease patient populations as they
continue to age.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
(NIAMS)
Appropriation, fiscal year 2021....................... $634,292,000
Budget request, fiscal year 2022...................... 680,186,000
Committee Recommendation.............................. 679,410,000
Change from enacted level......................... +45,118,000
Change from budget request........................ -776,000
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.
Opioids and Pain/Pain Management Research.--The Committee
includes an increase of $24,000,000 for NIAMS to support
research related to opioids, pain, and pain management, as
requested in the fiscal year 2022 budget.
Skin Disease Research Core Centers.--The Committee
recognizes the important work at the Core Centers funded by
NIAMS to conduct basic and clinical research on a variety of
skin diseases, including inflammatory and infectious skin
diseases. The Committee urges NIAMS to fund Centers with
diverse geographic locations, and to encourage proposals that
incorporate pediatric skin diseases and collaboration with
diverse stakeholders, such as States or patient and provider
groups.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
(NIDCD)
Appropriation, fiscal year 2021....................... $498,076,000
Budget request, fiscal year 2022...................... 511,792,000
Committee Recommendation.............................. 522,758,000
Change from enacted level......................... +24,682,000
Change from budget request........................ +10,966,000
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.
Spasmodic Dysphonia.--The Committee notes the research
NIDCD continues to facilitate on spasmodic dysphonia. The
Committee requests an update in the fiscal year 2023
Congressional Budget Justificationon collaborative efforts with
related Institutes, Centers, and stakeholders to advance
critical research into all forms of dystonia, including
spasmodic dysphonia.
NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)
Appropriation, fiscal year 2021....................... $174,957,000
Budget request, fiscal year 2022...................... 199,755,000
Committee Recommendation.............................. 200,782,000
Change from enacted level......................... +25,825,000
Change from budget request........................ +1,027,000
Mission.--The mission of NINR is to promote and improve the
health of individuals, families, and communities. To achieve
this mission, NINR supports and conducts clinical and basic
research and research training on health and illness, research
that spans and integrates the behavioral and biological
sciences, and develops the scientific basis for clinical
practice.
Health Disparities Research.--The Committee includes an
increase of $20,000,000 for NINR to support research related to
identifying and reducing health disparities, the same as the
fiscal year 2022 budget request.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)
Appropriation, fiscal year 2021....................... $554,923,000
Budget request, fiscal year 2022...................... 570,165,000
Committee Recommendation.............................. 582,422,000
Change from enacted level......................... +27,499,000
Change from budget request........................ +12,257,000
Mission.--NIAAA's mission is to generate and disseminate
fundamental knowledge about the 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.
NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)
Appropriation, fiscal year 2021....................... $1,479,660,000
Budget request, fiscal year 2022...................... 1,852,503,000
Committee Recommendation.............................. 1,860,329,000
Change from enacted level......................... +380,669,000
Change from budget request........................ +7,826,000
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 related to the addiction in the U.S. The
number of alcohol-related deaths doubled in the US from 1999 to
2017, the age-adjusted rate of deaths involving synthetic
opioids other than methadone increased 1,040 percent from 2013
to 2019, and the use of psychostimulants increased 317 percent.
One trait that is evident in every form of addiction is the
excessive discounting of the future by the addicted person, who
will value the immediate over benefits of the future. Episodic
Future Thinking is a promising intervention that helps
individuals who are predisposed to addiction consider the
positive consequences of remaining sober 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, decision-science, engineering,
and computer science to deploy Episodic Future Thinking
intervention strategies across a range of addictions.
Cannabis Research.--The Committee encourages NIDA to
support coordinated, multidisciplinary cannabis research,
including basic, clinical, and translational cannabis research
and research on the health effects of cannabis use, potential
therapeutic effects of cannabis use, and effects of cannabis
legalization. NIDA is encouraged to support peer-reviewed
scientific research, graduate and postdoctoral fellowships, and
any required infrastructure, with priority given to research
programs in States where State co-funding is available.
Cannabidiol Research.--The Committee strongly believes that
cannabidiol (CBD), cannabigerol (CBG), cannabichromene (CBC),
minor cannabinoids, and terpenes--compounds found in cannabis--
may provide beneficial medicinal effects. However, there is
insufficient scientific information about the short- and long-
term effects of these compounds. The Committee is also
concerned that marijuana policies on the Federal level and in
the States are being changed without the benefit of scientific
research to help guide those decisions. Additional, coordinated
research on a national scale is necessary to determine the
toxicology and medicinal effects of these compounds. The
Committee believes that NIH should consider significantly
expanding funds to study the medicinal effects and toxicology
of CBD, CBG, CBC, minor cannabinoids, and terpenes. This
expanded effort should include funding of clinical trials with
academic health centers to study the long-term medicinal
benefits and toxicology of CBD, CBG, CBC, minor cannabinoids,
and terpenes. The Committee encourages NIH 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.
Drug Impairment Standards for Marijuana.--The Committee is
concerned that development of a drug impairment standard for
marijuana remains unlikely in the near term and encourages NIH
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 behaviors that impact
public health, such as drug-impaired driving. The Committee is
aware that due to Drug Enforcement Administration restrictions
on registered growers, the majority of Federal research using
marijuana has been limited to marijuana produced by a single
grower and encourages NIH, when possible, to undertake research
that encompasses the diversity, quality, and potency of
commonly available cannabis products.
Kratom.--The Committee recognizes that 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
directs NIDA to continue to invest in this important research,
especially considering the increase in overdose deaths during
the COVID-19 pandemic.
Methamphetamine and Other Stimulants.--The Committee is
concerned that, according to CDC, over 30,000 overdose deaths
involved drugs in the drug categories that include
methamphetamine and cocaine in 2019, an increase of over
threefold since 2014. The sharp increase has led some to refer
to stimulant overdoses as the ``fourth wave'' of the current
drug addiction crisis in America following the rise of opioid-
related deaths involving prescription opioids, heroin, and
fentanyl-related substances. Methamphetamine is highly
addictive and there are no FDA-approved treatments for
methamphetamine and other stimulant use disorders. The
Committee continues to support NIDA's efforts to address the
opioid crisis, has provided continued funding for the HEAL
Initiative, and supports NIDA's efforts to combat the growing
problem of methamphetamine and other stimulant use and related
deaths.
Opioid and Stimulant Research.--The Committee continues to
be concerned about the opioid overdose epidemic and appreciates
the important role that research plays in the various Federal
initiatives aimed at this crisis. The Committee is also aware
of the most recent data from CDC that shows opioid overdose
fatalities increasing from 2018 to 2019, with the primary
driver being the increased overdose deaths involving synthetic
opioids, primarily illicitly manufactured fentanyls. To combat
this crisis, the Committee includes $405,400,000 within NIDA
for the HEAL Initiative, $135,105,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. The HEAL Initiative is a trans-NIH effort to
accelerate scientific discovery related to prevention and
treatment of opioid use disorder and developing nonaddictive
alternatives for pain management. In response to rising rates
of stimulant use and overdose, the Committee has included
language expanding the allowable use of these funds to include
research related to stimulant use and addiction. The Committee
also includes an additional $196,300,000 in NIDA to support
basic research related to opioids and other stimulants, as
requested in the fiscal year 2022 budget.
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 directs NIH, in
consultation with CDC, to provide a report to the Committee no
later than 180 days after the enactment of this Act that
provides an updated literature review and evaluation on the
potential public health impact of overdose prevention centers
in the U.S.
Pain Prescribing Education.--The Committee encourages NIDA
to continue and expand efforts to educate physicians and other
medical professionals on safe prescribing for pain and managing
patients who abuse prescription opioids, as well as best
practices for incorporating substance misuse and addiction
screening and treatment into their clinical practices.
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).
NIDA should 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
recommends that NIDA continue to support the education of
scientists and practitioners to find improved prevention and
treatments for substance use disorders.
Schedule I Drug Research.--The Committee recognizes that,
despite marijuana being legalized in some form in 35 States and
nearly 45,000,000 American adults reporting having used
marijuana in the past year, research on marijuana and other
Schedule I substances is extremely limited. The Committee
directs NIH, in collaboration with FDA, DEA, ONDCP, and any
other relevant agencies, to develop an approach to facilitate
access to Schedule I drugs for research.
Sleep and Circadian-Dependent Mechanisms Contributing to
Opioid Use Disorder.--The Committee notes NIDA's continued
support in research to better understand opioid use disorder
and urges engagement with stakeholders to examine contributing
factors, including sleep and circadian-dependent mechanisms.
Tobacco Regulatory Science Program.--The Committee supports
the Tobacco Regulatory Science Program and encourages NIH to
increase funding for research into the understanding of
nicotine addiction and to spur the development of better
prevention and treatment strategies. Of particular importance
is funding for research for effective interventions to help
youth and young adults to quit tobacco use or vaping, and to
understand the interrelationship between the vaping of tobacco
and marijuana. The Committee directs NIDA to conduct
interdisciplinary research on this topic with an emphasis on
risk perceptions, decision-making and neuroscience.
Underage 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 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. The NAS 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, the NAS 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, the NAS 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 any completed on marijuana, that are designed to
change the attitudes and health behaviors of pregnant and
breast-feeding women.
Based on its reviews, the NAS 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, 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 2021....................... $2,103,708,000
Budget request, fiscal year 2022...................... 2,213,574,000
Committee Recommendation.............................. 2,223,085,000
Change from enacted level......................... +119,377,000
Change from budget request........................ +9,511,000
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 encourages NIH to continue to
prioritize and invest in research on autism consistent with the
recommendations included in the Interagency Autism Coordinating
Committee's (IACC) Strategic Plan for Autism Spectrum Disorder.
However, while significant progress has been made in our
understanding of autism because of Federally-funded research,
large gaps remain that must be addressed to improve outcomes
and access to services for autistic individuals and their
families. Research has shown that autistic individuals have
higher rates of some co-occurring physical and mental health
conditions, which not only lead to quality of life issues, but
also increased medical utilization and costs. Similarly, to
address the racial, ethnic, and socioeconomic health equity
challenges experienced by autistic individuals and their
families, it is imperative that greater investment is made to
address disparities in access to services and interventions.
The Committee encourages NIH to support greater investment in
research focused on particular areas in need of growth,
outlined in the strategic plan, including research on lifespan
issues to address the needs of transition-age youth and adults
on the spectrum, research to enable development of evidence-
based services, and research to support the development and
delivery of new and improved screening tools, treatments and
interventions. 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.
BRAIN Initiative.--The Committee directs NIH to transfer
$76,000,000 from the NIH Innovation Account to NIMH to support
the BRAIN Initiative. These funds are authorized by the 21st
Century Cures Act (P.L. 114-255). 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 $25,000,000 for NIMH to expand research on the
impact of the COVID-19 pandemic on mental health, as requested
in the fiscal year 2022 budget.
Suicide Prevention.--The Committee is encouraged that 2019
was the first year in two decades in which the suicide rate
decreased. However, death by suicide remains the tenth leading
cause of death in the U.S., and the Committee remains committed
to providing the resources necessary to address this alarming
crisis. 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 continue to prioritize suicide research in fiscal
year 2022, with special emphasis on producing models that are
interpretable, scalable, and practical for clinical
implementation, including utilization of health care,
education, and criminal justice systems that serve populations
at risk. 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
pandemic. The Committee requests that NIMH provide an update on
these efforts in the fiscal year 2023 Congressional Budget
Justification.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)
Appropriation, fiscal year 2021....................... $615,780,000
Budget request, fiscal year 2022...................... 632,973,000
Committee Recommendation.............................. 646,295,000
Change from enacted level......................... +30,515,000
Change from budget request........................ +13,322,000
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.
Computational Medicine and RNA Molecules.--The Committee is
encouraged by recent discoveries in the computational medicine
field that are helping uncover more of the causes behind
disease onset and disease progression. Multiple reports, in
many human diseases and conditions, provide compelling evidence
that an individual's sex, ancestry, and age differentially
affect the individual's regulatory RNA molecules and their
impacts. The Committee recognizes that more research in this
area could lead to new and important biological discoveries,
improve our understanding of disease processes, and herald
highly personalized approaches to diagnosis, prognosis, and
therapy. The Committee urges NHGRI to continue to support
computational and experimental research on RNA molecules and
the mechanisms through which they affect biological processes
that cause disease.
Emerging Centers of Excellence in Genomic Sciences.--The
Committee provides no less than $15,000,000 to sustain and grow
the Emerging Centers of Excellence in Genomic Sciences
competitive grant program, an increase of $2,500,000 above the
fiscal year 2021 enacted level. The Committee maintains prior
direction that present awardees of the Centers for Excellence
in Genomic Sciences program shall not be eligible to receive
these grants.
Germline RUNX1 Mutations.--The Committee commends NHGRI for
collaborating with NCI to launch and maintain the 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 rare
opportunity to monitor the genomic evolution of cancer within a
precancerous population in real time. Currently, the study
tracks only 50 of the approximately 20,000 people in the U.S.
with these mutations. The Committee encourages NHGRI to
continue supporting this study. In addition, the Committee
encourages NHGRI to continue to work towards the implementation
of an open source database to share data in real-time for the
benefit of the entire research community and the patients and
their families searching for answers.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING (NIBIB)
Appropriation, fiscal year 2021....................... $410,728,000
Budget request, fiscal year 2022...................... 422,039,000
Committee Recommendation.............................. 431,081,000
Change from enacted level......................... +20,353,000
Change from budget request........................ +9,042,000
Mission.--The NIBIB mission is to improve health by leading
the development and accelerating the application of biomedical
technologies.
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES (NIMHD)
Appropriation, fiscal year 2021....................... $390,865,000
Budget request, fiscal year 2022...................... 652,244,000
Committee Recommendation.............................. 661,879,000
Change from enacted level......................... +271,014,000
Change from budget request........................ +9,635,000
Mission.--NIMHD's mission is to lead scientific research to
improve minority health and reduce health disparities.
Focal Segmental Glomerulosclerosis (FSGS).--The Committee
encourages NIMHD to collaborate with other Institutes, Centers,
and stakeholders to expand research opportunities on the APOL1
gene that causes African Americans to be disproportionately
affected by FSGS.
Mercury in Beauty Products.--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, are
disproportionately used by women of color. The Committee
encourages NIMHD to collaborate with FDA to identify research
gaps in the understanding of the health effects of these
products.
Research Centers at Minority Institutions.--The Committee
includes $88,000,000, an increase of $8,000,000 above the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request, for RCMIs to ensure that infrastructure development in
historically minority graduate and health professional schools
continue to enhance to meet these critical needs. The Committee
also recognizes the importance of the RCMI Coordinating Center
in ensuring that collectively, institutions can engage in
multi-site collaborative research, especially as the U.S. and
NIH positioned themselves to address the challenges imposed by
the COVID-19 pandemic to our health system and underserved
populations.
The Committee encourages the NIMHD to continue following
Congressional intent for the RCMI program and follow the spirit
of the original instructions provided to NIH by Congress. The
Committee notes the original intent of the RCMI program is to
provide equitable means for health professions institutions
with historical missions and precedence of serving minorities
and building research infrastructure.
Health Disparities Research.--The Committee includes an
increase of $250,000,000 for NIMHD to support additional
research related to identifying and reducing health
disparities, as requested in the fiscal year 2022 budget.
Rural Health.--Rural Americans are a population group that
experiences significant health disparities. Health disparities
are differences in health status when compared to the
population overall, often characterized by indicators such as
higher incidence of disease and/or disability, increased
mortality rates, lower life expectancies, and higher rates of
pain and suffering. Rural risk factors for health disparities
include geographic isolation, lower socioeconomic status,
higher rates of health risk behaviors, limited access to
healthcare specialists and subspecialists, and limited job
opportunities. The Committee encourages NIMHD to continue
research to address the health disparities found in rural
communities.
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH)
Appropriation, fiscal year 2021....................... $154,162,000
Budget request, fiscal year 2022...................... 184,323,000
Committee Recommendation.............................. 185,295,000
Change from enacted level......................... +31,133,000
Change from budget request........................ +972,000
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.
Integrative Health.--The Committee commends NCCIH as the
lead Federal scientific agency supporting research to determine
the usefulness and safety of complementary and integrative
health approaches and their roles in improving health and
health care. The Committee supports the Center's continued
leadership of several trans-NIH and inter-agency initiatives,
including the NIH-DoD-VA Pain Management Collaboratory (PMC)
and the Health Care Systems Research Collaboratory, both of
which are investigating best practices for implementing
complementary health approaches in clinical health care
settings. Consistent with goals that NCCIH identified in its
fiscal year 2021-2025 strategic plan, the Center is encouraged
to maintain its focus on whole person health, promoting
research on multimodal approaches in treating pain and
emphasize improving individual health.
Pain and Pain Management Research.--The Committee includes
an increase of $26,000,000 for NCCIH to support research
related to pain and pain management, as requested in the fiscal
year 2022 budget.
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)
Appropriation, fiscal year 2021....................... $855,421,000
Budget request, fiscal year 2022...................... 878,957,000
Committee Recommendation.............................. 897,812,000
Change from enacted level......................... +42,391,000
Change from budget request........................ +18,855,000
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 $616,183,000 for the CTSA Program, an
increase of $29,342,000 above the fiscal year 2021 enacted
level and $14,683,000 above the fiscal year 2022 budget
request. The Committee notes that while the CTSA program works
to advance the full spectrum of medical research and modernize
our research enterprise, as demonstrated by the CTSAs being a
driving force behind the Federal effort to rapidly develop
COVID-19 treatments, diagnostic tools, and vaccines. Central to
the ongoing success of the CTSA consortium are individual CTSA
hubs that form a nationwide network. The Committee directs
NCATS to maintain the current size of the core awards
supporting CTSA hubs, including the institutional partners that
are part of the hubs, and historic structure of the CTSA
program. This ongoing approach reflects the central role of the
hubs, including each hub's partners, as critical national
research infrastructure and the core of the CTSA Consortium.
The Committee reiterates previous guidance that NCATS duly
inform the Committee of any planned changes to the size of
awards, scope of the program, or strategic direction of
emerging or ongoing CTSA initiatives. Further, NIH is
encouraged to further integrate the CTSA program into cross-
agency initiatives that can leverage the full spectrum of
medical research for progress on a variety of contemporary
topics.
CTSA Diversity Supplements.--The Committee supports efforts
by NCATS to promote diversity in the workforce, especially
though its research supplements. The Committee encourages NCATS
to ensure funding is available for its diversity research
supplements for the CTSA program, and distributed equitability
across CTSA hubs. Furthermore, the Committee encourages NCATS
to continue funding, through the existing CTSA hubs, expanded
programs that address the health inequities and significant
burden of diseases and other conditions that disproportionally
affect minority and special populations at both the community
health and individual levels through a variety of funding
mechanisms. Enhancing this capacity will contribute to reducing
health disparities and promote health equity. The Committee
also encourages continued support for CTSA efforts to engage
communities for the purposes of educating community
stakeholders and implementing proven clinical programs and
treatments, including vaccines. Applying the CTSA model to
address longstanding regional health disparities can provide
innovative, multi-disciplinary approaches to reducing the
burden of disease among vulnerable populations.
Collaboration with Business Incubators.--The Committee
urges NCATS to explore ways to increase the success in meeting
its mission by exploring funding opportunities or potential
collaborations with business incubators that host small to
midsize science, research, and pharmaceutical companies that
use services-based approaches to nurture and guide the member
companies to success. Collaborations with such business
incubators may offer the most effective way to advance
translational science. Priority consideration should be given
to nonprofit life science incubators that seek to advance
biotechnology, maximize synergies between nonprofit scientists
and their commercial colleagues, and launch new ideas and
discoveries that will make a difference including drug
discovery, biomarker discovery and translational biotechnology
around common research themes in an environment conducive to
interaction, collaboration, and focus.
Rare Disease Research.--The Committee recognizes the
incredible unmet need in the rare disease research community
and encourages NCATS to expand rare disease funding
opportunities, including, but not limited to, the Rare Diseases
Clinical Research Network. Accelerating rare disease research
will allow society to capitalize on the evolution of science in
rare diseases, leading to new treatments for the more than 95
percent of rare diseases without approved therapies and
lowering the nearly $1 trillion annual economic burden of rare
diseases.
Cures Acceleration Network.--The Committee includes
$60,000,000 for the Cures Acceleration Network, the same as the
fiscal year 2021 enacted level. The Committee does not include
bill language proposed in the budget that would establish this
program as a percentage of the NCATS appropriation.
JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)
Appropriation, fiscal year 2021....................... $84,044,000
Budget request, fiscal year 2022...................... 96,322,000
Committee Recommendation.............................. 96,842,000
Change from enacted level......................... +12,798,000
Change from budget request........................ +520,000
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.
COVID-19 has shown the importance of FIC's essential role
in global infectious disease health research training, pandemic
preparedness, and global health security by assisting low- and
middle-income countries (LMICs) in advancing their own research
and health solutions and tools. The FIC has developed important
partnerships in countries to not only fight infectious
diseases, but also to build their capabilities to detect and
treat infectious diseases. The COVID-19 pandemic illustrates
the importance of FIC's efforts to strengthen country capacity
to enable cutting edge research at the origin of outbreaks,
improving the likelihood that emerging diseases can be
addressed at their source--ultimately protecting American
health security. The Committee believes these longstanding
relationships and unique capabilities position FIC to play an
important and expanded role in pandemic preparedness, including
developing a network of modeling hubs and joint research
programs to engage LMIC investigators to collaboratively train
for pandemic preparedness. The Committee requests information
from FIC in the fiscal year 2023 Congressional Budget
Justification about how FIC training programs and research
collaborations have, and with additional resources can,
increase efforts to advance global health security and pandemic
preparedness. The Committee is particularly interested in
understanding FIC's unique capabilities and capacities as well
as coordination with other Federal government agencies engaged
in these efforts.
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
requested in the fiscal year 2022 budget.
NATIONAL LIBRARY OF MEDICINE (NLM)
Appropriation, fiscal year 2021....................... $463,787,000
Budget request, fiscal year 2022...................... 474,864,000
Committee Recommendation.............................. 486,769,000
Change from enacted level......................... +22,982,000
Change from budget request........................ +11,905,000
Mission.--The NLM collects and organizes information
important to biomedicine; serves as a national information
resource for medical education, research, and health service
activities; enhances access to biomedical literature through
electronic services; serves the public by providing electronic
access to reliable health information for consumers; supports
and directs the national network of libraries of medicine;
provides grants for research in biomedical communications,
medical library development, and training health information
specialists; conducts and supports research in biomedical
informatics and computational biology; and creates information
resources for genomics, molecular biology, toxicology, medical
images, environmental health, emergency preparedness and
response, and health services research.
OFFICE OF THE DIRECTOR (OD)
Appropriation, fiscal year 2021....................... $2,411,110,000
Budget request, fiscal year 2022...................... 2,237,259,000
Committee Recommendation.............................. 2,667,385,000
Change from enacted level......................... +256,275,000
Change from budget request........................ +430,126,000
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.
Addressing Maternal Mental Health Gaps.--The Committee
recognizes growing evidence that maternal mental health has
long-reaching effects on the physical, intellectual, and
emotional development of a woman's children. Pregnancy-related
mortality in the U.S. has steadily increased from 7.2 deaths
per 100,000 in 1987 to 17.3 deaths per 100,000 in 2017. Black
mothers are three to four times more likely than White mothers
to die from complications related to pregnancy or childbirth.
Maternal mental health disorders and associated symptoms are
common, and cases often go unreported and untreated. The
societal cost of untreated perinatal mood and anxiety disorders
(PMADs) can reach $14.2 billion, and those with PMADs have a
higher risk of suicide, cesarean deliveries, and work
absenteeism and presenteeism. The COVID-19 pandemic has
exacerbated the mental and physical toll on pregnant and
postpartum mothers. The Committee directs NIH to provide a
report within 180 days of enactment of this Act with the number
and description of research grants awarded over the past three
fiscal years that address maternal mental health outcomes for
women who are pregnant and one year postpartum. Further, the
Committee encourages the Department to ensure mental health is
incorporated in any efforts to reduce maternal mortality rates.
Adult Cellular Therapies.--To support collaborative
evidence development, the Committee encourages NIH, in
coordination with FDA and HRSA, to continue efforts to enhance
transparency regarding outcomes from adult cellular therapies
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 Therapeutic Outcomes Database
and ClinicalTrials.gov.
Advancing Cell-Based Therapies.--The Committee recognizes
that adult 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, including COVID-19. While results of
early clinical studies are promising, the primary barrier to
advancing such therapies is the significant cost of conducting
large-scale, randomized clinical trials--especially among
academic and research institutions and small biotechnology
companies--which are a precursor to bringing safe and effective
therapies to patients.
Therefore, the Committee directs NIH to develop and submit
a report within 180 days of enactment of this Act that
describes current NIH funding for adult cell-based therapies,
disaggregated by Institute and Center, and plans to support and
expand investments in such therapies. Such report shall
describe plans to support clinical trials; the
characterization, optimization, and scaling of manufacturing of
cell-based therapies; and collaborative evidence development,
including the development and operation of an outcomes
database. The Committee encourages NIH to consult outside
experts, including researchers who have conducted clinical
trials involving adult cell-based therapies, to inform its
activities related to cell-based therapies.
All of Us Program.--The Committee provides a total of
$541,000,000 for the All of Us precision medicine initiative,
$41,000,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request. The total includes
$150,000,000 authorized in the 21st Century Cures Act (P.L.
114-255) to be transferred from the NIH Innovation Account.
The All of Us initiative is a historic effort to collect
data from over one million people living in the U.S. to
accelerate research and improve health and serves as a national
research resource to support thousands of studies, spanning
various health conditions including COVID-19. More than 75
percent of these participants are from communities historically
underrepresented in biomedical research, and more than 50
percent are from racial and ethnic minority groups. The
Committee encourages NIH to increase its outreach through a
network of trusted community engagement partners to continue
enrollment of participants from diverse and underserved
populations.
ALS Research Coordination and Acceleration.--The Committee
is aware of the significant need to expand scientific
understanding of amyotrophic lateral sclerosis (ALS) and to
translate ALS science more rapidly into effective treatments
that can make ALS a livable disease. To achieve these outcomes
as soon as possible, the Committee directs NIH to organize a
trans-agency initiative to develop an ALS research strategic
plan. The plan, which should be developed in collaboration with
the nation's leading ALS patient and biomedical research
organizations, should: identify the most promising areas of
research and the specific NIH activities where additional
funding could lead to more rapid translation of discoveries for
treatments, prevention, and interventions or technologies that
can reduce the burden of ALS; identify which Institutes and
Centers are undertaking ALS and ALS-related research and which
are not but have a role to play; and uncover any impediments to
ALS research. As part of this effort, NIH should hold at least
one public meeting at which stakeholders can provide testimony.
This effort should include, but not be limited to: NINDS, NIA,
NIEHS, NIMH, NHGRI, NIAMS, and NCATS.
Additionally, The Committee strongly supports the
Transformative Research Award program for ALS and directs the
Director to continue to fund this critical initiative in fiscal
year 2022.
Finally, the Committee includes $1,000,000 to commission a
study by NASEM to identify and recommend actions for the
public, private, and nonprofit sectors to undertake to make ALS
a livable disease within a decade. Given the significant
adverse physical, financial, psychological impact this
progressive neurodegenerative disease has on the individuals
and families affected by it, a comprehensive assessment of what
is necessary to address its effects is warranted. The study
should include, but not be limited to: how to develop more
effective and meaningful treatments and a cure; interventions
to reduce and prevent the progression and complications of ALS;
the type and range of care and services people and families
with ALS need and how to ensure they receive comprehensive,
quality care; what care, services, and preventive measures
people at-risk of ALS need; and how to improve the quality of
life, health, and well-being of affected individuals and
families. The Committee directs NIH to submit this study to the
Committee no later than October 2024 and requests an update on
the status of this study in the fiscal year 2023 Congressional
Budget Justification.
Amyloidosis.--The Committee directs NIH to continue its
expansion of research efforts in amyloidosis, a group of rare
diseases characterized by abnormally folded protein deposits in
tissues. Amyloidosis is often fatal, and there is no known
cure. Current methods of treatment are risky and unsuitable for
many patients. Average survival without treatment is in months.
The Committee directs NIH to provide an update in the fiscal
year 2023 Congressional Budget 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.
Autoimmune Neuropathies.--The Committee notes the effect
that the pandemic had on the progress of a state-of-the-science
conference on autoimmune neuropathies research into conditions
like Guillain-Barre syndrome and chronic inflammatory
demyelinating polyneuropathy. The Committee supports continued
efforts on establishing this critical conference.
Biomedical Research Facilities.--The Committee includes
$50,000,000, the same as the fiscal year 2021 enacted level and
$50,000,000 above the fiscal year 2022 budget request, 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 that are large
enough to underwrite the cost of a significant portion 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 at risk across career stages. The Committee strongly
encourages NIH to study the race and gender breakdown of the
impact of COVID on participation in the workforce by monitoring
the types of awards applied for and granted by gender, race,
and ethnicity for two years. If the data demonstrate that fewer
women are applying for grants, then it is imperative that NIH
take steps to address this disparity. The Committee requests a
status update from NIH on this research in the fiscal year 2023
Congressional Budget Justification as well as the steps being
taken to maintain and stabilize the diversity of the biomedical
research workforce.
Biosafety Labs.--The Biosafety in Microbiological and
Biomedical Laboratories (BMBL) recommends as a special practice
the reporting of all laboratory incidents and near misses in
Biosafety Lab (BSL) BSL-3 and BSL-4 laboratories. The Committee
directs NIH to ensure all funding for BSL-3, BSL-4, high
containment laboratory, or any entity involved in managing
Hazardous Biological Agents both foreign or domestic maintains
up to date, comprehensive policies, to promote optimal
Biosafety and Biosecurity practices. Such policies must
reference (1) incident reporting, (2) roles and
responsibilities, (3) training, (4) inventory control, and (5)
inspections and must be reported to NIH and/or related
agencies.
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. The Committee directs 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. In addition, the Committee
recognizes the need to increase the number of biomedical
research professionals as leaders in critical areas of national
need. The Committee directs NIH to establish a scholarship
program that encourages African American students to pursue a
career in medicine, science, and biomedical research to combat
the persistent decline of Black male physicians over the last
decade.
Brain Cancer.--The Committee recognizes that certain types
of brain cancers are associated with high mortality and
morbidity rates. Primary brain tumors, such as glioblastoma
multiforme, have a five-year survival rate of five percent in
adults and less than 20 percent in children. 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 in order to evaluate
and develop treatments and safe delivery systems to benefit
both species.
Center for Alternatives to Animals in Research and
Testing.--The Committee directs NIH to submit a plan not later
than 180 days after enactment of the Act for the establishment
of a Center for Alternatives to Animals in Research and Testing
within NIH, for the purposes of (1) developing, promoting, and
funding alternatives to animal research and testing, and (2)
developing a plan for reducing the number of animals used in
Federally funded research and testing.
Childhood Post-Infectious Neuroimmune Disorders.--The
Committee continues to be concerned that some children,
following streptococcal and other infections, may experience
the onset of neuropsychiatric and behavioral disorders. These
auto-inflammatory encephalopathic conditions include Pediatric
Autoimmune Neuropsychiatric Disorders Associated with
Streptococcal Infections (PANDAS) and Pediatric Acute-onset
Neuropsychiatric Syndrome (PANS). Due to a paucity of research
and limited avenues of treatment, children continue to
encounter significant delays in identification and treatment,
resulting in escalation of mental health symptoms and
associated costs. The incidence of neurological and psychiatric
symptoms associated with SARS-CoV-2 underscores the need for
research that expands our understanding of neuropsychiatric
illness following infection. Because these complications lie at
the nexus of medical and mental health, investigations into
their mechanisms have far-reaching implications. The Committee
encourages NIH to explore cross-disciplinary research in this
area, including neurobiology, neurology, immunology,
rheumatology, infectious disease, and mental health, and report
to the Committee in the fiscal year 2023 Congressional Budget
Justification on the understanding of the incidence, causes,
diagnostic criteria, and treatment of these conditions.
Chronic Fatigue Syndrome.--The Committee encourages NIH to
expand ME/CFS efforts such as new ME/CFS disease specific
funding announcements to deliver needed diagnostics and
treatments as quickly as possible and mechanisms to incentivize
researchers to enter the field.
Cockayne Syndrome.--The Committee recognizes that Cockayne
Syndrome is a rare hereditary autosomal recessive disorder that
disproportionately impacts children. It has no known
treatments, therapies, or cures. Cockayne Syndrome presents
unique research challenges for many reasons, including
difficulty in accruing enough patients to participate in
clinical trials and a lack of industry focus on such rare
genetic diseases due to the relatively small number of patients
diagnosed with this disease. The Committee strongly encourages
NIH to expand funding on research on Cockayne Syndrome,
including but not limited to gene replacement therapy.
Collection and Reporting of Animal Research Numbers and
Agency Funding.--The Committee recognizes that Congress has
long expressed an interest in reducing the use of nonhuman
animals in NIH-funded research and replacing animals with
valid, reliable alternatives. In the National Institutes of
Health Revitalization Act of 1993, Congress first requested
that 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.
Integral to that commitment are the accurate counting of
animals used in research and testing and the accurate reporting
of NIH funding dedicated to projects involving animals. The
Committee recognizes that it has been NIH's policy since 1985
to collect an ``average daily inventory'' of vertebrate animals
housed in research facilities that wish to receive agency
funding. The Committee understands that domestic facilities are
required to file such documentation every four years as part of
an Animal Welfare Assurance and that copies of the documents
are available to the public only through Freedom of Information
Act requests. The Committee requests a report from NIH within
120 days of enactment of this Act outlining a plan for
increasing the accuracy and transparency of collecting and
publicly disseminating research animal numbers. The plan should
explain how NIH will collect the information annually and
include a draft form that requires the total number of animals
per species bred and used in the previous year and assigns all
animals to a pain and distress category. The plan should also
include details on how NIH will create a publicly accessible
online database for dissemination of this information.
Secondly, the Committee requests that NIH include in its report
a plan for implementing a system that tracks which agency-
funded projects involve the use of animals and makes the
information publicly accessible. The Committee recognizes that
NIH currently collects such information with every grant
application using the Research & Related Other Project
Information form, which asks applicants to answer ``Yes'' or
``No'' to the question ``Are Vertebrate Animals Used?'' NIH's
plan should ensure that the answer to that question for each
funded project is searchable via the Expenditures and Results
module of NIH's Research Portfolio Online Reporting Tools
website as many other categories of information are.
Common Fund.--The Committee recommends $657,112,000 for the
Common Fund (CF), and an additional $12,600,000 provided to
support the Gabriella Miller Kids First Research Act for the
seventh year of the ten-year Pediatric Research Initiative.
This is $21,173,000 above the fiscal year 2021 enacted level
and $11,173,000 above the fiscal year 2022 budget request.
COVID-19 Technology Access Pool.--The Committee understands
that the World Health Organization has developed a COVID-19
Technology Access Pool (C-TAP), which aims to facilitate access
to COVID-19 health products by sharing intellectual property
through pooling and voluntary agreements. The Committee
strongly urges the Secretary, in partnership with NIH, to
consider what contributions NIH could make to C-TAP.
Cybersecurity.--The Committee includes an increase of
$100,000,000 to support expanded cybersecurity efforts at NIH,
as requested in the fiscal year 2022 budget. Funding will
enhance Security Operations Center functions, expand threat
mitigation and incident response capabilities, implement
important architectural improvements to the NIH network, and
implement tools and technologies to allow real time monitoring
of activity across a variety of sources.
Diversity at NIH Working Group and Strategic Plan.--The
Committee is encouraged by NIH's demonstrated commitment to
diversity and thanks the NIH for acting on the fiscal year 2021
request to develop a strategic plan that includes long- and
short-term goals to address disparities at NIH. The Committee
understands that NIH is beginning robust outreach to
traditionally marginalized communities to lay the foundation
for a comprehensive strategic plan and encourages NIH to
continue this line of work in order to fully understand the
scope of need in this area, properly make recommendations, then
develop and implement strategies to increase inclusivity and
diversity in biomedical science while aligning with Executive
Order 13985 on Advancing Racial Equity and Support for
Underserved Communities Through the Federal Government. The
Committee directs NIH to provide quarterly briefings to the
Committee on the progress of the development of the strategic
plan.
Diversity in NIH Clinical Trials.--While 40 percent of
Americans belong to a racial or ethnic minority, 80 to 90
percent of participants in clinical trials are White. Patients
in underserved communities are often less comfortable enrolling
in clinical trials or are unaware of how to do so, excluding
them from the opportunity to access potentially lifesaving
treatment. Further, it is essential that NIH researchers
develop a comprehensive understanding of how treatments impact
various populations. The Committee encourages NIH to increase
proactive outreach efforts to patients in minority and
underrepresented communities and providers serving these
populations, to improve awareness of clinical trials and
understanding of how patients can participate.
Duchenne Muscular Dystrophy.--Duchenne muscular dystrophy
is a severe form of muscular dystrophy for which there is no
cure and for which life expectancy is in the second or third
decade. The Committee urges NIH to establish a framework for
data sharing and sharing of specimens generated or collected
within six months of completion of any NIH-funded clinical
study. The Committee also urges NIH to support methodological
research on challenges related to gene therapies, such as
enabling delivery to individuals with neutralizing antibodies
to viral vectors, manufacturing supply to ensure all patients
can receive treatment, and minimizing potential life-
threatening immune response to high viral doses.
Early Career Researchers.--The Committee recognizes the
importance of awards intended to support training of early-
stage researchers, including physician scientists. The
Committee is also aware of the negative impact the ongoing
COVID-19 pandemic has had on research career trajectories and
that these challenges are particularly burdensome on early-
career researchers who have yet to achieve research
independence. The Committee commends NIH for allowing holders
of fellowship and career development awards to apply for funded
and no-cost extensions but is concerned about the possibility
of uneven levels of support between Institutes and Centers,
unclear qualifying standards, and demand that may exceed
resources. To address these concerns, the Committee encourages
NIH to develop and disseminate a standardized approach to
support eligible investigators across Institutes and Centers.
The Committee also encourages NIH to develop a funding
opportunity for a trans-NIH early career development award
targeted to investigators working in pediatrics that would
build upon the Next Generation Researchers Initiative and other
initiatives and to provide an update on these efforts to
Congress within 180 days of enactment of this Act.
Eating Disorders.--The Committee commends NIH for
supporting multi-Institute research on the chronic, fatal, and
serious mental illnesses encompassing eating disorders that
affect 30,000,000 Americans during their lifetimes, and its
association with other conditions such as diabetes,
infertility, heart disease, PTSD, substance use, co-morbid
mental illnesses, and tooth decay. The Committee encourages NIH
to increase support for eating disorders research and
encourages the relevant Institutes and Centers, including NIMH,
NIMHD, NICHD, and NIDA, to collaborate to address research gaps
in genetics, prevention, diagnosis, and treatment of eating
disorders.
Ehlers-Danlos Syndrome.--The Committee encourages NIH to
support research and 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 2021 enacted level and the fiscal year 2022 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.
The Committee includes funding for ECHO in the Office of the
Director, consistent with previous years.
Federal Advisory Committees Transparency Initiative.--The
Committee recognizes that Federal advisory committees
established pursuant to 42 U.S.C. 282(b)(6) fill an important
role in advising NIH on major decisions on plans and policies.
However, to guarantee due process, it is vital that all NIH
Federal advisory committees operate in a transparent way. The
Committee recognizes that one particular NIH Federal advisory
committee, the Literature Selection Technical Review Committee
(LSTRC), has not made its review process clear or transparent.
As such, the Committee directs the LSTRC, within 60 days of
enactment of this Act, to make public all documents and any
other relevant information related to its: (1) processes for
and standards of review, including the scope of the review, a
timeline and detailed steps of the review, and any other
guidelines used to ensure objective reviews; and (2) decision-
making processes and methodologies, including scoring rubrics,
metrics, and any other guidelines used to ensure objective
decisions. The Committee further directs the LSTRC, within 60
days of enactment of this Act, to make available detailed
instructions regarding how to appeal its decisions. Moreover,
the Director of NLM shall ensure and certify to the Committee
that the LSTRC is operating in accordance with the provisions
of the Federal Advisory Committee Act (FACA), as amended (5
U.S.C., Appendix 2).
Firearm Injury and Mortality Prevention Research.--The
Committee includes $25,000,000 to support research on the
prevention of gun violence, $12,500,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. The Committee also requires NIH and CDC 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 Animal Research.--The Committee requests additional
information in the fiscal year 2023 Congressional Budget
Justification about how NIH monitors and ensures foreign
institutions' compliance with applicable laws, regulations, and
policies governing NIH-funded animal research.
Foreign Threats to Research.--Foreign actors continue to
engage in the theft of intellectual property from NIH and its
grantees, posing threats to national security. The Committee
directs NIH to provide quarterly 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 provide $5,000,000 to the Inspector General to
continue additional investigations into this issue. The
Committee also includes an increase of $2,500,000 for the
Office of Extramural Research to expand its resources dedicated
to reviewing potential cases of fraud.
Fragile X.--The Committee commends NIH for funding three
Fragile X Centers within the guidelines established in the
Strategic Plan for Research on FMR1-Related Conditions. 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 look at existing pilot studies that are
exploring innovative ways to screen newborns, and to coordinate
efforts and research with the CDC as they consider screening
solutions for FMR1-related conditions.
Gabriella Miller Kids First Pediatric Research Program.--
The Committee recognizes that pediatric cancer is a leading
cause of death among children and is 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 Pediatric Research Program enables
researchers to uncover new insights into the biology of
childhood disease. 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 disease and provides
$12,600,000 to support pediatric research as authorized by the
Gabriella Miller Kids First Research Act (P.L. 113-94).
Gene-Environment Interactions in Neurodegenerative
Disorders in the Diverse Populations of African Americans and
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 21st Century
Cures Act and the BRAIN Initiative. The Committee recognizes
the need to better understand the interactions between genetics
and environmental factors, in particular with older and diverse
populations of African Americans and Latinos. The Committee
encourages NIH to accelerate collaborative research across
relevant Institutes and Centers and the research community to
address the goal of determining the role of the interaction
between environmental exposures to toxic chemicals and genetics
and their impact on neurodegenerative disorders in diverse
populations of African Americans and Latinos, to allow for
earlier diagnosis and subsequent treatment to arrest the
progression of these devastating neurodegenerative disorders.
Harassment Policies.--The Committee is deeply frustrated by
NIH's failure to implement its direction to address harassment
in extramural research settings. Both the Statement of managers
accompanying the Further Consolidated Appropriations Act, 2020
(Public Law 116-94) and the Consolidated Appropriations Act,
2021 (Public Law 116-260) directed NIH to revise its guidance
to make clear that grantees must identify any changes to key
personnel on an award that are related to concerns about
harassment. The Committee has included a new general provision
to require institutions that receive NIH funding to notify the
agency when key personnel are removed from their position for
harassment.
Health Disparities for Persons with Disabilities.--Despite
being uniquely affected by COVID-19, people with disabilities
experienced gaps and inequities in health care in the response
to the COVID-19 pandemic. This illustrates that there is a need
for increased data collection to provide policymakers with
necessary information to improve pandemic planning and
outcomes. The Committee strongly encourages NIH to examine
health and health care inequities more broadly for people with
disabilities, including those with physical, sensory,
cognitive, intellectual and developmental, and psychological
disabilities. The Committee strongly encourages NIH to fund
research on identifying inequities in health and health care
for people with disabilities and to support research that
develops and evaluates interventions to reduce these
disparities, including approaches that focus on addressing
systemic and community-level barriers.
HEALthy Brain and Child Development (HBCD) Study.--The
Committee recognizes and supports the HEALthy Brain and Child
Development Study, which will establish a large cohort of
pregnant women from regions of the country significantly
affected by the opioid crisis and follow them and their
children for at least 10 years. This knowledge will be critical
to understanding typical brain development and how pre- and
postnatal exposure to opioids and other substances or adverse
environments affect brain development and other outcomes,
including risk for future substance use, mental health
disorders, and other behavioral and emotional difficulties and
disorders. The Committee recognizes that the HBCD Study is
supported in part by the HEAL Initiative, and NIH Institutes,
Centers, and Offices, including OBSSR, ORWH, NIMHD, NIBIB,
NIEHS, NICHD, NINDS, NIAAA, NIMH, and NIDA, and encourages
other Institutes and Centers to support this important study.
Hearing Health Screening for Older Americans.--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
2023 Congressional Budget Justification on hearing screening
research for older adults across the NIH. The Committee
encourages NIDCD and NIA to support studies that address the
research needs and gaps identified by the U.S. Preventive
Services Task Force (USPSTF) review of hearing screening
recommendations for older Americans.
Hepatitis B.--The Committee recognizes the estimated $4
billion of annual medical costs associated with the care and
treatment of those infected with the hepatitis B virus and
urges NIH to redouble its efforts to identify more effective
treatments for the disease. While there are treatments
available to control HBV, they must be taken for years if not
for life. Without treatment, one in four of those infected will
die prematurely from cirrhosis, liver failure, and/or liver
cancer. This serious public health threat results in over
800,000 worldwide deaths each year, making it the tenth leading
cause of death in the world. The Committee commends NIH for it
support in the development of the 2019 Strategic Plan for
Trans-NIH Research to Cure Hepatitis B and urges NIH to help
implement the plan by issuing new targeted calls for research.
The Committee requests that NIH support an update of the
Strategic Plan for Trans-NIH Research to Cure Hepatitis B and
that it submit it to the Committee, within 180 days of
enactment of this Act, a specific plan to pursue a cure for
hepatitis B in coordination with the Trans-NIH Hepatitis B
Working Group.
Humane Research Alternatives.--Recognizing that humane,
cost-effective, and scientifically suitable non-animal methods
are available but underutilized, the Committee requests that
NIH assemble a panel to investigate and make recommendations
regarding incentives for more quickly and effectively moving
NIH intramural and external research away from methods that
rely on animals to methods that rely on non-animal methods
including epidemiological and clinical studies, cell-based
methods, computer modeling and simulation, and human tissue
studies. The panel should review and recommend means of
encouraging greater reliance on human-relevant non-animal
methods/approaches. Panel membership should include individuals
with proven knowledge of/experience with non-animal research
methods; with expertise in evaluating the adequacy of searches
for non-animal methods/approaches described in research
proposals; and with knowledge of the welfare concerns and
scientific limitations of animal-based studies. The Committee
asks that NIH provide a report of the panel's findings within
60 days of enactment of this Act.
Impact of Technology and Digital Media Use Among Infants,
Children, and Teens.--The Committee remains concerned about the
impacts of technology use and media consumption on infants,
children, and adolescents, especially during the COVID-19
pandemic. COVID-19 has resulted in closures of schools, sports,
and extracurricular activities giving children less access to
offline social opportunities and resulting in increased time
children spend on screens and digital media. 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 encourages
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.
INCLUDE Initiative.--The Committee includes no less than
$80,000,000, an increase of $15,000,000 above the fiscal year
2021 enacted level, within OD for the INCLUDE Initiative. The
Committee is pleased that this multi-year, trans-NIH research
initiative has enabled significant advances in understanding
immune system dysregulation, new research into the connection
with Alzheimer's disease, and the creation of national Data
Coordinating Center, all of which may dramatically improve the
health and quality of life of individuals with Down syndrome as
well as millions of typical individuals. The Committee
encourages NIH to pursue some of the most neglected areas of
research and care such as health disparities for African
Americans with Down syndrome, mosaic Down syndrome, those with
the dual diagnosis of Down syndrome and autism, and new studies
on metabolic dysregulation. The Committee requests the Director
provide an updated plan within 60 days of enactment of this Act
that includes a timeline, 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.
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 urges NIH to
expedite planned and ongoing studies already nominated and
established through the National Toxicology Program (NTP). The
Committee is concerned that some of these studies were
nominated in 2001 but have yet to be conducted. The Committee
also urges NIH to prioritize new research, explore the causal
links, and interventions to the potential neurotoxic,
immunosuppressive, immunoreactive, autoimmune, 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. The Committee requests an update
in the fiscal year 2023 Congressional Budget Justification on
its efforts.
Inflammation.--Inflammation is one of the body's major
defense mechanisms in response to infection or injury, but when
it is uncontrolled, it causes inflammatory diseases such as
cardiometabolic diseases (such as hypertension, obesity, and
diabetes), neurodegenerative diseases (such as Alzheimer's
disease and dementia), and mood disorders (such as depression).
The Committee supports and encourages NIH to fund research into
how inflammation may contribute to these various disorders.
Inflammatory Bowel Disease (IBD).--The Committee is aware
of current and emerging NIH priorities focused on nutrition,
including the recently finalized Strategic Plan for NIH
Nutrition Research and the Common Fund's Nutrition for
Precision Health initiative. Given these priorities, the
Committee encourages NIH to coordinate across Institutes and
Centers focused on nutrition research to support research to
understand the relationship between food and immune-mediated
conditions, including IBD. This may include research on the
development of evidence-based anti-inflammatory diets and the
roles such diets can play in managing IBD and other immune-
mediated conditions.
Lung Cancer Research.--The recent decline in cancer
mortality that has been fueled by progress in lung cancer is
directly attributable to NIH-funded research. Advances in the
understanding of the molecular underpinnings of lung cancer and
the 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 therefore encourages the NIH to continue supporting
important research across these areas, to broaden the base of
lung cancer survivors across different disease types, including
small cell lung cancer.
Lyme and Other Tick-Borne Diseases.--The Committee
encourages NIH to support research on early diagnosis and
treatment of Lyme and other tick-borne diseases (TBD) to
prevent the development of late stage disease and more serious
and longer-term disability, but also to intensify research on
diagnosis and treatment of late stage and chronic disease.
Priority should be based on disease burden, which CDC has
indicated for Lyme disease to be approximately 476,000 people
diagnosed and treated annually in the U.S. Lyme has a
significant patient population who are not diagnosed until late
stage, when treatment is more difficult, and a significant
percentage of patients who relapse and go on to develop chronic
symptoms. Along with development of highly sensitive and
specific diagnostics for all stages of disease, a goal should
be to develop diagnostics with appropriate sensitivity and
specificity for the detection of subclinical or low-level
infection for use in disease eradication. Treatments for all
stages of Lyme and other TBD, determining optimal combinations
of new candidate or older drugs and exploring novel
combinations should be developed. Although a cure may be
defined to include sustained remission, a goal of treatment
should be eradication of the pathogen, in which case resurgence
is not possible.
The Committee is gratified that NIH officials have
recognized the need for further exploration of maternal-fetal
or vertical transmission of Lyme disease and the occurrence of
adverse outcomes among women with untreated and disseminated
Lyme disease during pregnancy. 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 U.S. Air Force Bases.--The
Committee remains concerned about NIH's intention to retain
government-owned chimpanzees at the Alamogordo Primate Facility
(APF), a laboratory facility, instead of retiring them to the
national chimpanzee sanctuary, Chimp Haven. While NIH cites the
health condition of the chimpanzees as a reason to warehouse
them at APF, the health condition of the chimpanzees and their
long history of laboratory use makes it urgent that they be
provided an opportunity to live the remainder of their lives in
sanctuary, even if for a short period. The Committee directs
the NIH to resume transport of government-owned and supported
chimpanzees beginning with chimpanzees at APF. Movement of
chimpanzees from Southwest National Primate Research Center
(SNPRC) and Keeling Center for Comparative Medicine and
Research (KCCMR) should follow transport of the APF chimpanzees
to Chimp Haven. The Committee also directs the NIH to provide a
written report to the Committee every 180 days, beginning no
later than December 31, 2021, 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, SNPRC or
KCCMR; (3) a list of any chimpanzee deaths that have occurred
at any time after January 1, 2020, at either APF, SNPRC, KCCMR,
or the national sanctuary system, and (4) the plan, including
the timeline, for transferring the chimpanzees from APF, SNPRC,
and KCCMR to Chimp Haven.
Maternal Infections.--The Committee requests an update on
research to better understand and prevent congenital
cytomegalovirus in the fiscal year 2023 Congressional Budget
Justification.
Modeling and Simulation Technology Deployment.--The
Committee encourages NIAID, NIBIB, and other NIH Institutes and
Centers as appropriate, to support the development and study of
in silico approaches to accelerate vaccines for emerging
infectious diseases including, but not limited to,
computational simulation, data analytics, and the digital
patient model, with the objective of reducing the time to
market for virus vaccines.
National Laboratories.--NIH funding supports investments
which are collaborative with the ongoing work of the Department
of Energy. The Committee directs NIH to provide an update in
the fiscal year 2023 Congressional Budget Justification 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 would benefit from 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.
National Primate Research Centers.--The Committee does not
include funding directed towards expanding non-human primate
resource infrastructure. The budget request included
$50,000,000 for this activity.
National SARS-CoV-2 Genomic Surveillance Program.--New
SARS-CoV-2 variants continue to emerge across the globe,
including variants that may have increased transmissibility and
potential to evade vaccines. This dire situation demonstrates
the need for a comprehensive genomic sequencing and
surveillance program to discover and track the spread of these
variants and devise appropriate public health countermeasures.
The Committee directs NIH and CDC, in coordination with other
HHS agencies as appropriate, to continue to expand national
genomic surveillance to rapidly scale up sequencing of viral
samples and dissemination of SARS-CoV-2 genomic data.
Native Hawaiian/Pacific Islander Health Research.--The
Committee encourages NIH to place high priority on addressing
the research needs of Native Hawaiian and Pacific Islander
Health Research. The OD, in coordination with NIMHD and other
Institutes and Centers, should work closely with NHPI
communities and NHPI-serving organizations, which are located
in States with significant NHPI populations to allow for the
development of future researchers and scientists from these
same communities.
Natural History Museums as Critical Contributors to Virus
Research.--The Committee notes that the nation's natural
history museums provide an unparalleled resource for studying
zoonotic diseases such as COVID-19. These museums hold millions
of animal samples collected over decades from across the globe,
offer deep and broad scientific expertise, and are uniquely
positioned to assist in preparing for and predicting the next
pandemic-causing viruses. The Committee encourages increased
utilization and support of this largely untapped resource.
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, as
well as deafness, blindness, developmental delays, and autism.
The Committee encourages NCI to continue to support a robust 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 encourages NEI, NINDS, and NIDCD to continue to
aggressively fund 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 are at significant risk for autism, learning
disabilities, motor delays, and attention deficits, the
Committee encourages NINDS, NIMH, and NICHD to support
laboratory-based and patient-directed research investigations
in these areas. Since NF2 accounts for some genetic forms of
deafness, the Committee encourages NIDCD to continue its
investment NF2-related research. NF1 can cause vision loss due
to optic gliomas. The Committee encourages NEI to support NF1-
focused research on optic gliomas and vision restoration.
NIH Division of Police.--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 Director 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 further directs the NIH Division of Police,
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.
Office of AIDS Research.--The Committee includes no less
than $3,290,000,000 for HIV/AIDS research, an increase of
$200,000,000 above the estimated fiscal year 2021 level.
Office of Behavioral and Social Sciences Research
(OBSSR).--The Committee includes $49,827,000 for OBSSR, an
increase of $20,000,000 above the fiscal year 2021 enacted
level and $19,523,000 above the fiscal year 2022 budget
request. The Committee notes that OBSSR has the mission to
enhance NIH's behavioral science research enterprise across all
Institutes and Centers. As multiple Surgeons General and NASEM
have declared that most health problems facing the nation have
significant behavioral components, the Committee strongly
supports the continued strengthening of the behavioral science
enterprise at NIH and urges OBSSR funding be increased to
accomplish this mission. In this regard, the Committee is
pleased that an NIH working group has been established to
review how better to integrate and realize the benefits of
overall health from behavioral research at NIH, and directs
that appropriate OBSSR funding levels, authority, and
organizational structure be included in this review.
Office of Nutrition Research.--The Committee is encouraged
by recent efforts to prioritize nutrition research across
Institutes and Centers, including the release of first NIH-wide
strategic plan for nutrition research. As such, the Committee
supports the transfer of the Office of Nutrition Research to OD
and encourages the Director to allocate sufficient resources to
this office to ensure it can operate effectively as a trans-NIH
entity.
Office of Research on Women's Health.--The Committee
includes $61,480,000 for the Office of Research on Women's
Health, an increase of $17,555,000 above the fiscal year 2021
enacted level and $9,177,000 above the fiscal year 2022 budget
request. This office ensures women's health research and
research on the biological and sociocultural influence of sex
and gender are included within the larger NIH scientific
framework. Congress recognizes that ORWH is the first public
health service office to officially promote women's health
research within and beyond the NIH scientific community. ORWH
provides critical leadership to develop research programs like
the Specialized Centers of Research Excellence (SCORE), a
program designed to expedite the development and application of
new 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
Committee applauds ORWH's effort to encourage research across
many scientific disciplines to examine how sex and gender
factors influence health and contribute to various diseases.
Within the total, the Committee includes an additional
$2,000,000 expand the number of sites in the Building
Interdisciplinary Research Careers in Women's Health (BIRCWH)
program, an initiative that aims to increase the number and
skills of investigators who conduct research on sex and gender
influences on health and disease. ORWH is encouraged to expand
the program to less-resourced institutions, such as HBCUs,
tribal colleges and Institutions of Emerging Excellence.
Office of the Chief Officer for Scientific Workforce
Diversity.--The Committee includes $22,000,000 for the Office
of the Chief Officer for Scientific Workforce Diversity,
$16,000,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request.
OIG Transfer.--The Committee includes $5,000,000, the same
as the fiscal year 2021 enacted level and the fiscal year 2022
budget request, for transfer to the HHS OIG to support
oversight of NIH activities.
Parkinson's disease (PD) and Dementia.--The Committee
recognizes that although Parkinson's 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 of Parkinson's, PD represents an under-explored
opportunity to study the onset and progression of dementia. The
Committee strongly urges NINDS and NIA 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 2023
Congressional Budget 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. Emerging data also link the risk of severe COVID-
19 with certain factors such as low vitamin D levels,
hyperandrogenism, inflammation, and ethnicity predisposition,
all of which are directly associated with PCOS. The Committee
encourages NHLBI, NICHD, ORWH, and NIDDK to support research
investigating the risk of severe SARS-CoV-2 infection in the
PCOS patient population and the strong overlap of risk factors
for both worse PCOS cardio-metabolic manifestations and severe
COVID-19. Findings should be disseminated to health care
providers, PCOS patients, and the public, as well as
highlighted for clinical practice. The Committee also
encourages NIH to report on research that has been conducted on
PCOS and its impact on cardio-metabolic health to date in the
fiscal year 2023 Congressional Budget Justification. Finally,
the Committee requests that PCOS be added to the NIH Research,
Condition, and Disease Categories reporting.
Post-acute COVID and Chronic Fatigue Syndrome (ME/CFS).--
The Committee commends NIH on its ongoing ME/CFS efforts,
including the rapid expansion of research regarding post-acute
COVID-19 syndrome (PACS) and its potential connections to ME/
CFS, its leadership in the Interagency Working Group for ME/
CFS, and the recent success of mapMECFS and searchMECFS
projects. The Committee recognizes the scientific and clinical
opportunities in post-viral research and strongly encourages
NIH to continue and expand its efforts to understand the
underlying causes and risk factors for individuals with PACS
and ME/CFS, with a focus on diagnosis, treatment, and
prevention. The Committee encourages NIH to accelerate and
expand efforts related to PACS and ME/CFS; such as (1)
investing and collaborating to form large data sets through
patient registries, biobanks, and interdisciplinary research
investment (2) issuing PACS and ME/CFS disease specific funding
announcements (3) coordinating an initiative to develop
consensus on the diagnosis of PACS and the selection criteria
for study participants involved in ME/CFS research, and (4)
implementing mechanisms to incentivize new and early career
researchers to enter and contribute data to the ME/CFS
scientific field.
Primary Mitochondrial Disease Research.--The Committee is
aware that NIH has spearheaded a number of initiatives to
identify new mitochondrial disorders, discover the linkages
between mitochondrial disorders, and translate advances in
mitochondrial research to treatments, cures, and other medical
interventions for mitochondrial disorders and their secondary
diseases, such as Alzheimer's disease, Parkinson's disease, and
cancer. Given the advancements seen through peer-reviewed
research into mitochondrial disorders at several academic sites
across the nation, the Committee encourages NIH to increase its
funding of primary mitochondrial disease research and requests
the agency provide an update on these efforts within 180 days
of enactment of this Act.
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 treatment
resistant post-traumatic stress disorder (PTSD) and major
depressive disorder, particularly for veteran participants. 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.
Rare Disease Research.--The Committee is aware that nearly
one in ten individuals in the U.S. is affected by a rare
disease, and that rare diseases frequently are genetic or have
a genetic component. The Committee urges NIH to expand research
on rare genetic and chromosomal abnormalities, such as 7q11.23
Duplication Syndrome and Hereditary Spastic Paraparesis 49
(TECPR2). The Committee directs NIH to provide an update on
these two conditions in the fiscal year 2023 Congressional
Budget Justification.
Research on Long COVID.--The Committee commends NIH for
undertaking a major initiative to research the causes of, and
the best ways to prevent and treat, what is often referred to
as Long COVID, which occurs when individuals experience a
variety of symptoms long past the time that they have recovered
from the initial stages of COVID-19 illness. Symptoms can
include fatigue, exercise intolerance, shortness of breath,
trouble with memory and concentration, headache, sleep
disorders, orthostatic tachycardia, chest, muscle and joint
pains, fevers, gastrointestinal symptoms, anxiety, post-
traumatic stress disorder, and depression, can last for months
or longer, and can range from mild to incapacitating. In
addition, it is unclear to what extent COVID-19 and its long-
term effects may interact with pre-existing conditions such as
vascular and neurodegenerative diseases, potentially changing
their course and morbidity. The Committee directs NIH to
sustain and strengthen its research into Long COVID. As part of
this research, the Committee urges NIH to study Long COVID in
children and youth.
Furthermore, the Committee recognizes that the COVID-19
pandemic has exposed an array of related health disparities,
including a difference in severity and outcomes between female
and male patients due to sex and gender influences. This is
also true for individuals who continue to experience COVID-19
symptoms and/or damage to organs to varying degrees months
after their initial diagnosis. To better understand how sex
differences are implicated in the severity of the COVID-19
pandemic, the Committee encourages the Institutes and Centers
of the NIH in coordination with the NIH Office of the Director
and Office of Women's Health Research to support research that
studies how sex as a biological variable impacts short and
long-term outcomes due to infection with SARS-CoV-2.
SARS-CoV-2 Genomic Sequence Data.--The Committee is
concerned by reports that early SARS-CoV-2 genomic sequence
data from China, specifically the Wuhan region, were withdrawn
from the Sequence Read Archive (SRA) at the National Institutes
of Health. The Committee is aware of allegations that the
Chinese Communist Party has refused to provide raw data to
international scientists and the World Health Organization to
impede the investigation into the origins of Covid-19. From the
beginning of the pandemic, there have been suggestions that the
Chinese Communist Party barred scientists from releasing data
and even delayed the release of the genetic map of the virus to
the world. The Committee understands that it is difficult to
identify, early in pandemics, what data may be most relevant
because of the disperse nature of initial reports and the
uncertainty surrounding an emerging virus--however, some
scientists have cited difficulties in studying the origins of
the virus due to a lack of early data from Wuhan. Furthermore,
the Committee is aware that there are legitimate reasons to
request the withdrawal of genomic sequence data from SRA,
including insufficient data quality and incomplete consent
procedures, however, the early sequence data at issue here may
be key to understanding the origin of SARS-CoV-2. Within 30
days of the enactment of this Act, the Director of the National
Institutes of Health shall report to the Committee on the
withdrawal of SARS-CoV-2 genomic sequence data from the
Sequence Read Archive. The report should include the total
number of requests for withdrawals of SARS-CoV-2 data broken
down by institution, the number of sequences that were
subsequently withdrawn from the SRA, the reasons provided by
the institution for the request for withdrawal, any
characteristics provided for the sequences and other pertinent
information, as well as any pending requests for SARS-CoV-2
genomic sequence withdrawals.
Sickle Cell Disease (SCD).--The Committee commends NIH for
its ongoing support of clinical research for SCD, which imposes
major morbidity on an estimated 90,000 to 100,000 individuals
in the U.S., with three million Americans carrying the sickle
cell trait. The Committee encourages NIH to support clinical
trials for prenatal and postnatal treatment of SCD, which
includes a wealth of promising approaches to eradicate this
disease, save lives, and dramatically reduce the substantial
health care costs associated with SCD for both children and
adults. The NIH is encouraged 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 to cure SCD. The Committee encourages NHLBI and
NHGRI to collaborate on research on Sickle Cell Trait. It is
critical to better understand the risks for health
complications and the potential link to severe illness and risk
of death from COVID-19 for the one to three million Americans
living with Sickle Cell Trait, the single gene mutation for
SCD.
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; and report out by Institute 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.
Finally, the Committee encourages NIH to support research on
the potential causes behind a growing incidence and prevalence
of bladder cancer in individuals with Spina Bifida.
Thalassemia.--Nutrition can be an important tool in the
management of rare diseases. Currently, there is no 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.
Trans-NIH Pediatric Research Consortium.--The Committee is
aware of the Trans-NIH Pediatric Research Consortium (N-PeRC)
that was established in 2018 to better coordinate and support
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 as to multi-
Institute or Center pediatric research projects implemented as
a result of N-PeRC and projects in the planning stage.
Additionally, the Committee requests a report in the fiscal
year 2023 Congressional Budget Justification on how N-PeRC
plans to support 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.
Undiagnosed Diseases.--The Committee recognizes the
important role the NIH-funded Undiagnosed Diseases Network
(UDN) has played to improve diagnosis of rare diseases and
other undiagnosed conditions and encourages NIH to continue
supporting this work, including by developing a plan to sustain
the work of the UDN.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2021....................... $200,000,000
Budget request, fiscal year 2022...................... 250,000,000
Committee Recommendation.............................. 250,000,000
Change from enacted level......................... +50,000,000
Change from budget request........................ - - -
Mission.--This account provides for the design,
construction, improvement, and major repair of clinical,
laboratory, and office buildings and supporting facilities
essential to the mission of the 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; and other
smaller facilities throughout the U.S.
NIH INNOVATION ACCOUNT
This account supports NIH programs authorized in the 21st
Century Cures Act (P.L. 114-255).
ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH
Appropriation, fiscal year 2021....................... $0
Budget request, fiscal year 2022...................... 6,500,000,000
Committee Recommendation.............................. 3,000,000,000
Change from enacted level......................... +3,000,000,000
Change from budget request........................ -3,500,000,000
The Committee includes $3,000,000,000 to establish the
Advanced Research Projects Agency for Health (ARPA-H),
$3,000,000,000 above the fiscal year 2021 enacted level and
$3,500,000,000 below the fiscal year 2022 budget request.
The Committee strongly supports the goals and vision behind
the proposal for ARPA-H and believes that once established,
ARPA-H will be able to make pivotal investments in breakthrough
technologies and broadly applicable platforms that have the
potential to transform medicine, research, and health. The
Committee looks forward to working with the Administration to
establish ARPA-H and expects to expand its capacity to support
innovative projects in future fiscal years.
The Committee agrees that ARPA-H projects focused on
developing treatments and cures for cancer, Alzheimer's
disease, and diabetes would be a worthy investment, given the
prevalence and immense burden of these diseases on society, as
well as the potential for such an investment to achieve
progress. The Committee strongly encourages NIH to pursue ARPA-
H projects related to finding treatments and a cure for ALS,
given its devastating impact on those who suffer from ALS and
their families. The Committee expects to be kept apprised of
NIH's proposed criteria for selecting and prioritizing projects
for ARPA-H funding.
For ARPA-H to be successful, the Committee believes ARPA-H
must be a distinct Institute within NIH, with a unique culture
and organization that should focus on time-limited projects
with goals, benchmarks, and accountability. The Committee
strongly encourages NIH to recruit an ARPA-H Director with
extraordinary technical and leadership skills, who has a proven
track-record in innovation and partnership-building. As the
success of this endeavor will be largely dependent upon the
recruitment and empowerment of a diverse cohort of program
managers, the Committee urges NIH to consider recruiting from a
wide range of industry, academia, and other sectors. The
Committee encourages NIH to collaborate with DARPA to develop
the foundational policies, procedures, and staff training for
ARPA-H employees.
The Committee is aware that there may be ongoing activities
within NIH's current Institutes and Centers that may be better
aligned with ARPA-H's mission. The Committee encourages NIH to
closely examine whether there is duplication or misalignment of
programs once ARPA-H is stood up and to notify the Committee of
any proposed reorganization.
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Appropriation, fiscal year 2021....................... $6,015,508,000
Budget request, fiscal year 2022...................... 9,734,011,000
Committee Recommendation.............................. 9,160,277,000
Change from enacted level......................... +3,144,769,000
Change from budget request........................ -572,234,000
The Committee recommendation for the Substance Abuse and
Mental Health Services Administration (SAMHSA) program level
includes $9,014,610,000 in discretionary budget authority,
$133,667,000 in PHS Evaluation Tap Funding, and $12,000,000 in
transfers from the Prevention and Public Health Fund (PPHF).
In addition, the American Rescue Plan (P.L. 117-2) included
$3,235,000,000 for SAMHSA to address the increased need for
mental health and substance use disorder services due to the
COVID-19 pandemic.
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 Abuse
Prevention and Treatment Block Grant as a source for the Public
Health Service Act section 241 evaluation set aside in fiscal
year 2022.
MENTAL HEALTH
Appropriation, fiscal year 2021....................... $1,792,275,000
Budget request, fiscal year 2022...................... 2,936,528,000
Committee Recommendation.............................. 3,161,295,000
Change from enacted level......................... +1,369,020,000
Change from budget request........................ +224,767,000
Within the total provided for Mental Health Programs of
Regional and National Significance, the Committee includes the
following amounts:
------------------------------------------------------------------------
FY 2022
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Seclusion and Restraint.......................... $1,147,000
Project AWARE.................................... 155,502,000
Mental Health Awareness Training................. 35,945,000
Healthy Transitions.............................. 31,451,000
Infant and Early Childhood Mental Health......... 25,000,000
Children and Family Programs..................... 7,229,000
Consumer and Family Network Grants............... 4,954,000
Project LAUNCH................................... 23,605,000
Mental Health System Transformation.............. 3,779,000
Primary and Behavioral Health Care Integration... 57,877,000
Behavioral Health Crisis Coordinating Office..... 10,000,000
National Strategy for Suicide Prevention......... 28,200,000
Zero Suicide................................. 26,200,000
American Indian and Alaska Native Set- 3,400,000
Aside...................................
Suicide Lifeline................................. 113,621,000
Garrett Lee Smith-Youth Suicide Prevention
State Grants................................. 34,427,000
Campus Grants................................ 6,488,000
American Indian and Alaska Native Suicide 3,431,000
Prevention......................................
Tribal Behavioral Health Grants.................. 25,000,000
Homeless Prevention Programs..................... 30,696,000
Minority AIDS.................................... 9,224,000
Criminal and Juvenile Justice Programs........... 51,394,000
Assisted Outpatient Treatment.................... 21,420,000
Assertive Community Treatment for Individuals 9,000,000
with Serious Mental Illness.....................
Science and Service:
Garrett Lee Smith-Suicide Prevention Resource 9,000,000
Center..........................................
Practice Improvement and Training................ 7,828,000
Consumer and Consumer Support Technical 1,918,000
Assistance Centers..............................
Primary and Behavioral Health Care Integration 1,991,000
Technical Assistance............................
Interagency Task Force on Trauma-Informed Care... 1,000
Minority Fellowship Program...................... 11,713,000
Disaster Response................................ 1,953,000
Homelessness..................................... 2,296,000
------------------------------------------------------------------------
Assisted Outpatient Treatment.--The Committee includes an
increase of $420,000 to expand access to evidence-based mental
health services for individuals with serious mental illness.
Behavioral Health Crisis Coordinating Office.--The
Committee includes $10,000,000 for the Office of the Assistant
Secretary for Mental and Substance Use to create and 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 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. The Committee directs the Secretary to include
a multi-year plan in the fiscal year 2023 Congressional Budget
Justification outlining a nationwide crisis care system plan of
action.
Criminal Justice Activities.--The Committee includes an
increase of $45,125,000 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 substance use disorders.
Garrett Lee Smith (GLS) Youth Suicide Prevention.--The
Committee includes an increase of $10,000,000 for GLS Youth
Suicide Prevention, to develop and implement youth suicide
prevention and early intervention strategies.
Healthy Transitions.--The Committee includes an increase of
$2,000,000 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 at risk of developing a
serious mental health condition.
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
$17,000,000 for Infant and Early Childhood Mental Health. This
will support increased access to a range of evidence-based and
culturally appropriate infant and early childhood mental health
services, and aid in addressing the national shortage of mental
health professionals with infant and early childhood expertise.
The Committee urges 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.
Interagency Task Force for Trauma-Informed Care.--The
Committee includes $1,000,000 for the Interagency Task Force
for Trauma-Informed Care, as authorized by the SUPPORT Act, to
develop best practices to identify, prevent, and mitigate the
effects of trauma on infants, children, youth, and their
families.
Minority Fellowship.--The Committee provides $20,289,000,
an increase of $4,120,000, 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 substance use disorders 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 Zero Suicide model, a comprehensive, multi-setting approach
to suicide prevention in health care systems. The Committee
also includes an increase of $500,000 for the AI/AN Suicide
Prevention Initiative.
National Suicide Prevention Lifeline
The Committee recognizes that suicide is a leading cause of
death in the United States, taking the lives of more than
47,000 Americans 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 an increase of
$89,621,000, which is $12,000,000 above the fiscal year 2022
budget request, to enhance the National Suicide Prevention
Lifeline's (NSPL) infrastructure in preparation for the launch
to a new 988 number in July 2022. 988 has the potential to make
it simpler for people experiencing a mental health crisis to
connect with lifesaving crisis intervention services. However,
the Committee is disappointed that SAMHSA has not completed the
report on the resources required to implement 988, as required
by the National Suicide Hotline Designation Act (P.L. 116-172).
This report is critical in ensuring the appropriate amount of
funding is available to strengthen the infrastructure of the
existing Lifeline to increase the capacity of Lifeline centers
to be ready to respond to the expected increase in calls,
chats, and texts from people in crisis seeking assistance. The
Committee directs SAMHSA to provide this report within 30 days
of enactment of this Act. The Committee also directs that as
SAMHSA works to enhance the NSPL infrastructure, it should
expand existing capabilities for response in a manner that, to
the extent possible, utilizes existing phone, chat, and text
capabilities.
NSPL Specialized Services for LGBTQ Youth.--The Committee
directs that of the funds made available for NSPL, $7,200,000
shall be used to provide specialized services for LGBTQ youth
within the NSPL. SAMHSA shall make this funding competitively
available to an organization with experience working with LGBTQ
youth and capable of handling LGBTQ youth callers through
Integrated Voice Response.
NSPL Text-Based Crisis Support Capabilities.--The Committee
is aware that texting for individuals experiencing a mental
health crisis is important, particularly among young people for
whom texting is often a preferable means of communication to
voice calls. The Committee also recognizes the significant
operational and financial challenge of building the
infrastructure for text capacity to support implementation of
text to the 988 number by the network of local crisis centers
that support the NSPL. Given the high number of individuals
whose cell phone number does not match the cell phone area code
in their area, the regional model that is in place for routing
telephone calls to a local crisis center may not be necessary
for texters in crisis. Furthermore, both the Veterans Crisis
Line and the Disaster Distress Hotline have employed national
backup centers to receive texts. As SAMHSA considers making
text-based crisis support capabilities available to members of
the public, the Committee directs SAMHSA to avoid duplicating
existing capabilities to the extent possible. The Committee
directs SAMHSA to coordinate and work with existing text and
chat providers that have the technology to triage text
conversations based upon severity of risk, to improve risk
assessment and response capacity.
NSPL Partnerships.--The Committee recognizes that the
designation of 988 as the new three-digit dialing code for the
National Suicide Prevention Lifeline will help increase the
effectiveness of suicide prevention efforts, increase access to
crisis services, reduce the stigma of mental health conditions,
and save lives. As SAMHSA considers partnerships to administer
988, the Committee encourages SAMHSA to consider partnering
with non-profit or academic institutions with first-hand
experience administering a national network of local behavioral
health crisis call services to ensure the highest level of
quality and efficiency.
Primary and Behavioral Health Care Integration.--The
Committee includes an increase of $5,000,000 to improve the
coordination and integration of primary care services and
publicly funded behavioral health services.
Project AWARE.--To increase access to mental health
services, as set out by the 2013 ``Now is the Time'' plan, the
Committee includes a total increase of $48,501,000 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. This includes an increase of $42,251,000
for Project AWARE state grants, an increase of $6,250,000 for
Resilience in Communities after Stress and Trauma (ReCAST)
grants. In addition, the Committee includes an increase of
$11,982,000 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 American
Indian/Alaska Native populations.
Certified Community Behavioral Health Clinics (CCBHC).--The
Committee includes an increase of $125,000,000 for the CCHBC
program. In addition, the American Rescue Plan (P.L. 117-2)
included $420,000,000 to support CCBHCs. 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.--The Committee includes an
increase of $25,000,000 for the Children's Mental Health
program, which supports 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.
Mental Health Block Grant
The Committee includes $1,582,571,000, an increase of
$825,000,000, for the Mental Health Block Grant (MHBG). In
addition, the American Rescue Plan (P.L. 117-2) included
$1,500,000,000 for the 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. The Committee expects SAMHSA to
continue its collaboration with the National Institute of
Mental Health (NIMH) and to encourage States to use this
funding to support programs that demonstrate strong evidence of
effectiveness. In addition, the Committee urges States to use a
portion of their MHBG formula funding to provide mental health
services to the survivors of mass shootings as well as their
families.
MHBG Crisis Care Set-Aside.--The Committee includes a 10
percent set-aside in the MHBG for evidence-based crisis care
programs addressing 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. The goal is a crisis care
system where a person in crisis will have someone to talk to,
someone to respond, and/or somewhere to go for crisis
intervention at any time.
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. The
Committee notes emerging science developed by the NIMH on early
intervention and prevention of mental disorders. Many
neuropsychiatric illnesses have a typical age of onset in late
adolescence, and studies demonstrate that half of those who
will develop mental health disorders show symptoms by age 14.
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 0-5.--The Committee strongly
believes that by investing in early mental health prevention,
identification, and treatment, we can reduce the need for
treatment later in life when it becomes much more difficult,
time intensive, and expensive. Early intervention can change
the course for children experiencing or at risk of developing
mental health disorders. The Committee is concerned that there
has not been a sufficient focus on this population. The
Committee strongly 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 directs SAMHSA to provide a report, within
180 days of enactment of this Act, on the portion of MHBG
funding that States are allocating to services and activities
for infants and toddlers.
Mental Health Disparities.--The Committee believes that
addressing health care disparities experienced by racial and
ethnic minorities should be a priority in programs funded by
Federal agencies, including programs funded in whole or part by
the Community Mental Health Services Block Grant authorized
under 42 U.S.C. 300x 1. The Committee directs SAMHSA to
require, in the reporting mandated of states receiving funds
under 42 U.S.C. 300x 1, that State Mental Health Agencies
report on the extent to which services are provided to
individuals from racial and ethnic minorities and the outcomes
experienced by those individuals. The Committee directs that
impact and outcomes should be reported for racial and ethnic
minority adults with serious mental illness and racial and
ethnic minority children with serious emotional disturbance in
reports of data submitted relating to diversions from
hospitalization, arrests, treatment for first episode
psychosis, reductions in suicide, response through crisis
services, and treatment of homeless individuals. State Mental
Health Agencies shall also report on outreach to, and the
hiring of, racial and ethnic minority providers of mental
health services.
Mental Health Crisis Response Partnership Pilot Program.--
The Committee is aware that the lack of sufficient mental
health care resources in communities too often results in law
enforcement responding to what is actually a mental health
emergency. SAMHSA's ``National Guidelines for Behavioral Health
Crisis Care'' outline a roadmap for robust crisis care services
that can divert people experiencing a mental health crisis from
the criminal justice system into mental health treatment. The
Committee has directed significant resources to improve mental
health crisis care and increase access to mental health
services. However, the availability of mental health crisis
care remains inconsistent across the United States, 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 $100,000,000 for
a pilot 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 also directs the Department to provide
a report, within 180 days of enactment of this Act, on existing
steps being taken to strengthen partnerships between mental
health providers, behavioral health teams, and first
responders, as well as a report not later than one year
following the obligation of awards in fiscal year 2022 for this
pilot program, including best practices and recommendations for
subsequent grant cycles.
National Child Traumatic Stress Initiative.--The Committee
includes an increase of $28,113,000 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.
Projects for Assistance in Transition from Homelessness (PATH)
The Committee includes an increase of $10,000,000 for the
PATH program, which supports grants to States and territories
for assistance to individuals suffering from severe mental
illness and/or substance use disorders 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. This puts significant strain on public budgets while
patients do not receive the robust behavioral health care they
need. The Committee recognizes that housing support paired with
wraparound services is a successful model and appreciates that
the fiscal year 2011 President's Budget supported the concept.
In fiscal year 2021 the Committee requested a report from 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 an increase of $3,854,000, for
the Protection and Advocacy for Individuals with Mental Illness
program, which ensures that the rights of mentally ill
individuals are protected while they are patients in all public
and private facilities or while they are living in the
community. Funds are allocated to States according to a formula
based on population and relative per capita incomes.
Addressing Access to Firearms and Suicide Prevention
Programs.--The Committee encourages 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
the National Suicide Prevention Lifeline to develop 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
encourages the Secretary, acting through the Assistant
Secretary for Mental Health and Substance Use, to develop
school-based 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 individuals who are responsible for
identifying and assessing behaviors of concern and facilitating
the implementation of evidence-based interventions.
Impact of COVID-19 on the Mental Health of Older
Americans.--The Committee recognizes the exacerbated impact of
COVID-19 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.
Research shows that rates of anxiety and depression among older
adults during the pandemic are higher among female, Hispanic,
and low-income seniors. In disbursing MHBG funds, the Committee
encourages SAMHSA to work with States to address the impact of
increased isolation of seniors.
Mental Health Centers of Excellence.--The Committee
recognizes the need for more effective mental health programs
and a need to better provide treatment recommendations to meet
the needs of those experiencing mental illness. The Committee
encourages 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.
Perinatal Suicide Prevention.--Perinatal suicides, which
occur during pregnancy or up to one year postpartum, are a
leading cause of maternal mortality in the United States. The
prevalence of suicidal ideation among pregnant and postpartum
individuals was five times higher in 2017 than in 2006, and
during that period, Black pregnant and postpartum individuals
experienced larger increases in suicidality than other racial
and ethnic groups. Given these trends, the Committee urges
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.
SUBSTANCE ABUSE TREATMENT
Appropriation, fiscal year 2021....................... $3,854,756,000
Budget request, fiscal year 2022...................... 6,408,943,000
Committee Recommendation.............................. 5,511,943,000
Change from enacted level......................... +1,657,187,000
Change from budget request........................ -897,000,000
Within the total provided for Programs of Regional and
National Significance, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Capacity:
Opioid Treatment Programs and Regulatory $13,086,000
Activities......................................
Screening, Brief Intervention, Referral to 30,510,000
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......................... 63,000,000
Rural Focus.................................. 36,000,000
Pregnant and Postpartum Women.................... 49,397,000
Recovery Community Services Program.............. 5,151,000
Children and Families............................ 30,197,000
Treatment Systems for Homeless................... 40,114,000
Minority AIDS.................................... 66,881,000
Criminal Justice Activities...................... 124,380,000
Drug Courts.................................. 105,000,000
Improving Access to Overdose Treatment........... 1,500,000
Building Communities of Recovery................. 20,000,000
Peer Support Technical Assistance Center......... 1,500,000
Comprehensive Opioid Recovery Centers............ 6,000,000
Emergency Department Alternatives to Opioids..... 9,000,000
Treatment, Recovery, and Workforce Support....... 9,000,000
Science and Service:
Addiction Technology Transfer Centers............ 9,046,000
Minority Fellowship Program...................... 7,186,000
------------------------------------------------------------------------
Building Communities of Recovery.--The Committee includes
an increase of $10,000,000 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 $2,000,000 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.
Criminal Justice Activities and Drug Courts.--The Committee
includes an increase of $35,380,000 for Criminal Justice
activities. Of this amount, $35,000,000 is directed to Drug
Court activities. The Committee continues to direct SAMHSA to
ensure that all funding appropriated for drug treatment courts
is allocated to serve people diagnosed with a substance use
disorder as their primary condition. The Committee directs
SAMHSA to ensure that all drug treatment court grant recipients
work directly with the corresponding State substance abuse
agency in the planning, implementation, and evaluation of the
grant. The Committee further directs SAMHSA to expand training
and technical assistance to drug treatment court grant
recipients to ensure evidence-based practices are fully
implemented.
Emergency Department Alternatives to Opioids.--The
Committee includes an increase of $3,000,000 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 $6,000,000 for Grants to Prevent Prescription Drug/Opioid
Overdose Deaths, and an increase of $21,000,000, for First
Responder Training for Opioid Overdose Reversal Drugs, which
includes an increase of $12,000,000 for a rural set-aside. The
Committee directs that $6,500,000 of funds for First Responder
Training be made available to SIREN 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, 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 $500,000 to provide technical
assistance to recovery community organizations and peer support
networks.
Pregnant and Postpartum Women SUD Treatment.--The Committee
includes an increase of $16,466,000 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. A provision in the
Comprehensive Addiction and Recovery Act (CARA) authorizes
SAMSHA to allocate a portion of these resources for a pilot
program to State alcohol and drug agencies to support
outpatient, intensive outpatient and related services in a
family centered approach. The Committee again encourages SAMHSA
to fund an additional cohort of States above and beyond those
pilots already funded.
Recovery Community Services.--The Committee includes an
increase of $2,717,000 to help recovery communities strengthen
their infrastructure and provide peer recovery support services
to those in or seeking recovery from SUD. The intent of the
Recovery Community Services Program Statewide Network (RSCP-SN)
program is to strengthen the relationships between RCOs 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 (ROSC) landscape.
Screening, Brief Intervention, and Referral to Treatment
(SBIRT).--The Committee includes an increase of $2,510,000, for
SBIRT. The Committee recognizes that SBIRT is still not widely
adopted by broader health care or social service networks,
particularly in underserved communities. Failure to routinely
screen youth and adults for early misuse of opioids and other
substances is a missed opportunity to stem the substance misuse
crisis. 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
CSAT within the existing SBIRT program.
Targeted Capacity Expansion-Medication Assisted
Treatment.--The Committee includes an increase of $56,500,000
for Medication Assisted Treatment (MAT) for Prescription Drug
and Opioid Addiction; an increase of $5,500,000, for grants to
Indian tribes, tribal organizations, or consortia; and an
increase of $224,000 for general Targeted Capacity Expansion
activities.
Treatment Systems for Homeless.--The Committee includes an
increase of $3,728,000 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 $3,000,000 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 substance use disorder
treatment and recovery to live independently and participate in
the workforce.
State Opioid Response (SOR) Grants
The Committee includes $2,000,000,000 for SOR grants, an
increase of $500,000,000. The Committee directs SAMHSA to
continue supplemental grants in fiscal year 2022 to States
whose award from the SOR formula grant declines by more than 40
percent in fiscal year 2022 compared to fiscal year 2019. 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 Abuse
Prevention and Treatment Block Grant under part B of title X of
the Public Health Service Act. This approach will ensure
continuity of funding, effective coordination of efforts, and
decrease fragmentation within each State system.
SOR Funding Cliff.--The Committee continues to include a 15
percent set-aside for States with the highest age-adjusted
mortality rate related to opioid use disorders. The Committee
remains concerned 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 2022, the Committee directs the Assistant Secretary to
award funds to avoid funding cliffs between States with similar
mortality rates. The Committee notes that funding cliffs
between grant cycles can pose a significant challenge for
States seeking to maintain programs that were instrumental in
reducing drug overdose fatalities. The Committee requests a
report within 180 days of enactment of this Act on the extent
to which such reductions to States in previous grant cycles
affected outreach and provision of services, as well as
treatment and recovery outcomes.
Substance Abuse Prevention and Treatment Block Grant
The Committee includes a program level of $2,858,079,000
for the Substance Abuse Prevention and Treatment Block Grant
(SABG), an increase of $1,000,000,000. In addition, the
American Rescue Plan (P.L. 117-2) included $1,500,000,000 for
the SABG. SABG provides funding to States to support alcohol
and drug abuse prevention, treatment, and rehabilitation
services. The Committee recognizes the critical role the block
grant plays in State systems across the country, 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 SABG 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.
SABG Recovery Set-Aside.--The Committee establishes a ten
percent set-aside within total SABG 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; (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 support operating costs for organizations that
provide 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 Abuse Prevention and Treatment Block Grants in
supporting States' efforts to provide resources for expanded
mental health and substance use disorder 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 encourages SAMHSA to begin implementing public
reporting on their existing block grants. The Committee directs
SAMHSA to submit a report, 180 days after the enactment of this
Act, to identify any staffing, IT infrastructure, legislative
policies, or funding barriers that would prevent grantees and
SAMHSA from collecting and providing outcome data on their
block grant programs.
Data Collection for SUD Grants to States.--A December 2020
GAO report examining SUD grants to States found that SAMHSA
does not have consistent, relevant, and timely data on the
number of individuals provided treatment and recovery support
through the SABG, State Targeted Response to the Opioid Crisis
Grant (STR), and SOR programs. The Committee recognizes the
challenges the lack of data poses in evaluating the
effectiveness of these grants and encourages SAMHSA to adopt
GAO's recommendation to identify and implement changes to their
data collection efforts to improve the consistency, relevance,
and timeliness of data collected on the number of individuals
who receive substance use disorder treatment and recovery
support services with funding from the SABG and SOR programs.
Evidence-Based Practices to Combat the Opioid Crisis.--The
CDC projects that more than 88,000 drug overdose deaths
occurred in the United States in the 12 months ending in August
2020, the highest number of overdose deaths ever recorded in a
12-month period. Given the acceleration of the drug overdose
epidemic, due in part to the COVID-19 pandemic, the Committee
directs SAMSHA to encourage States to use grant funds provided
to combat this substance use disorder crisis to prioritize
evidence-based best practices exemplified by the states,
including but not limited to: Overdose Education and Naloxone
Distribution (OEND), Medication Assisted Treatment (MAT), 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 the
development of evidence-based programs and treatments
specifically tailored for those with alcohol and substance use
disorder 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.
National Recovery Month.--The Committee recognizes that
National Recovery Month is a meaningful observation to
recognize individuals in recovery from substance use disorders
and mental illness. Between September 2019 and August 2020,
more than 85,000 people nationwide died from drug overdoses and
47,000 nationwide died from suicide in 2019. Promoting
awareness of treatment for substance use and mental health
disorders and combating stigma, both goals of National Recovery
Month, are important steps to help prevent overdoses and
suicide. The Committee recognizes SAMHSA as an important leader
in National Recovery Month and encourages SAMHSA to maintain a
leadership role in these efforts.
Opioid Use Disorder Relapse.--The Committee recognizes that
relapse might occur after opioid use disorder 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
relapse to opioid dependence, and encourages SAMHSA to
disseminate and emphasize implementation of these practices in
all settings where treatment is offered, including
rehabilitation and criminal justice settings.
Substance Use Disorder Response in Rural America.--The
Committee is aware that response to the SUD crisis continues to
pose unique challenges for rural America, which suffers from
problems related to limited access to both appropriate care and
health professionals critical to diagnosing and treating
patients along with supporting recovery. Rural America's unique
challenges require a comprehensive approach, including training
to provide care in a culturally responsive manner with an
understanding of diverse populations; the use of technologies
to ensure improved access to medically underserved areas
through the use of telehealth; and workforce and skills
development to advance data capture and analytics. 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.
Recovery Housing.--The Committee recognizes the importance
of recovery housing, in which individuals abstain from use of
non-prescribed substances in a supportive environment. Research
shows that individuals with SUD who live in recovery housing
are more likely to maintain recovery, have higher rates of
employment, and are less likely to become incarcerated. 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.
SUBSTANCE ABUSE PREVENTION
Appropriation, fiscal year 2021....................... $208,219,000
Budget request, fiscal year 2022...................... 216,667,000
Committee Recommendation.............................. 243,503,000
Change from enacted level......................... +35,284,000
Change from budget request........................ +26,836,000
Within the total provided for Programs of Regional and
National Significance, the Committee provides the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Capacity:
Strategic Prevention Framework................... $139,484,000
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...... 15,000,000
National Adult-Oriented Media Public Service 2,500,000
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. 3,000,000
Science and Service:
Center for the Application of Prevention 7,493,000
Technologies....................................
Science and Service Program Coordination......... 4,072,000
Minority Fellowship Program...................... 1,390,000
------------------------------------------------------------------------
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. This is too often
the beginning of a pathway to dependence, substance use
disorder, and overdose. Furthermore, medication take-back
programs are difficult to access for many Americans and
inadequate to broadly impact disposal behavior. Newer
technologies to deactivate and safely dispose of prescription
drugs in the home have been shown through independent research
to lead to improved outcomes. The Committee includes $3,000,000
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 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.
Sober Truth on Preventing Underage Drinking (STOP) Act.--
The Committee includes $15,000,000, an increase of $5,000,000,
for the STOP Act. Of this amount, $11,500,000 is for the
Community Based Enhancement Grant Program to help community
coalitions address underage drinking; $2,500,000 is for an
annual public service campaign on underage drinking; and
$1,000,000 is for the ICCPUD to carry out its reporting and
coordination responsibilities. The Committee is disappointed
that SAMHSA has not released a new Funding Opportunity
Announcement (FOA) for the STOP Act Community Based Enhancement
Grant program since 2019 and directs SAMHSA to ensure a new FOA
for this program is released in fiscal year 2022.
Strategic Prevention Framework.--The Committee provides
$139,484,000, an increase of $20,000,000, for the Strategic
Prevention Framework (SPF). Of the total provided, $124,484,000
is for SPF-Partnerships for Success (SPF-PFS) and $15,000,000
is for SPF-Rx. The Committee strongly believes that investing
in prevention is essential to ending the substance misuse
crisis, and supports the SPF-PFS program, which is designed to
prevent the onset of substance misuse, while strengthening
prevention capacity and infrastructure. The Committee intends
that this program support comprehensive, multi-sector substance
use prevention strategies to stop or delay the age of
initiation of each State or local applicant's most pressing
substance use issues, as determined by the State and/or local
epidemiological data. The Committee directs SAMHSA to issue a
report, within 120 days of enactment of this Act, assessing the
extent to which the work of local grantees complements and
align with the primary prevention efforts led by the
corresponding State alcohol and drug agency.
SUD Prevention Workforce.--The Committee recognizes that
the nation's work on SUD prevention relies on an adequate
supply of educated prevention professionals. The Committee is
aware that more data and information is needed about the SUD
prevention workforce. Therefore, the Committee directs SAMHSA
to conduct a comprehensive national study regarding the
substance use prevention workforce. The study should include an
environmental scan of the existing workforce, salaries, current
challenges in maintaining support for an adequate workforce, a
plan to address these challenges and potential federal
programming to help implement the plan. The Committee directs
SAMHSA to develop the study in consultation with relevant
stakeholders, including the association representing State
alcohol and drug agencies, researchers, and others.
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 American
Indian/Alaska Native populations.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
Appropriation, fiscal year 2021....................... $160,258,000
Budget request, fiscal year 2022...................... 170,373,000
Committee Recommendation.............................. 243,536,000
Change from enacted level......................... +83,278,000
Change from budget request........................ +73,163,000
The Committee provides the following amounts for Health
Surveillance and Program Support:
------------------------------------------------------------------------
Budget Activity FY 2022 Committee
------------------------------------------------------------------------
Health Surveillance.................................. $47,595,000
PHS Evaluation Funds............................. 30,428,000
Program Support...................................... 84,316,000
Public Awareness and Support......................... 13,260,000
Performance and Quality Information Systems.......... 10,200,000
Drug Abuse Warning Network........................... 16,500,000
Behavioral Health Workforce.......................... 1,000,000
PHS Evaluation Funds............................. 1,000,000
------------------------------------------------------------------------
Within the funds included in this account, $70,665,000
shall be used for the following projects in the following
amounts:
------------------------------------------------------------------------
Project Amount
------------------------------------------------------------------------
Access Community Health Network, Chicago, IL for $140,000
behavioral health and supportive services...........
Adult & Teen Challenge USA, Ozark, MO for recovery 475,000
support services, equipment, and technology.........
AdventHealth, Sanford, FL for substance use treatment 400,000
and support services................................
All Star Children's Foundation, Sarasota, FL for 1,500,000
child welfare and trauma services program and
associated support services.........................
Arlington County Government, Arlington, VA for a 390,000
mobile mental health crisis reponse team............
Ashley, Inc., Havre de Grace, MD for a substance use 525,000
treatment program partnership to identify,
implement, and broadly disseminate new forms of SUD
treatment targeted to underserved populations.......
Assisted Recovery Centers of America, St. Louis, MO 1,300,000
for mental health and substance use treatment and
other wraparound services...........................
Baltimore City Health Department, Baltimore, MD for a 475,000
mobile unit providing clinical SUD treatment and
other services......................................
Behavioral Health Network of Vermont Inc., 1,150,000
Montpelier, VT for Wheels and Waves opiate use
disorder treatment program..........................
BJC Healthcare, St. Louis, MO for behavioral health 800,000
services for people experiencing homelessness.......
Capital Clubhouse Inc., Washington, DC for mental 210,000
health and other support services...................
Cascade AIDS Project, Portland, OR for behavioral 850,000
health services, including medication assisted
treatment...........................................
Champions In Service, Pacoima, CA for mental health 200,000
and substance use disorder treatment and services...
Change the Outcome, Chanhassen, MN for substance use 375,000
prevention and treatment services for youth and
young adults........................................
Children's Fund, Inc., San Bernardino, CA for trauma- 100,000
informed mental health care for children............
Children's Health System of Texas, Dallas, TX for 900,000
children's mental health services...................
Children's Hospital of Orange County, Orange, CA for 325,000
mental health treatment services and programs for
children and families...............................
Chinese-American Planning Council, New York, NY for 500,000
mental health services, including outreach,
education and other support services................
City of Augusta, ME for Project Recovery, to increase 265,000
access to substance use treatment and recovery
services............................................
City of Azusa, CA for mental health and support 560,000
services through the Azusa Teen and Family Center...
City of Dublin, CA for a Mental Health Urgent Care 450,000
Center to provide access to mental health crisis
care................................................
City of Indianapolis, IN for mental health and 500,000
substance use treatment services for people in need
of permanent supportive housing.....................
City of Laredo, TX for a substance use treatment 2,000,000
center..............................................
City of Murrieta, CA for homeless services........... 500,000
City of Oakland, CA for the Oakland Mental Health 1,230,000
Resilience project..................................
City of Palo Alto, CA for a mental health crisis 2,000,000
response team.......................................
City of Round Rock, TX for behavioral health services 1,000,000
mobile outreach and associated information
technology..........................................
City of Seattle, WA for behavioral health crisis 775,000
response through the Health One program.............
City of St. Louis Mental Health Board of Trustees, 600,000
St. Louis, MO for behavioral health and trauma
prevention services for people impacted by gun
violence............................................
Clearfield Educational Foundation Inc., Clearfield, 1,020,000
PA for mental health and substance abuse services...
Columbia University Irving Medical Center, New York, 750,000
NY for community-based mental health services,
including training and service delivery.............
Adventist Health System West, Roseville, CA for 985,000
mental health and substance use disorder services,
including wraparound services.......................
Community Action of Greater Indianapolis Inc, 75,000
Indianapolis, IN for behavioral health treatment and
services, including supportive services.............
Contra Costa County Health Services Department-- 1,100,000
Behavioral Health Division, Martinez, CA for mobile
behavioral health crisis response teams.............
County of Burlington, Mount Holly, NJ for substance 300,000
use disorder treatment and recovery services through
the Hope One initiative.............................
Covenant House Georgia, Atlanta, GA for mental health 190,000
and supportive services for families experiencing
homelessness........................................
Delaware County Department of Human Services, Upper 650,000
Darby, PA for mobile crisis teams to respond to
behavioral health emergencies.......................
Erie County Department of Health, Buffalo, NY for 1,000,000
peer support workers to improve access to substance
use treatment and recovery services.................
Essex County Community Foundation, Danvers, MA for 700,000
mental health services targeted to populations
disproportionately affected by COVID-19.............
Fifth Ward Community Redevelopment Corporation, 1,000,000
Houston, TX for community mental health treatment
and support services................................
First Behavioral Health Care Center, Turlock, CA to 310,000
expand access to mental health services, including a
public awareness campaign...........................
Franciscan Health Olympia Fields, Olympia Fields, IL 625,000
for behavioral health telemedicine..................
Franklin County Opioid Task Force, Greenfield, MA to 200,000
support individuals in recovery from alcohol and
other substance use disorder to re-enter the
workforce...........................................
Frederick County Government, Frederick, MD for a 850,000
behavioral health Crisis Stabilization Center.......
Friends of the Children, Portland, OR for mentoring 750,000
services for children...............................
Gads Hill Center, Chicago, IL for trauma-informed 350,000
mental and behavioral health services...............
Garden State Equality, Asbury Park, NJ to address the 175,000
impacts of trauma on mental health for LGBTQ and
BIPOC youth.........................................
Georgia Council on Substance Abuse, Atlanta, GA for 30,000
recovery services, including education, training and
peer recovery support services......................
Georgia State University, Atlanta, GA for mental 200,000
health services and other supports for children who
have experienced trauma.............................
Great Lakes Dryhootch, Inc., Milwaukee, WI for the 155,000
Dryhootch Quick Reaction Force program to provide
mental health services for veterans.................
Greater Flint Health Coalition, Flint, MI for a 750,000
Community Information Exchange, for mental health
prevention and treatment activities, including
equipment and technology............................
Hartford Communities that Care, Hartford, CT for the 630,000
Hartford Care Response Team, a hospital linked
violence intervention program.......................
Healthier Kids Foundation, San Jose, CA for a 400,000
preventive mental health program for students.......
Hedwig House, Inc, Lansdale, PA for mental health 270,000
services, including treatment and other supportive
services............................................
Holy Redeemer Hospital, Huntingdon Valley, PA for a 250,000
Neonatal Abstinence Syndrome program, including
equipment and wraparound services...................
Hope of the Valley Rescue Mission, Pacoima, CA for 2,000,000
mental health and substance use treatment and
services for people experiencing homelessness, and
training for the mental health workforce............
Hope Services, San Jose, CA for mental health 160,000
services for people with developmental disabilities.
John Morroni Legacy Foundation, Clearwater, FL for 500,000
mental health treatment and services for first
responders..........................................
Kane County State's Attorney's Office, St. Charles, 350,000
IL for a pre-arrest diversion initiative based on
the Law Enforcement Assisted Diversion model........
Latino Organization of the Southwest, Chicago, IL for 500,000
a teen support program, including equipment and
technology..........................................
Lesbian and Gay Community Services Center, Inc., New 350,000
York, NY for mental health counseling and substance
use treatment services..............................
Lexington-Fayette Urban County Government, Lexington, 620,000
KY for the purchase of equipment and recovery
support services....................................
Lifeline Connections, Vancouver, WA for a mentor 50,000
program.............................................
Long Island Crisis Center, Inc., Bellmore, NY for 150,000
behavioral health services..........................
LOVE Program, Rialto, CA to provide mental health and 380,000
substance use disorder treatment services and
diversion programs for juveniles in the criminal
justice system......................................
Maimonides Medical Center, Brooklyn, NY for mental 700,000
health and supportive services for parents and
infants.............................................
Massachusetts Executive Office for Health and Human 1,650,000
Services, Boston, MA to establish the Middlesex
County Restoration Center to provide behavioral
health crisis and urgent care services, and other
supportive services.................................
Maui Economic Opportunity, Inc., Wailuku, HI for 100,000
alcohol and tobacco prevention activities for youth.
MedCura Health, Stone Mountain, GA for mental health 300,000
services for people experiencing homelessness.......
Mental Health Association of Essex and Morris, Inc., 300,000
Parsippany, NJ for suicide prevention services......
Mental Health Partners, Lafayette, CO to provide 275,000
community mental health and well-being services to
mitigate the long term impacts of trauma............
Mile High United Way, Denver, CO for behavioral 100,000
health services for young adults experiencing
homelessness........................................
Milestone Recovery, Portland, ME for a substance use 690,000
disorder outpatient treatment and support program...
Monroe County Office of Mental Health, Rochester, NY 265,000
for peer advocate training..........................
Mount Vernon Neighborhood Health Center, Mount 100,000
Vernon, NY for behavioral health services for
homebound elderly and disabled adults...............
New Hampshire Chapter of the National Alliance on 380,000
Mental Illness, Concord, NH for the Connect Suicide
Prevention Program..................................
NYC Health + Hospitals/Jacobi, Bronx, NY for the 400,000
Stand Up to Violence program to provide youth mental
health and substance use treatment services and
other support services..............................
Oakland County Health Network, Troy, MI for mental 260,000
health and law enforcement co-response for
behavioral health crises, including Crisis
Intervention Team and Mental Health First Aid
training............................................
Office of the Mayor-President, City of Baton Rouge, 1,000,000
LA for a resource and service center for recovery
from trauma.........................................
Oklahoma Children's Hospital, Oklahoma City, OK for 1,000,000
facilities, equipment, and children's behavioral
health services.....................................
Orange County Government, Orlando, FL for behavioral 300,000
health services for students........................
Oswego County Department of Social Services, Oswego, 250,000
NY for transportation...............................
Para Los Ninos, Los Angeles, CA for early childhood 350,000
mental health services and family supports,
including technology to provide telehealth services.
Parents Anonymous, Claremont, CA for mental health 1,000,000
services for Asian, Latinx and Black/African
American families...................................
Parkview Legacy Foundation, Riverside, CA for 625,000
behavioral health focused programs for students
returning to school after COVID-19..................
Path with Art, Seattle, WA for mental health and 210,000
trauma recovery programming.........................
Penny Lane Centers, North Hills, CA to provide mental 400,000
health care and supportive services to people
experiencing homelessness...........................
Polk County Board of Commissioners, Bartow, FL for a 850,000
behavioral health outreach mobile crisis team.......
PRC, San Francisco, CA for behavioral health services 525,000
for people experiencing homelessness................
Rales Jewish Family Services, Boca Raton, FL for 400,000
telemental health services to address mental illness
and substance use, including equipment and
technology..........................................
Reliance Health, Inc., Norwich, CT for a recovery 125,000
support program.....................................
Rick's Place, Wilbraham, MA for grief support 100,000
services............................................
Rosecrance, Inc, Freeport, IL for a behavioral health 300,000
outpatient clinic...................................
San Francisco AIDS Foundation, San Francisco, CA for 600,000
mental health and substance use treatment and
services, including case management services, for
long term survivors of HIV/AIDS.....................
Sankofa Safe Child Initiative, Chicago, IL for mental 275,000
health services for teens who have experienced
trauma..............................................
Santa Clara County Office of Education, San Jose, CA 300,000
for prevention and early intervention services to
address student mental health and trauma............
Selfhelp Community Services, New York, NY for mental 15,000
health and emotional wellness activities for seniors
Sociedad de Educacion y Rehabilitacion (SER) de 180,000
Puerto Rico, Inc., San Juan, PR for behavioral
intervention services...............................
Sonoma County, Santa Rosa, CA for the Accessing 1,600,000
Coordinated Care and Empowering Self Sufficiency
program to provide mental health and substance use
screening, treatment and other services, including
equipment and technology............................
Stanislaus County Behavioral Health and Recovery 1,810,000
Services, Modesto, CA for mental health services
through the Promotores/Community Health Outreach
Worker program and Community-Based Mental Health
Clinicians..........................................
Starr Commonwealth, Albion, MI for facilities, 850,000
equipment, and mental and behavioral health services
Swords to Plowshares, San Francisco, CA for mental 975,000
health and substance use treatment services, case
management and other support services for veterans..
Texas State University, San Marcos, TX for a 2,000,000
Community Mental Health Surveillance Collaborative
to strengthen mental health infrastructure,
including training, equipment, and technology.......
The Community Rehabilitation Center, Inc., 500,000
Jacksonville, FL to increase access to and improve
quality of mental health, health care, and substance
use disorder treatment services.....................
The Greater Scranton YMCA, Dunmore, PA for mental 1,850,000
health and substance use disorder treatment
services, including wraparound services.............
The Greater Washington Jewish Coalition Against 300,000
Domestic Abuse, Rockville, MD to provide mental
health and other support services for domestic
violence survivors and their families...............
The University Corporation dba Strength United, 1,000,000
Northridge, CA to address the long-term mental
health needs of children following the COVID-19
pandemic, including suicide prevention activities,
equipment and technology............................
TriCounty Community Network, Pottstown, PA for mental 450,000
health screening and treatment services, and other
support services....................................
UCHealth Trauma Services, Aurora, CO for an at-risk 450,000
intervention and mentoring violence prevention
program, including mental health treatment and other
services............................................
United Way of Broward County, Ft. Lauderdale, FL for 650,000
a suicide prevention program........................
Unlawful Narcotics Investigations, Treatment, and 500,000
Education, Inc., London, KY for substance abuse
prevention and the purchase of equipment and
information technology..............................
UPMC Western Behavioral Health at Twin Lakes, 100,000
Somerset, PA for recovery support services..........
Valley Youth House, Bethlehem, PA for mental health 400,000
services for at-risk children and families..........
Veterans Inc., Worcester, MA for behavioral health 430,000
services for veterans and their families............
Village of Schaumburg, Schaumburg, IL for a mobile 340,000
response unit for mental health and substance misuse
Vinland National Center, Loretto, MN for mental 140,000
health and substance use treatment services, and
other support services, for people with brain
injuries............................................
Washington County Health Department, Hagerstown, MD 475,000
for behavioral health crisis treatment services.....
Woods Services, Inc., Langhorne, PA for mental health 500,000
services............................................
YWCA NH, Manchester, NH for mental health care and 750,000
support services for children and families exposed
to trauma...........................................
------------------------------------------------------------------------
Drug Abuse Warning Network (DAWN).--The Committee includes
an increase of $6,500,000 for DAWN, a nationwide public health
surveillance system to monitor emergency department visits
related to substance use.
Health Surveillance.--The Committee includes an increase of
$337,000 to support activities of the Center for Behavioral
Health Statistics and Quality and an increase of $200,000 for
Performance and Quality Information Systems.
Program Support.--The Committee includes an increase of
$5,316,000 for SAMHSA personnel costs, the first increase in
four years, to ensure SAMHSA has the resources to respond to
the growing mental health and substance use crises.
Public Awareness and Support.--The Committee includes an
increase of $260,000 to raise awareness and understanding of
mental and substance use disorders.
Data on Substance Misuse in the U.S. Territories.--The
Committee has serious concerns about the limited availability
of data regarding drug and substance misuse in Puerto Rico and
the rest of the U.S. territories. The Committee is particularly
concerned that the National Survey on Drug Use and Health
(NSDUH) does not include statistics from these jurisdictions.
The Committee therefore encourages SAMHSA to take all
reasonable steps to include Puerto Rico and the rest of the
territories in the NSDUH, in the same manner that data is
collected and published for the 50 States and the District of
Columbia, and to submit a report detailing its efforts not
later than 180 days after the enactment of this Act.
PTSD in First Responders.--The Committee is aware of
research indicating that individuals working in the civilian
first responder disciplines of law enforcement, fire services,
and emergency medical services are at greater risk for full or
partial post-traumatic stress disorder (PTSD) than most other
occupations because their responsibilities routinely entail
confrontation with traumatic stressors. Within the funds
provided for Health Surveillance and Program Support, the
Committee directs SAMHSA to sponsor a report that examines what
is known and where there are gaps regarding trauma and
stressor-related disorders among this population, including
prevalence rate, risk factors, symptom presentation, course,
comorbidities, and rates of suicidal thoughts and actions,
barriers to accessing and seeking care. This report would serve
as a foundation for future surveillance ad program
opportunities.
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 2021....................... $338,000,000
udget request, fiscal year 2022....................... 353,000,000
Committee Recommendation.............................. 380,000,000
Change from enacted level......................... +34,650,000
Change from budget request........................ - - -
The Committee includes $380,000,000 in program level
funding for the Agency for Healthcare Research and Quality
(AHRQ), $34,650,000 above the fiscal year 2021 enacted level
and the same as the fiscal year 2022 budget request. The total
includes $250,792,000 in discretionary budget authority and
$129,208,000 in PHS Act section 241 evaluation set-aside
transfers.
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 2022 Committee
------------------------------------------------------------------------
Scientific Support for the US Preventive Services 11,542,000
Task Force..........................................
Digital Health Care Research......................... 16,349,000
Patient Safety Research.............................. 72,615,000
Health Services Research, Data, and Dissemination.... 127,053,000
Medical Expenditure Panel Survey..................... 71,791,000
Program Management................................... 73,300,000
------------------------------------------------------------------------
Antimicrobial Resistance.--The Committee continues to
provide no less than $10,000,000 for activities related to
combating antibiotic-resistant bacteria.
Accessibility of Online Telehealth Platforms.--The
Committee recognizes that the COVID-19 pandemic led to the
increased use of online portals and web services for patients
seeking information, scheduling, and accessing remote services.
However, the Committee is concerned that many online platforms
are not user-friendly, especially for less digitally literate
communities, including seniors. The Committee urges AHRQ to
coordinate with ONC, CMS, and OCR on any Federal efforts that
could be made to evaluate the accessibility of digital health
platforms for Federally-supported providers, including any
assessments of how seniors and persons with disabilities are
included in the design and testing of the platforms. Further,
the Committee urges AHRQ to work with ONC, CMS and OCR to
establish best practices for health care providers to improve
their online telehealth platforms for seniors, individuals with
disabilities, and individuals with limited English proficiency.
Cardiovascular Clinical Outcomes.--The Committee looks
forward to receiving the study requested in the Consolidated
Appropriations Act, 2021 that assesses the current evidence for
lipid control and cardiovascular event reduction and quality
measures for the improvement of clinical outcomes (e.g.
coronary heart disease death, myocardial infarction, ischemic
stroke, or urgent coronary revascularization procedure). The
Committee also encourages AHRQ to develop and disseminate
education resources and materials about improving
cardiovascular clinical outcomes.
Center for Primary Care Research.--The Committee includes
$5,000,000 to establish the Center for Primary Care Research
authorized at 42 USC 299b-4(b). AHRQ is uniquely positioned to
support primary care clinical and practice research and to help
disseminate the research nationwide. The 2021 NASEM report on
High Quality Primary Care supported the importance of targeted
funding for Primary Care Research (PCR) and recommended
prioritization of funding for AHRQ's Center for Excellence in
Primary Care Research. In 2020, the RAND Corporation published
a report requested by Congress that emphasized the significant
role AHRQ plays in PCR and recommended providing targeted funds
to create a proper hub for Federal PCR. The areas of focus
could include strategies to improve primary care delivery,
including through the use of clinical pharmacists and inter-
professional; team-based care; advancing the development of
primary care researchers; expanding research on persons with
multiple co-morbid conditions; and improving primary care in
rural and underserved areas, especially in remote and non-
contiguous States.
Research on Health Equity.--The Committee includes an
increase of $3,000,000 for AHRQ to support investigator-
initiated research grants related to health equity and an
additional $1,000,000 to support research supplements related
to health equity, the same as the fiscal year 2022 budget
request.
Health System Innovations Responding to COVID-19.--The
Committee includes an additional $5,000,000, the same as the
fiscal year 2022 budget request, to support new investigator-
initiated research grants related to COVID-19, including grants
focused on improving the quality of care and patient outcomes;
improving patient safety; understanding the pandemic's impact
on socially vulnerable populations and people with multiple
chronic conditions; and understanding how digital health
innovations such as telehealth contributed to the health system
response to COVID-19.
Improving Maternal Morbidity and Mortality State and Local
Data.--The Committee includes $7,350,000, the same as the
fiscal year 2022 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.
Kratom.--The Committee directs the Secretary to maintain
current Agency policy to not recommend that the substances
mitragynine and 7-hydroxymitragynine, known as kratom, be
permanently controlled in Schedule I of the Controlled
Substances Act, either temporarily or permanently, until
scientific research can sufficiently support such an action.
The Committee encourages AHRQ to continue to fund research on
natural products that are used by many to treat pain in place
of opioids, including kratom. Given the wide availability and
increased use of these substances, it is imperative to know
more about potential risks or benefits, and whether they can
have a role in finding new and effective non-opioid methods to
treat pain. The Committee recommends an additional $3,000,000
for this research and directs AHRQ to make center-based grants
to address research which will lead to clinical trials in
geographic regions which are among the hardest hit by the
opioid crisis.
Lyme and Other Tick-Borne Diseases (TBD).--The Committee is
concerned about the experiences of low-income, minority, and
migrant populations with Lyme and other TBD and believes that
better data should be developed on the incidence of TBD in
these populations and the experiences of those populations in
accessing care for suspected TBD, including provider awareness
of TBD, diagnostic tools, treatment protocols, and health
outcomes. The Committee directs AHRQ to coordinate with HRSA
and its Bureau of Primary Health Care and the Office of Rural
Health Policy, other HRSA Bureaus and Offices as appropriate,
and the Indian Health Service to develop a plan for exploratory
research to assess the extent of the problem of TBD in the low
income, minority, and migrant populations and in the national
network of clinics and health centers which provide health
care, and which in turn receive a large portion of payments
from CMS.
Opioids Research.--The Committee includes $5,000,000, an
increase of $2,000,000 above the fiscal year 2021 enacted level
and $5,000,000 below the fiscal year 2022 budget request, to
support expanded research related to opioid use and misuse,
including research focused on increasing equity in treatment
access and outcomes, accelerating implementation of effective
evidence-based care in primary and ambulatory care, and
developing whole person models of care that address the social
factors which shape treatment and adherence and long-term
recovery.
Patient Safety Risks and Harms.--The Committee recognizes
the seriousness of diagnostic errors in the health care system.
Diagnostic error has been under-recognized and leads to a
quarter-million inpatients experiencing serious hardship each
year, including approximately 100,000 deaths. The Committee
provides an increase of $8,000,000 for researching diagnostic
error and associated risk to patient safety.
Prenatal Care for Pregnant Individuals.--The Committee
recognizes the Department's ongoing efforts to address the
pressing public health issue of rising maternal mortality.
Research shows prenatal care is a critical component of
preventative care for pregnant individuals. The Committee
includes no less than $500,000, the same as the fiscal year
2021 enacted level, for research that examines the potential
cost savings to the public health system of providing a special
enrollment period for pregnant individuals, as well as the
impact of a special enrollment period on the private insurance
market.
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, hospitals
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 of surgical care, and decrease disparities in care. The
Committee urges ARHQ 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 provides total funding of $2,000,000 for the purposes
authorized under the Trafficking Awareness Training for Health
Care Act to establish a pilot program for the creation,
distribution, and evaluation of best practices for medical
professionals to identify and respond to victims of human
trafficking. Medical professionals are in a unique position to
identify abuse and help victims of trafficking. Funding this
program will ensure they are adequately trained to do so.
USPSTF Clinical Data.--The Committee is concerned about
significant deficiencies in the process and structure of the
United States Preventive Services Task Force (USPSTF), as
illustrated by its recommendations concerning screening
mammography and cervical cancer screening. Comprehensive USPSTF
reform is necessary to ensure that its recommendations further
public health for all Americans and address health inequities.
USPSTF's process needs to be revised to provide timely
recommendations, be fully transparent, afford ample opportunity
for public comment at each stage, make such comments publicly
available, and provide meaningful responses to such comments.
The comment process for USPSTF must provide a more robust and
transparent opportunity for and public disclosure of expert and
patient input, as well as an external advisory board of
clinical experts that serves as a check, throughout the
process. Moreover, USPSTF's methodologies should be firmly
grounded in evidence that most accurately represents the
Nation's racial and ethnic subpopulations; this evidence must
include high quality real-world data sets and longitudinal or
observational studies and not just randomized controlled
trials. Specifically, the Committee calls for action on the
established lack of data specific to health equity and racial
diversity to more clearly inform the USPSTF decision-making.
Furthermore, USPSTF should review a recommendation upon a
showing of new evidence. In addition, USPSTF's composition
should reflect an appropriate breadth of practicing physician
expertise, including specialist expertise, as well as public
input reflecting diverse patient populations. The Committee
encourages the USPSTF to adopt these reforms to its process for
developing recommendations.
Centers for Medicare & Medicaid Services
GRANTS TO STATES FOR MEDICAID
Appropriation, fiscal year 2021................ $313,904,098,000
Budget request, fiscal year 2022............... 368,666,106,000
Committee Recommendation....................... 368,666,106,000
Change from enacted level.................. +54,762,007,000
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 $148,732,315,000, which was
provided as advance funding for the first quarter of fiscal
year 2022. In addition, the Committee recommends an advance
appropriation of $165,722,018,000 for program costs in the
first quarter of fiscal year 2023, to remain available until
expended.
The Committee continues bill language providing indefinite
budget authority for unanticipated costs in fiscal year 2022.
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 2021................ 439,514,000,000
Budget request, fiscal year 2022............... 487,862,000,000
Committee Recommendation....................... 487,862,000,000
Change from enacted level.................. +48,348,000,000
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 2021....................... $3,669,744,000
Budget request, fiscal year 2022...................... 4,315,843,000
Committee Recommendation.............................. 4,315,843,000
Change from enacted level......................... +646,099,000
Change from budget request........................ - - -
Program Operations
The Committee includes $4,315,843,000 for Program
Operations, which is $646,099,000 more than the fiscal year
2021 enacted level and equal to the fiscal year 2022 budget
request. This appropriation includes $25,400,000 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.
In addition, the American Rescue Plan (P.L. 117-2) included
$500,000,000 for the survey and certification program, for
strike teams to provide onsite technical assistance and
education to nursing homes to reduce transmission and spread of
COVID-19.
Addressing Domestic Violence and Homelessness.--The
Committee recognizes that the COVID-19 pandemic has increased
both domestic violence and homelessness, as the pandemic has
placed great stress on families. CMS has recognized both
homelessness and domestic violence as social determinants of
health impacting Medicaid and Medicare beneficiaries. Model
interventions such as Domestic Violence Housing First programs
can address this challenge. The Committee requests, within 120
days of enactment of this Act, a report outlining the actions
the agency is taking to address the combination of homelessness
and domestic violence, including how the Center for Medicare &
Medicaid Innovation (CMMI) and other parts of CMS are
considering the feasibility of creating demonstration programs,
in collaboration with the Administration for Children and
Families and the Department of Housing and Urban Development,
that will engage Medicare and Medicaid providers to address
this dual problem.
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,
developmental delays, suicide, and substance misuse, among
others. 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 H. Rept.
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 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 adverse childhood experiences.
Ambulatory Surgical Centers.--The Committee looks forward
to receiving the report on ambulatory surgical centers, as
requested in H. Rept. 116-450.
Antimicrobial Resistance.--The Committee recognizes
antimicrobial resistance is a serious threat to seniors.
Medicare beneficiaries are more likely than the general
population to become acutely ill with a multi-drug resistant
bacterial infection and are potentially more susceptible to
adverse events associated with older antibiotics used in the
current standard of care. The Committee supports the ability of
seniors to receive access to the most clinically appropriate
antibiotic therapies available.
Blue Button.--The Committee believes that the Blue Button
program can play an important patient safety and care
coordination role for Medicare beneficiaries and their health
care providers, particularly in relation to COVID-19
vaccination efforts and the increasing use of telehealth.
Unfortunately, Blue Button has had a low participation rate.
The Committee urges the Secretary to examine barriers to
participation, including health and technology related
inequities, and widely educate beneficiaries about Blue Button.
CMS Contact Center Operations (CCO).--The Committee
understands that the CCO is one of the largest federal service
contracts, and that CMS is anticipating awarding another 10-
year contract for these critical services. The Committee is
concerned that there has been insufficient competition for the
CCO contract, and the Beneficiary Contact Center contract that
preceded it, over the past 15 years. The Committee includes a
provision to prevent fiscal year 2022 funds from being used for
a new CCO contract or to issue any solicitation for a contract
with a performance period of more than 24 months. In addition,
the Committee directs CMS to conduct a review of the
acquisition strategy for the CCO services to ensure genuine
full and open competition for the award of a new definitive CCO
contract, and to ensure this contract is structured to
guarantee that taxpayer dollars are spent responsibly and with
accountability. The Committee requests a report on the results
of this review within 180 days of enactment of this Act.
Community Health Workers.--The Committee recognizes the
importance of community health workers, who are trusted members
of their communities and comprise a vital frontline health
workforce that help to address social, economic, behavioral and
preventive health needs, and appreciates CMS highlighting their
role in a January 7, 2021 letter to State Health Officials. The
Committee further recognizes the ongoing role of community
health workers in an equitable, resilient recovery from the
COVID-19 pandemic and in achieving long-term, sustainable
health equity. Given their proven effectiveness in improving
health outcomes, reducing costs in underserved communities, and
advancing health equity, the Committee urges CMS to continue to
work with States, in partnership with community health workers
and their professional organizations, to incorporate community
health workers into coverage in a way that aligns with
scientific evidence and fully leverages their expertise and
skills.
Complex Rehabilitation Technology.--The Committee is aware
that provisions in P.L. 116-94 were intended to empower
Medicare beneficiaries with severe disabilities through
improved access to specialized Complex Rehabilitation
Technology (CRT) manual wheelchairs and accessories. The
Committee encourages CMS to provide adequate and equal access
to users of CRT manual wheelchairs and accessories and to
consider making that protection permanent.
Compounded Medications.--The Committee requests a report,
within 120 days of enactment of this Act, assessing Medicare's
current policy for reimbursement to Part D plans for
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.
Consumer Assistance Program.--The Committee encourages the
Secretary to allocate up to $400,000,000 derived from
Affordable Care Act (ACA) user fees to restore Consumer
Assistance Program (CAP) 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.
Critical Access Hospitals and Sole Community Hospitals.--
The Committee looks forward to receiving the GAO study
requested in H. Rept. 116-450, which will examine the cost of
emergency mental and behavioral health services provided at
Critical Access Hospitals (CAH). Behavioral health providers
are scarcer in rural areas, but more patients are suffering
from mental health concerns due to the COVID-19 pandemic.
However, new treatment pathways (such as tele-mental health
care) are not always accessible in rural areas. The Committee
requests HHS provide a briefing on behavioral health services
furnished at CAHs, sole community and other rural hospitals,
whether the mix of services furnished at these hospitals
changed during the COVID-19 pandemic, and identify
opportunities to improve mental health care in these settings.
Diabetes Self-Management Training Benefit.--The Committee
is aware that one in four health care dollars in the U.S. is
spent on people living with diabetes, totaling more than $300
billion a year. Nearly 70 percent of that cost is provided by
federal health care programs (e.g., Medicare, Medicaid,
TRICARE). The Committee is also aware that 13 percent of all
adults and nearly one-third of individuals aged 65 years or
older are living with diabetes. Given the prevalence and cost
of diabetes, particularly among communities of color, the
Committee is concerned that barriers to accessing the Medicare
diabetes self-management training benefit have resulted in
utilization by only 5 percent of newly diagnosed Medicare
beneficiaries. The Committee encourages CMS to explore the
barriers to accessing the diabetes self-management training
benefit and to provide a report, within 120 days of enactment,
on efforts to address these barriers.
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.
Drug Quality.--The Committee is deeply 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 requests a report, within
180 days of enactment, on the amount that the Medicare and
Medicaid programs spent on medication in the previous three
fiscal years that was subsequently recalled by manufacturers.
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.
Evidence-Based Home Visiting Programs.--The Committee
recognizes the wide range of improved outcomes and cost-savings
that evidence-based home visiting programs provide to first-
time mothers and their children. Additionally, in light of the
impact of the COVID-19 pandemic on care and the rising rates of
maternal and infant health disparities among families of color,
the need for quality supports in the home is even greater,
especially for mothers and babies. The Committee is pleased
that CMS is assisting States that choose to design a Medicaid
benefit package to provide home visiting services for pregnant
and postpartum women, and for families with young children. The
Committee urges CMS to continue to build upon its 2016 Joint
Informational Bulletin to clearly articulate how Medicaid
dollars can be blended and braided appropriately in home
visiting programs to reach eligible families, provide
streamlined coverage options for home visiting services, and
cover specific components of home visiting programs.
Fraud and Abuse in Electrodiagnostic (EDX) Medicine.--The
Committee notes the ongoing investment in activities to address
health care fraud and abuse along with enhanced interagency
coordination. The Committee encourages HHS and the Department
of Justice to continue working with the stakeholder community,
as they do through the Healthcare Fraud Prevention Partnership,
on innovative strategies to address persistent forms of fraud
and abuse that exploit gaps in the current oversight framework
and undermine quality patient care throughout the health care
system, including systemic efforts by criminal actors and
mobile labs in EDX testing.
Finding Alternatives to Use of Quality-Adjusted Life Years
for Drug Price Indexing.--The Committee encourages CMS to study
appropriate alternatives for using Quality-Adjusted Life Years
in determining indexes for prices and coverage for medications,
treatments, and other services. The Committee supports the
National Council on Disability's analysis in its 2019 report,
``Quality-Adjusted Life Years and the Devaluation of Life with
Disability,'' and recognizes the significance of determining
alternative methodologies for establishing pricing mechanisms
that are not discriminatory to individuals with disabilities.
The Committee requests a report within 180 days of enactment of
this Act on alternative methodologies, including analysis as to
whether or not these alternatives themselves may be
discriminatory if used incorrectly, as well as if there are
different best practices which can and should be used
separately for the pricing of medications and treatments versus
decisions related to benefits and coverage.
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.
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. Congress urges CMS to pursue a pilot program
allowing select IMDs that provide the majority of their care to
those suffering from acute psychiatric distress to receive
Medicaid funding. CMS should focus on the institutions that
receive the largest volumes of cases in States that do not
currently have the mental health treatment waiver and which
offer longstanding, effective treatment regimens.
IMD Exclusion Report.--The Committee requests a report,
within 2 years of enactment of this Act, 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.
Implementation of Medicaid PDMP Expansion.--Data show that
prescription drug monitoring programs (PDMPs) integrated into
state Medicaid systems can reduce over-prescribing and misuse
of opiates and other prescription drugs. The Committee requests
a report, within one year of enactment of this Act, on the
interoperability of existing state PDMP infrastructure, the
status of implementation of Sec. 5042 of the SUPPORT for
Patients and Communities Act, the actions being taken to
further improve interoperability, and how CMS intends build on
existing interoperability infrastructure to avoid duplication
and waste of allocated funding.
Kidney Transplant Availability, Recovery, Long-Term
Outcomes.--The Committee recognizes the significant costs to
the Medicare program resulting from care for end-stage renal
disease and kidney dialysis and supports the goal of
significantly reducing dialysis use. The Committee supports
efforts to identify ways to increase kidney transplant
availability and to improve recovery and long-term outcomes.
The Committee requests a report within 180 days of enactment of
this Act on recommendations for quality measures to be
implemented for improved studying and tracking long-term kidney
transplant outcomes, including for patients transitioning
between Medicare and commercial coverage, as well as means of
improving data interoperability in order to facilitate long-
term tracking of long-term transplant patient data.
Limited Wraparound Coverage.--The Committee remains
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 requests a
report, within 90 days of enactment of this Act, 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. This report should
include an analysis of the outcomes of the pilot program and an
explanation for CMS' decision not to extend it. The Committee
continues to recommend this pilot program be made permanent and
encourages CMS to restore the program.
Long Term Care Facility Licensing.--The Committee is aware
that certain facilities that are owned or operated by
individuals who have been denied by their respective state
licensing body can still receive CMS funds. The Committee
directs CMS to provide a publicly available report, no later
than 180 days after enactment of this Act, on the number of
long term care facilities that receive CMS funds that are owned
and or operated by individuals who have been denied licenses to
do so by their respective state licensing body.
Lung Cancer Screening.--The Committee is concerned with the
persistently low rate of lung cancer screening across the
United States. Lung cancer remains the deadliest form of
cancer, with significant racial disparities in outcomes. People
of color are more likely to be diagnosed with and die from lung
cancer, but they are also less likely to undergo screening. In
March 2021, the United States Preventive Services Task Force
(USPSTF) revised its recommendations on lung cancer screening
eligibility, significantly increasing the number of individuals
who should be screened. The Committee encourages CMS to
evaluate what steps it can take to improve access to lung
cancer screening, including decreasing the cost to participate
in registries, expanding the number of CMS-approved lung cancer
screening registries, and promoting the development of quality
measures in lung cancer screening and care to focus on reducing
racial disparities in lung cancer screening. The Committee
requests CMS provide a report within 120 days of enactment of
this Act on its findings from this evaluation.
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 report within 90 days of
enactment of this Act on steps taken to develop such guidance.
Medicare Advantage and Long-Term Acute Care Hospitals
(LTCHs).--The Committee is aware there is concern that 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 Appropriate Use Criteria Program.--The Committee
is aware that the Protecting Access to Medicare Act established
the Medicare Appropriate Use Criteria (AUC) Program for
advanced diagnostic imaging. While the Committee recognizes the
value of encouraging physicians and other health care
professionals to consult AUC and clinical guidelines to support
medical decision making, more than seven years have passed
since Congress created the AUC program, which has not advanced
beyond educational and operations testing. The Committee
requests a report within 180 days of enactment of this Act on
implementation of this program, including challenges and
successes. In this report, CMS shall consider existing quality
improvement programs and relevant models authorized under
Sec.1115A of the Social Security Act and their influence on
encouraging appropriate use of advanced diagnostic imaging. The
Committee directs CMS to consult with stakeholders, including
medical professional societies and developers of AUC and
clinical guidelines, when formulating its report.
Medicare Promotion.--The Committee reiterates its direction
that CMS avoid taking any action that actively promotes one
form of Medicare coverage over another, particularly with
respect to the choice between traditional Medicare and Medicare
Advantage. The Committee further directs CMS to design and
maintain its online coverage options tool in a manner that
provides complete and unbiased information, particularly as CMS
works to replace the Medicare Plan Finder with the new Medicare
Coverage Tools platform. CMS should remain objective and
neutral in its education and outreach materials concerning
options that beneficiaries have during the open enrollment
period and at any other time.
Molecular Diagnostics.--More than 550,000 Americans are
diagnosed with a rare form of cancer every year. Rare cancers
account for 380 of 400 distinct forms of cancer and almost one-
third of all diagnoses and include all pediatric-specific
cancers. Molecular diagnostics are an important part of
determining the form of cancer and which treatment is the best
option. Each subtype of cancer requires a targeted therapy in
order to save a life or to significantly improve life span, and
data is required for each cancer to inform where targeted
therapies can be used. However, this data is frequently lacking
for rare cancers, leading to the use of older and less
effective therapies. The Committee understands that CMS has
established Medicare national coverage policies for molecular
diagnostics at the time of diagnosis for only certain cancers.
The Committee encourages CMS to issue guidance to their plans
on how to determine if molecular diagnostics are reasonable and
necessary, and update the Medicare coverage guidelines for
molecular diagnostics for all cancers where it is determined to
be reasonable and necessary at the time of diagnosis.
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.
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 and encourages CMS to explore the development of a
MIPS quality improvement activity related to nuclear medicine
injection quality as well as the feasibility of a MIPS quality
measure to allow for the meaningful evaluation and improvement
of nuclear medicine injection quality.
Nutrition Education.--The Committee encourages CMS to
coordinate with the HRSA to develop recommendations for
expanded nutrition education in medical school and graduate
medical education curricula.
Nursing and Allied Health Workforce Shortages.--The
Committee notes that in a March 2021 survey conducted by the
HHS Office of the Inspector General, hospitals reported that
nursing shortages during the COVID-19 pandemic significantly
strained health care delivery and were a significant obstacle
to addressing the public health emergency. The survey found
that these shortages exacerbated longstanding challenges in
health care delivery, access to care, and health outcomes. The
Committee requests a report within 180 days of enactment of
this Act addressing the role of Medicare funding in supporting
the training of nursing and allied health professionals. Such
report should also include an assessment of how CMS can
exercise its discretion under existing payment rules to further
address shortfalls in the nursing and allied health workforce.
Oral Health Services.--The Committee is pleased that CMS is
moving forward to fill the Chief Dental Officer position, which
has been vacant since October 2017. This left a significant gap
of clinical oral health expertise within CMS. Medicaid provides
oral health services to millions of people, including
vulnerable populations such as children (including those with
special health care needs), pregnant women, and disabled
adults. The Committee notes that States have flexibility to
determine dental benefits for adult Medicaid enrollees and
while most States provide at least emergency dental services
for adults, less than half currently provide comprehensive
dental care. The Committee urges the Chief Dental Officer to
examine opportunities within existing statutory authority to
expand Medicare coverage of dental services. The Committee also
urges CMS to provide recommendations no later than one year
after enactment of this Act regarding policies to increase
coverage of, and access to, comprehensive dental benefits for
adults in State Medicaid programs.
Patient Access to Home Health Care.--The Committee supports
the intent of the network adequacy rules of CMS for Medicare
Advantage organizations under 42 C.F.R. 417 and 422 and for
Medicaid managed care organizations under 42 C.F.R. 438 and 457
as maintaining a network of qualified providers sufficient to
provide adequate access for covered services to meet the health
care needs of the patient population served.
Payment Structures Impact on ESRD Patients.--The Committee
is concerned that patient outcomes may be negatively impacted
by dialysis provider behaviors resulting from the 2021 bundled
payment change affecting calcimimetics. Absent calcimimetic
therapies, patients being treated for End Stage Renal Disease
(ESRD) are at greater risk of requiring parathyroid surgeries,
exposing them to further health care risk while shifting
dialysis providers' financial burden to the federal government.
Like ESRD, such outcomes are likely to impact marginalized and
communities of color disproportionately. The Committee requests
CMS monitor utilization and certain beneficiary health outcomes
under the ESRD PPS resulting from the 2021 bundled payment
change. The Committee encourages CMS to consider issuing a
report highlighting statistical changes in the clinical
administration of calcimimetic therapies (including on
marginalized and communities of color subpopulations), any
instances of incentive payment structures from dialysis
providers, and any recommendations on treatment protocols or
policy changes.
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 on how to reduce
amputations no later than one year after enactment of this Act.
Pharmacists and COVID-19 Authorities.--The Committee is
pleased with CMS' clarification that medication management
services provided by pharmacists services incident to
physicians and other qualified health care professionals (QHPs)
are covered under Medicare Part B. This clarification was
designed to encourage team-based care during the COVID-19
public health emergency (PHE) and increase access of
individuals with substance use disorder to services. The
Committee appreciates CMS' recognition of the expanding roles
of pharmacists with broadened scopes of practice. The Committee
requests CMS hear from physicians, pharmacists, and other
qualified health professionals on their efforts to work with
the American Medical Association (AMA) CPT Editorial Panel to
develop mechanisms to attribute, report, and sustain
pharmacists' medication management and other patient care
contributions to beneficiaries in the Medicare Part B program.
In addition, the Committee is aware of the Secretary's request
for information to determine whether regulatory actions taken
by HHS to expand clinician's authorities to mitigate and
prevent COVID-19 during the PHE should be made permanent. The
Committee requests the Secretary report within 180 days of
enactment of this Act on the outcomes that pharmacists and
pharmacies provided during the COVID-19 pandemic.
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.
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
2022, so this community-based model of care may be evaluated as
to whether it increases access and affordability for Medicare
or Medicaid beneficiaries.
Radiation Oncology (RO) Model.--Despite the delay in
implementation, the Committee is concerned that the 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 H. Rpt. 116-450.
Regulatory and Payment Reforms.--The Committee urges CMS to
work with hospitals, community-based organizations, and other
stakeholders to identify substantive regulatory delivery and
payment reforms that integrate behavioral health in primary
care; create new and evaluate existing delivery models to
improve efficiency and value-based care; and incentivize the
health care workforce to meet the unmet care needs of Medicare
beneficiaries in underserved areas.
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.
Screening and Diagnostic Testing in Cancer Treatment.--The
Committee understands that the use of pre-treatment
interventions, such as screening for signs of cancer or testing
with a companion diagnostic to determine a specific cancer
type, can help health care providers select treatment options
with a greater probability of success, leading to better
outcomes for patients. The Committee also recognizes that the
use of these interventions can reduce unnecessary health care
costs by avoiding ineffective treatments and that awareness of
genetic risk factors can encourage preventive care and early
diagnosis. This is particularly important now, as the Committee
recognizes that during the COVID-19 pandemic, providers and
hospitals have reported a decrease in non-COVID related patient
visits, including vital cancer screenings and follow-up
appointments. The Committee urges CMS to identify ways to
expand access to screening and testing, especially among the
most at-risk patient populations, eligibility criteria for
testing and screenings recommended by USPSTF and relevant
medical societies, and increase public and health care provider
awareness of the importance of appropriate testing and
diagnostics.
Sepsis.--The Committee requests that CMS task their
contracted Quality Improvement Organizations (QIOs) to engage
with hospitals to provide technical assistance that reflects
recent advances in sepsis treatment to help them comply and
report SEP-1 standards of care. The Committee further requests
that CMS report to the Committee within one year of enactment
of this Act with an assessment of the impact of the QIO
engagement on SEP-1 rates and with feedback on any revisions to
the SEP-1 standards of care that will improve treatment of
sepsis by U.S. hospitals.
Site Neutral Reimbursement.--The Committee encourages CMS
to evaluate the financial impacts on rural hospitals and
Critical Access Hospitals in all rulemaking relating to payment
rates, including all pending rules relating to CMS outpatient
prospective payment system and the Medicare ambulatory surgical
center payment system.
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 CHIP authority, or through waivers,
to address social determinants of health 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 social determinants of health through contracts.
Specimen Collection and Counseling Services for Pharmacist-
Delivered COVID-19 Testing.--The Committee is aware that CMS
made it easier for pharmacies to enroll in Medicare as
independent clinical laboratories and permitted any health care
professional authorized under state law to order COVID-19 tests
(and influenza and RSV tests when conducted concurrently with
COVID-19 tests) during the COVID-19 public health emergency.
The Committee is aware that CMS clarified coding for symptom
assessment, specimen collection, and patient counseling, all
standard components of COVID-19 testing services conducted by
other health care professionals. However, CMS' only option for
symptom assessment, specimen collection, and patient counseling
by pharmacists is to enter into an incident to arrangement with
a physician or non-physician practitioner (NPP). The Committee
is concerned that most community pharmacists do not have
incident to arrangements with physician practices or NPPs,
which inhibits the goal of widely accessible COVID-19 testing
in community pharmacies. The Committee requests CMS hear from
physicians and other qualified health care professionals on
their efforts to work with the AMA CPT Editorial Panel to
develop coding options for pharmacists provision of symptom
assessment, specimen collection, and patient counseling, when
ordering and administering COVID-19 point of care tests at
community pharmacies equivalent to all other health care
professionals.
Step-Down Care for Psychiatric Patients.--The Committee is
aware of the potential health benefits and cost savings of
step-down care options for inpatient psychiatric care as it
relates to an overall consumption of health services and costs
without increased hospital admissions while also freeing up
much needed inpatient beds. The lack of step-down care and
housing options for psychiatric patients being discharged from
local hospitals has led to long and expensive waits in
hospitals that burden patients, families and hospital staff.
The Committee requests CMS to, within 180 days of enactment of
this Act, conduct an assessment of the benefits of step-down
care options for patient care and consideration of payment
policy.
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.
Telehealth and Homelessness.--The Committee recognizes the
role that behavioral and mental illnesses play in the homeless
population and that telehealth offers a unique possibility to
meet these individuals where they are in providing all health
services, but particularly for mental health. The Committee
encourages CMS to identify and share with States best practices
regarding ways in which telehealth and remote patient
monitoring can be leveraged through the Medicaid and Medicare
programs for the homeless population. This should include
identification of barriers to mental health services via
telehealth coverage, as well as strategies to address those
barriers.
Telehealth for Pediatric ESRD.--The Committee understands
that due to the scarcity of pediatric nephrologists and
precautions following the COVID-19 pandemic, more children are
successfully receiving care for end stage renal disease at home
through telehealth technology. However, persistent inequalities
in access to broadband and information technology prevent many
children from accessing this technology. The Committee requests
that, within 120 days of enactment of this Act, the Secretary
provide a report on the usage of telehealth technology for
pediatric end stage renal disease patients covered by Medicare
and Medicaid during the COVID-19 pandemic, including an
analysis of use in HRSA-designated rural counties and
designated eligible census tracts in metropolitan counties and
HRSA-designated medically underserved areas.
Zero Trust Program.--The Committee encourages CMS to
increase support for the Zero Trust Program for CMS health
information and data security modernization to address,
mitigate, and reduce security risks.
State Survey and Certification
The Committee provides $472,163,000 for State Survey and
Certification activities, which is $74,829,000 above the fiscal
year 2021 enacted level and equal to the fiscal year 2022
budget request. 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 $864,000,000 for Federal
Administration activities related to the Medicare and Medicaid
programs, which is $91,467,000 above the fiscal year 2021
enacted level and equal to the fiscal year 2022 budget request.
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 2021....................... $807,000,000
Budget request, fiscal year 2022...................... 872,793,000
Committee Recommendation.............................. 872,793,000
Change from enacted level......................... +65,793,000
Change from budget request........................ - - -
The Health Care Fraud and Abuse Control Account (HCFAC)
supports activities conducted by CMS, the HHS Office of
Inspector General, and the Department of Justice (DOJ). This
appropriation includes a base amount of $317,000,000 and an
additional $555,793,000 through a discretionary budget cap
adjustment provided to meet the terms of H. Res. 467. This is
$65,793,000 above the fiscal year 2021 enacted level and equal
to the fiscal year 2022 budget request.
This funding is in addition to other mandatory funding
provided through authorizing legislation. The funding will
provide resources to continue efforts for Medicaid program
integrity activities, for safeguarding the Medicare
prescription drug benefit and the Medicare Advantage program,
and for program integrity efforts related to these programs
carried out by the DOJ.
Senior Medicare Patrol.--The Committee includes
$30,000,000, an increase of $10,000,000, for the Senior
Medicare Patrol program. The Committee continues to include
modified bill language to enable the Secretary to fund the
Senior Medicare Patrol, which is administered by the
Administration for Community Living, from either discretionary
or mandatory funds provided to this account.
Health Care Fraud Unit.--These units prosecute health care
fraud-related cases involving patient harm or large financial
loss to the public fisc. Protecting vulnerable populations and
ensuring program integrity lie at the core of their work. The
strike force model involves a cross-agency collaborative
approach, bringing together both investigative and analytical
resources of several Federal agencies, along with the
prosecutorial resources of U.S. Attorney's Offices and state
and local law enforcement partners. The Committee includes an
increase to expand offices into more areas in the western
United States.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriation, fiscal year 2021....................... $3,039,000,000
Budget request, fiscal year 2022...................... 2,795,000,000
Committee Recommendation.......................... 2,795,000,000
Change from enacted level......................... -245,000,000
Change from budget request........................ - - -
The Committee also recommends $1,300,000,000 in advance
funding, as requested, for the first quarter of fiscal year
2023 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 2021....................... $3,750,304,000
Budget request, fiscal year 2022...................... 3,850,304,000
Committee Recommendation.............................. 3,900,304,000
Change from enacted level......................... +150,000,000
Change from budget request........................ +50,000,000
The Committee recommends $3,900,304,000 for the Low Income
Home Energy Assistance program, which is $150,000,000 above the
fiscal year 2021 enacted level and $50,000,000 above the fiscal
year 2022 budget request. The Low Income Home Energy Assistance
Program (LIHEAP) supports eligible families and households
through programs providing assistance with energy costs.
In addition, the Coronavirus Aid, Relief, and Economic
Security (CARES) Act (P.L. 116-136) included $900,000,000 and
the American Rescue Plan (P.L. 117-2) included $4,500,000,000
in funding 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, the same amount of funding to each
State, territory, and Tribe as was appropriated in the
Consolidated Appropriations Act, 2021.
Formula and Allocations Report.--The Committee continues to
express strong support for LIHEAP, but remains concerned about
the complexities of the LIHEAP formulation process. The
Committee strongly urges ACF to explore ways to simplify and
automate its funding formula calculations to increase the
ability of staff to complete calculations quickly, and
administer funding more readily. Given the significant amount
of spending dedicated to LIHEAP in fiscal years 2020 and 2021,
including emergency funding from the CARES Act (P.L. 116-136)
and the American Rescue Plan (P.L. 117-2), the Committee
directs ACF to submit, and make publicly available on its
website, a report detailing the program's formula and State
allocations for each source of funding from fiscal years 2020
and 2021. ACF is encouraged to include any additional
information that may provide context for funding allocations.
REFUGEE AND ENTRANT ASSISTANCE
Appropriation, fiscal year 2021....................... $1,910,201,000
Budget request, fiscal year 2022...................... 4,404,947,000
Committee Recommendation.............................. 4,504,947,000
Change from enacted level......................... +2,594,746,000
Change from budget request........................ +100,000,000
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, and to
include any updates in estimated funding needs as a result of
changes in trends in those categories.
In times of sudden reductions in refugee arrivals, the
Committee encourages HHS, to the extent practicable, to ensure
that resettlement agencies are able to maintain their
infrastructure and capacity at a level to continue to serve new
refugees, previously arrived refugees, and other populations of
concern who remain statutorily eligible for integration
services, and to ensure that there is capacity for future
arrivals to be adequately served.
Within the total, the Committee includes the following:
------------------------------------------------------------------------
FY 2022
Budget Activity Committee
------------------------------------------------------------------------
Transitional and Medical Services.................... $605,000,000
Victims of Trafficking............................... 39,480,000
Refugee Support Services............................. 450,000,000
Unaccompanied Children............................... 3,383,467,000
Survivors of Torture................................. 27,000,000
------------------------------------------------------------------------
Transitional and Medical Services
The Committee includes $605,000,000, which is $251,000,000
above the fiscal year 2021 enacted level and equal to the
fiscal year 2022 budget request. 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 $39,480,000 for the Victims of
Trafficking program, which is $10,725,000 above the fiscal year
2021 enacted level and equal to the fiscal year 2022 budget
request. The recommendation includes $4,500,000 for the
National Human Trafficking Hotline.
The Committee encourages ACF to use a portion of increased
funding for legal services for victims, increasing funds
equally for 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
$242,799,000 above the fiscal year 2021 enacted level and equal
to the fiscal year 2022 budget request. 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.
Unaccompanied Children
The Committee includes $3,383,467,000 for the Unaccompanied
Children (UC) Program, which is $2,080,222,000 above the fiscal
year 2021 enacted level and $100,000,000 above the fiscal year
2022 budget request. The Committee urges ORR to redesign the UC
program with an increased focus on compassionately caring for
unaccompanied children in State-licensed, small-scale, and
community-based settings, and safely and expeditiously
discharging children to vetted sponsors. The Committee is
extremely concerned about reliance on expensive, unlicensed
facilities when capacity is strained. The Committee appreciates
that the increase requested in the budget is intended to avoid
continued reliance on unlicensed facilities, but is concerned
that budget estimates may not adequately reflect the impact
that the COVID-19 pandemic continues to have on State-licensed
capacity. The Committee expects HHS to continue to refine
estimates as it recovers from the pandemic. The Committee
recommends additional funding above the fiscal year 2022 budget
request and includes directives in this report for ORR to raise
standards of care; expand services for children; rebuild,
support and train staff on trauma-informed care; establish an
independent office to better serve children in ORR's care; and
increase planning for future humanitarian responses at the
border.
The Committee recognizes the critical importance of post-
release legal and social services and child advocates, and
notes that the Congressional Budget Justification did not
include sufficient details of ORR's plans for providing such
priority services to children in fiscal year 2022. The
Committee directs ORR to significantly increase services for
children, and includes not less than $300,000,000, an increase
of $88,000,000 over the fiscal year 2021 enacted level, for
legal services, post-release services, and child advocates. The
Committee recognizes that increased referrals of children
during fiscal year 2021 may require ORR to expend greater sums
in fiscal year 2022, and the Committee encourages the program
to spend additional funds on such services, as necessary,
commensurate with referrals from U.S. Customs and Border Patrol
(CBP) and the needs of the children, including the need for
legal services for children after their release from ORR
custody. It is critical that ORR report regularly to the
Committee and include in its required spend plans, the number
of referrals from CBP, 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. The Committee expects
ORR to set targets for the number and percentage of children
that will be provided such services, and to regularly
communicate with the Committee to ensure that the number of
children with access to such services significantly increases
over fiscal year 2021.
Age-Outs.--The Committee directs 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 has been
identified for the child, along with any necessary social
support services, prior to discharge from ORR.
Bond Hearings and Placement Reviews.--The Committee
believes it is incumbent upon HHS to ensure that children's
rights to placement in the least restrictive setting are
protected, and strongly supports an unaccompanied child's right
to challenge their placement in restrictive settings in front
of the HHS Departmental Appeals Board (DAB) with representation
of legal counsel and with an ORR-appointed child advocate. The
Committee expects the HHS DAB to ensure that administrative law
judges (ALJs) for UC hearings operate separate and apart from
all ORR staff who take part in, review, or adjudicate placement
of unaccompanied children, and that they will have training and
expertise on the Flores Settlement Agreement, the Trafficking
Victims Protection Reauthorization Act, and the particular
vulnerabilities of unaccompanied children.
In addition, the Committee understands that ORR recently
launched a Placement Review Panel (PRP) pilot, with the intent
of providing unaccompanied children who are placed in secure
and residential treatment center programs a venue by which to
request a review of their ORR placement in such facilities. The
Committee does not expect this PRP to replace or in any way
limit a child's right to appeal their placement before any U.S.
District Court with jurisdiction over the child. However, if
the PRP can serve as an additional venue for children to
challenge their placement, the Committee expects the
participants on the panel to operate separate and apart from
ORR staff who take part in, review, or adjudicate placement of
unaccompanied children, and requests that ORR brief the
Committee within 60 days of enactment of this Act on the role
of the PRP, and the distinction between the PRP and the DAB.
Case Management and Community Support Services.--To expand
the scope of case management programs and to increase
participation in these services, the Committee directs HHS to
coordinate with DHS to provide an analysis of existing
programs, including existing case management services funded
through U.S. Immigration and Customs Enforcement, as well as
the recently funded Alternatives to Detention Case Management
Pilot Program to provide these services though FEMA-
administered grants to community-based organizations, which
will be overseen by the DHS Office for Civil Rights and Civil
Liberties. Further, the Committee directs HHS and DHS to
explore the feasibility of funding and managing case management
services currently offered by DHS through agencies or offices
within HHS that serve similar populations and to provide the
Committee a briefing within 180 days of enactment of this Act
on the results of the analysis and their evaluation, which
shall also include a recommendation for the appropriate
organizational placement for case management services to serve
additional populations through community-based organizations
seeking to provide case management and social services focused
on fair and equitable outcomes for individuals and families.
The briefing shall outline the risks and opportunities
associated with existing and proposed programs, and mitigation
strategies that could be deployed to address those, along with
any funding and staffing impacts.
Child Advocates.--The recommendation includes funding 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, and to
children who are expected to remain in ORR custody for
prolonged periods of time. The Committee directs ORR to ensure
the continued independence of the Child Advocate program from
other contracted service providers to avoid any conflicts of
interest.
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 in Prolonged Detention.--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. Finally, 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.
Facility Oversight.--The Committee expects ORR to maintain
strict oversight of all ORR-funded care provider facilities and
to correct violations of Federal, State or local codes related
to the standards of childcare or the well-being of children, as
well as violations of ORR policies and procedures, or any
requirements as listed in the Flores Settlement Agreement,
regardless of the status of the underlying agreement. The
Committee directs ORR to submit, within 60 days of enactment of
this Act, an updated version of the report submitted to the
Committee pursuant to House Report 115-862. The updated report
should include new or updated information on facility
violations, and any systemic trends in noncompliance, along
with efforts to remedy noncompliance across the provider
facility network.
Humanitarian Response Operating Plan.--The Committee
recognizes the challenges that ORR has with quickly adding
personnel and building capacity to meet demands during
significant increases of unaccompanied children at the border.
The Committee directs HHS and ORR to coordinate with DHS, FEMA,
CBP, USCIS, and relevant stakeholders to develop a Humanitarian
Response Operating Plan for how priority personnel from across
the government, in coordination with national and local non-
government organizations, can be rapidly deployed to the
southern border as necessary during migration surges. The plan
should assess the existing capabilities and capacity of HHS,
DHS, and relevant stakeholders to provide the specialized
services necessary to prioritize the welfare of children while
they are in government custody, and to avoid unnecessary delays
in releasing children safely to vetted sponsors. The plan
should identify mechanisms for participating Federal agencies
to identify and quickly deploy, in coordination with affected
State and local jurisdictions and national and local non-
government humanitarian organizations, priority personnel
licensed in case management, social work, and child welfare,
along with an estimate of the funding requirements associated
with such deployments. The Committee expects any groups
identified as potential deployment resources to be trained in
providing trauma-informed care.
In developing the plan, HHS and DHS should consult with
experienced caseworkers, social workers, and child welfare
experts to incorporate best practices into the plan. The
Committee directs HHS to submit the plan to the Committee
within 180 days of enactment of this Act, and to update it
annually to reflect new information and lessons learned. As
part of the plan, the Committee requests a cost estimate for
the resources necessary to keep identified personnel
sufficiently trained, to fund rapid deployments to the border,
and to have emergency case management contracts or grants
available to deploy additional case managers or other priority
services.
In-Kind Donations.--The Committee continues to request ORR
include information on the use of this provision in future
Congressional Budget Justifications, including examples of
donations that are offered, donations that are accepted, and
donations that care providers believe they cannot accept.
Legal Services.--The Committee supports the continued
expansion of independent legal services for unaccompanied
children and notes that services provided by qualified and
independent legal counsel to unaccompanied children can
increase the efficiency and effectiveness 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. Post-release direct
representation shall 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.
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 $5,500,000
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 expansion of such services,
including contracting with governmental and non-governmental
entities, while instituting policies that prevent disclosure of
this information to immigration enforcement officials. These
services shall include mental health services which are
developmentally appropriate for children and which assist staff
to respond to trauma based on age and the nature of the trauma
given the diversity of children in custody.
In response to the growing number of children with
specialized needs in ORR custody, including children under 12,
children with disabilities, and children with mental health
needs, the Committee expects ORR to further expand mental
health services and the use of other interventions, in
consultation with context-focused specialists and experts in
early childhood development, the needs of children with
disabilities, mental health, child trauma and immigration
trauma, and to provide in-person and continuous training to
ORR-contracted staff on these specialized needs. Further, 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 groups of
children listed in this paragraph, including regarding
appropriateness of residential treatment centers as a form of
residential care. The Committee directs ORR to include in its
fiscal year 2023 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 recognizes that a
number of children referred to ORR from CBP as unaccompanied
were traveling with a non-parental relative, and believes there
may be opportunities to collaborate with DHS in order to
significantly reduce the amount of time a child may be
separated from a family member. The Committee directs HHS, in
coordination with DHS, to develop a mechanism for reporting the
number of children who were processed by CBP with adults
claiming a relationship as non-parental relatives but referred
to ORR as unaccompanied. The Committee directs ORR to submit a
report within 120 days of enactment of this Act proposing any
process changes, IT modifications, or authorities that would be
necessary for ORR to regularly report the number of children
referred from CBP who were processed with Category 2a or 2b
relatives, and for HHS and ORR case managers to have the
visibility necessary to locate, with DHS cooperation, a non-
parental relative that arrived with a child at the border so
that HHS can begin the process of verifying the relationship
and assessing that adult for sponsor suitability.
Office of the Ombudsperson.--The Committee directs ORR to
establish an Office of the Ombudsperson within HHS to act as an
advocate for upholding the rights of immigrant children in
custody, and to independently advise the Secretary on the
challenges of, and ways to systemically evaluate, refocus and
rebuild, the UC program. The Office shall be headed by an
Ombudsperson, who should have demonstrated experience in
immigration law and child advocacy or child welfare, and shall
be appointed by, and report directly to the Secretary of HHS.
The Committee requests a briefing within 120 days of enactment
of this Act on a strategy for establishment of such an Office,
including any actions the Secretary will take to position the
Ombudsperson within ORR in such a way that does not duplicate
existing functions of other independent offices, including the
Office of Inspector General and the Office of Civil Rights.
The Ombudsperson shall have access to information on
unaccompanied children in HHS's care in order to identify
trends or to further investigate cases that may need additional
resources in order to shorten a child's length of stay.
Additionally, the Ombudsperson shall have access to facilities
data, reviews, and recommendations of the HHS Office of
Inspector General, in order to investigate systemic issues or
improvements of facilities or grantees. The Committee urges the
Ombudsperson to regularly meet with stakeholders, to ensure
they are aware of stakeholder concerns and priorities, and to
provide feedback on stakeholder requests.
The Committee directs the Ombudsperson to submit a report
to Congress no less than once each fiscal year on the
accomplishments and challenges of the UC program, highlighting
trends and recommendations for future actions and improvements,
and outlining the activities of the Ombudsperson for the next
fiscal year.
Operational Directives and Field Guidance for Safe,
Expeditious Discharge.--The Committee believes the operational
directives issued in response to the previous Administration's
misguided Memorandum of Agreement (MOA) on Information Sharing
reduced the damage that had been done to the sponsor
suitability determination process and appropriately reduced the
length of time children spent in ORR's care. The Committee
expects ORR to retain and improve on such policies to place
children safely and expeditiously with vetted sponsors. The
Committee recognizes that ORR has issued a series of field
guidance documents to its care provider network to further
expedite safe discharge to sponsors. The Committee directs ORR
to continue to review any policies that may be prolonging a
child's stay in custody, including those related to the
sponsorship review process, and to work with child welfare
experts as it continues to evaluate ways to safely reduce a
child's time in care.
Policies for Engaging with Law Enforcement.--The Committee
believes that it is critical for ORR to have policies in place
for staff to use for when it is appropriate to contact local
law enforcement, as well as policies that stipulate how local
law enforcement should engage with children in ORR's care to
ensure that those interactions account for the trauma a child
might be facing. The Committee urges ORR to create and make
publicly available the policies and procedures for staff and
children's interactions with local law enforcement.
Post-Release Services.--The Committee includes an increase
in funding for post-releases 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, and 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 requests ORR
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.
Separated Families Services Fund.--The Committee strongly
supports the mission and efforts of the Interagency Task Force
on the Reunification of Families and includes $30,000,000, as
requested, to support ongoing mental health and other
supportive services for children, parents, and legal guardians
who were separated at the U.S.-Mexico border under the previous
administration.
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 2023 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 notes that HHS has
significantly expanded its unlicensed shelter capacity as high
numbers of children have sought protection at the Southern
border and amid ongoing challenges posed by the COVID-19
pandemic. 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 continues to have serious
concerns about HHS's continued reliance on unlicensed
facilities, including ``emergency intake sites'', that lack
critical services and safeguards. 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 shelters where a substantial number
of children reside in the same room. The Committee directs ORR
to submit, within 30 days of enactment of this Act, its plan
for discontinuing use of any open unlicensed facilities,
including the anticipated closure dates for each unlicensed
facility, and the target dates by which each such facility will
comply with required standards while in use.
The Committee expects ORR to adopt systemic changes to
eliminate future reliance on unlicensed facilities and directs
ORR to ensure sufficient bed capacity for unaccompanied
children in permanent, small, State-licensed shelters, group
homes, and transitional and long-term foster care. The
Committee directs ORR to submit a report within 180 days of
enactment of this Act on strategies ORR can pursue to ensure
that ORR maintains access to, and can expeditiously activate as
necessary, sufficient licensed bed capacity to serve
unaccompanied children during periods of higher referrals or
emergencies. The report should also assess ORR's ability to
address any staffing issues, or add case management and other
priority services for children placed in reactivated licensed
settings.
Survivors of Torture
The Committee includes $27,000,000 for the Survivors of
Torture program, which is $10,000,000 above the fiscal year
2021 enacted level and equal to the fiscal year 2022 budget
request. 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 2021....................... $5,911,000,000
Budget request, fiscal year 2022...................... 7,377,000,000
Committee Recommendation.............................. 7,377,000,000
Change from enacted level......................... +1,466,000,000
Change from budget request........................ - - -
The Committee recommends $7,377,000,000 for the Child Care
and Development Block Grant (CCDBG) program, which is
$1,466,000,000 above the fiscal year 2021 enacted level and
equal to the fiscal year 2022 budget request. The Committee
strongly supports the commitment in the budget to allot three
percent for Indian Tribes, in addition to the $177,330,000 set-
aside included in the accompanying bill. 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.
In addition, the Coronavirus Response and Relief
Supplemental Appropriations (CRRSA) Act (P.L. 116-260) included
$10,000,000,000 and the American Rescue Plan (P.L. 117-2)
included $39,000,000,000 in CCDBG funding to support children,
families, and child care providers during the pandemic, and to
stabilize the child care industry with flexible funding that
could be used for personnel costs, rent, cleaning supplies, and
mental health support for children and staff.
Assistant Secretary for Planning and Evaluation/CCDBG
Eligibility and Receipt.--The Committee expects HHS ASPE to
provide and make publicly accessible updated annual estimates
and factsheets of Child Care Eligibility and Receipt under
Federal and State rules as promptly as practicable. Within six
months of enactment of this Act, the Committee directs ASPE to
post on its website estimates and factsheets for fiscal year
2018, along with a timeline for when the agency intends to
provide updates for 2019 and subsequent years.
Child Care Facilities Needs Assessment.--The Committee
appreciates that ACF is in the process of conducting a
feasibility study to determine how States could conduct needs
assessments of their child care and early education facilities.
The Committee directs ACF to continue to dedicate a portion of
Federal CCDBG research funding (42 U.S.C. 9858m) as it
evaluates possible methodologies for conducting facilities
needs assessments and prepares cost estimates for the funding
that would be necessary for experts to conduct Statewide needs
assessments. As part of that evaluation, the Committee expects
the Office of Child Care (OCC) to engage with key experts and
stakeholders who have worked on recent facilities standards
reports, conducted Statewide facilities needs assessments, and
who have experience in conducting Statewide needs assessments
or working on child care and early childhood education
facilities issues. OCC shall brief the Committee on its
findings as soon as practicable, and include the recommended
methodology, along with the resources that would be necessary
to fund such Statewide needs assessments in the fiscal year
2023 Congressional Budget Justification.
The Committee encourages HHS to coordinate with the
Department of Housing and Urban Development and the Bureau of
Indian Affairs as it assesses the child care infrastructure and
early learning needs in underserved rural and tribal
communities, including for Head Start and early Head Start
facilities. Further, the Committee encourages HHS to consult
with the Department of Agriculture Rural Development, Small
Business Administration, and the Department of Treasury
Community Development Financial Institutions Fund, on potential
opportunities to leverage resources available to bolster early
childhood learning and development in rural America.
Child Care Relief and Recovery GAO Study.--The Committee
directs GAO to study the State implementation of the various
coronavirus relief and recovery packages to identify long-term
strategies for improving the child care industry and supporting
child care businesses including the use of grants and/or
contracts, improving payment practices, and strategies to
recruit and retain the workforce.
Homelessness Data.--The Committee encourages OCC to provide
technical assistance to 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 2021....................... $1,700,000,000
Budget request, fiscal year 2022...................... $1,700,000,000
Committee Recommendation.............................. 1,900,000,000
Change from enacted level......................... +200,000,000
Change from budget request........................ +200,000,000
The Social Services Block Grants 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.
In addition, the bill includes $200,000,000 for the
purposes of creating a diaper distribution grant program, to
provide much-needed resources to social service agencies or
other non-profit organizations specifically for diaper and
diapering supply needs.
CHILDREN AND FAMILIES SERVICES PROGRAMS
Appropriation, fiscal year 2021....................... $13,040,511,000
Budget request, fiscal year 2022...................... 14,902,760,000
Committee Recommendation.............................. 15,232,981,000
Change from enacted level......................... +2,192,470,000
Change from budget request........................ +330,221,000
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 2022 Committee
Budget Activity
------------------------------------------------------------------------
Programs for Children, Youth, and Families:
Head Start.................................... $12,182,095,000
Preschool Development Grants.................. 450,000,000
Runaway/Homeless Youth........................ 126,787,000
Abuse of Runaway Youth Prevention............. 23,000,000
State Child Abuse Prevention.................. 125,000,000
Discretionary Child Abuse Prevention.......... 42,000,000
Community-based Child Abuse Prevention........ 90,000,000
Child Welfare Services........................ 275,000,000
Child Welfare Training........................ 121,000,000
Adoption Opportunities........................ 46,100,000
Adoption Incentives........................... 75,000,000
Social Services/Income Maintenance Research... 9,512,000
Native American Programs...................... 65,000,000
Community Services:
Community Services Block Grant................ 800,000,000
Community Economic Development................ 23,000,000
Rural Community Facilities.................... 11,000,000
Domestic Violence Hotline......................... 25,780,000
Family Violence/Battered Women's Shelters......... 463,450,000
Independent Living Training Vouchers.............. 48,257,000
Disaster Human Services Case Management........... 4,000,000
Program Direction................................. 227,000,000
------------------------------------------------------------------------
Head Start
The Committee recommends $12,182,095,000 for the Head Start
program, which is $1,434,000,000 above the fiscal year 2021
enacted level and $250,000,000 above the fiscal year 2022
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
$234,000,000 for a cost-of-living adjustment.
Early Head Start (EHS) Expansion and Early Head Start-Child
Care (EHS-CC) Partnerships.--The Committee provides
$750,000,000 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 45 days of enactment of
this Act on how the Office of Head Start intends to award EHS
expansion funding, including EHS-CCP funds, without making
awards 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 2023 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.
Extended Duration.--The Committee understands the need for
Head Start programs to offer longer hours of service to better
align with K-12 schedules and support working parents, and
includes $200,000,000 for programs to expand program hours of
service consistent with the 2016 Head Start Program Performance
Standards.
Migrant and Seasonal Head Start (MSHS) Eligibility
Requirements.--The Committee remains concerned about how
enrollment and eligibility requirements for the MSHS program
may act as barriers for low-income farmworker families seeking
MSHS services. The Committee reiterates the need for the report
on the Impact of the Federal Poverty Guideline, as requested in
House Report 116-450, including the section examining how such
requirements may be affecting MSHS. The Committee expects the
OHS to brief the Committees on the findings and recommendations
of that report as soon as practicable, but not later than 30
days after enactment of this Act, so that it can continue to
discuss possible solutions to expand access to such families.
In addition, the Committee is concerned that families
applying for MSHS services may be deemed ineligible based on
the disruption to the lives of agricultural workers as a result
of the COVID-19 pandemic. The Committee understands that
several flexibilities exist with regard to how a farmworker can
demonstrate eligibility for MSHS programs, and directs OHS to
issue guidance within 30 days of enactment of this Act on the
flexibilities MSHS programs can offer farmworker families with
regard to demonstrating income eligibility, or residency, if
they were unable to migrate as a result of the pandemic.
Most Vulnerable Communities GAO Study.--The Committee
directs GAO to conduct a study identifying whether Head Start
meets the needs of the most vulnerable children and communities
around the country, or whether flexibility could be given in
order to allocate funds to communities, age groups, or families
that are in greatest need around the country.
Quality Improvement Funding for Trauma-Informed Care.--The
Committee continues to recognize that children affected by
trauma face significant challenges that require specialized
care. The Committee provides $250,000,000 in quality
improvement funding for programs to increase services for
mental health professionals to provide expert care and
counseling to families and the Head Start workforce; provide
staff training on trauma-informed approaches to service
delivery; and add staff to Head Start classrooms.
Supporting Families.--The Committee strongly supports Head
Start's efforts to support families' well-being and economic
security by partnering with parents on employment, education,
and career goals. The Committee encourages programs to invest
in parents through parent-to-teacher training programs,
partnerships with local community colleges, apprenticeship
programs, and local employers committed to helping Head Start
and Early Head Start families find meaningful employment and
career tracks.
Tribal Colleges and Universities-Head Start Partnership
Program.--The Committee recommends $8,000,000 for the Tribal
Colleges and Universities (TCU)-Head Start Partnership Program.
Preschool Development Grants
The Committee recommends $450,000,000 for Preschool
Development Grants, which is $175,000,000 above the fiscal year
2021 enacted level and equal to the fiscal year 2022 budget
request. This program provides grants to States to build State
and local capacity to provide preschool for 4-year-olds from
low- and moderate-income families.
Runaway and Homeless Youth
The Committee recommends $149,787,000 for the Runaway and
Homeless Youth (RHY) program, which is $13,007,000 above the
fiscal year 2021 enacted level and $4,800,000 above the fiscal
year 2022 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 (i.e., 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 $125,000,000 for Child Abuse
Prevention and Treatment Act (CAPTA) State Grants, which is
$34,909,000 above the fiscal year 2021 enacted level and
$5,000,000 above the fiscal year 2022 budget request.
Child Abuse Discretionary Activities
The Committee recommends $42,000,000 for Child Abuse
Discretionary Activities, which is $7,000,000 above the fiscal
year 2021 enacted level and the fiscal year 2022 budget
request.
Child Abuse Hotline.--The Committee recommends $2,000,000
to support and expand a national child abuse hotline, to
increase outreach efforts and provide additional resources and
intervention through multiple modalities, including chat, text,
and call, to 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 including a category of animal abuse to the caregiver
characteristics and environmental factors fields in NCANDS as
an additional factor that could place a child at risk for
maltreatment.
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 $90,000,000 for Community-Based
Child Abuse Prevention, which is $29,340,000 above the fiscal
year 2021 enacted level and $10,000,000 above the fiscal year
2022 budget request. 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 provide 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 $121,000,000 for the Child Welfare
Research, Training and Demonstration program, which is
$102,016,000 above the fiscal year 2021 enacted level and equal
to the fiscal year 2022 budget request. 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.
Addressing Racial Inequity in the Child Welfare System.--
The Committee recognizes the need for reforms in the child
welfare system, and supports the request to provide
$100,000,000 for a new competitive grant program to address
racial inequity in the child welfare field and reorient systems
towards a prevention-first model. This funding would allow
State, local, and tribal child welfare agencies to partner with
other government and community stakeholders across the
education, health, human services, and early childhood sectors
to advance comprehensive policy and practice reforms focused on
advancing racial equity and safely reducing the number of
children entering foster care, particularly in communities
over-represented in the child welfare system.
Child Advocacy Studies Training.--The Committee continues
to support enhancing Statewide multi-disciplinary child
advocacy studies training through undergraduate and graduate
curricula to improve training in how to prevent, identify, and
respond to incidences of child abuse.
Child Protection Simulation Training.--The Committee
provides an additional $2,000,000 to fund partnerships with
child protection simulation training laboratories that have
established capabilities and State partnerships, and that
provide in-person and online, trauma-informed, evidence-based
training. Funding may be used to provide logistical and other
support for personnel and program development and expansion.
Race Equity in the Child Welfare Workforce.--The Committee
supports efforts to increase the hiring, retention, and
leadership development of a racially diverse workforce at all
levels of public and private child welfare agencies and
provides an additional $2,000,000, as requested.
Adoption Opportunities
The Committee recommends $46,100,000 for the Adoption
Opportunities program, which is $2,000,000 above the fiscal
year 2021 enacted level and equal to the fiscal year 2022
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 recommendation includes $1,000,000 for the National
Adoption Competency Mental Health Training Initiative and
encourages 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 $9,512,000 for Social Services and
Income Maintenance Research, which is $2,000,000 above the
fiscal year 2021 enacted level and $1,000,000 above the fiscal
year 2022 budget request.
Native American Programs
The Committee recommends $65,000,000 for Native American
Programs, which is $7,950,000 above the fiscal year 2021
enacted level and $4,527,000 above the fiscal year 2022 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
$15,000,000 for Native American language preservation
activities, including not less than $10,000,000 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 $55,000,000 above the fiscal year 2021 enacted level
and $46,100,000 above the fiscal year 2022 budget request. The
CSBG provides funds to alleviate the causes and conditions of
poverty in communities.
Community Economic Development.--The Committee recommends
$23,000,000 for Community Economic Development, which is
$2,617,000 above the fiscal year 2021 enacted level and
$1,394,000 above the fiscal year 2022 budget request. 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.
The Committee understands that the COVID-19 pandemic may
have resulted in project delays and that funds previously
awarded and available to grantees may have since been
cancelled. The Committee encourages the program to prioritize
funding to applicants seeking reimbursement for projects for
which funding had been obligated but not expended, and has
since been returned to the U.S. Treasury.
Rural Community Facilities Development.--The Committee
recommends $11,000,000 for the Rural Community Facilities
Development program, which is $1,000,000 above the fiscal year
2021 enacted level and $400,000 above the fiscal year 2022
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 $25,780,000 for the Domestic
Violence Hotline, which is $12,780,000 above the fiscal year
2021 enacted level and equal to the fiscal year 2022 budget
request. The Hotline provides 24-hour, toll-free and
confidential services immediately connecting callers to local
service providers.
The Committee believes The Hotline may be well positioned
to support people that reach out and indicate that they have
caused harm, and in doing so, may be able to play a critical
part of ending the cycle of abuse and ultimately decreasing
rates of domestic violence. The recommendation includes
$1,000,000 for a pilot project to explore best practices,
intervention, and prevention methods, and establish a hotline
to reduce incidents of domestic violence by addressing people
that cause harm.
Family Violence Prevention and Battered Women's Shelters
The Committee recommends $463,450,000 for the Family
Violence Prevention and Battered Women's Shelters programs,
which is $280,950,000 above the fiscal year 2021 enacted level
and equal to the fiscal year 2022 budget request. The Family
Violence Prevention and Services Act programs provide funding
to support the prevention of incidents of family violence,
domestic violence, and dating violence, and provide the
immediate shelter and supportive services for adult and youth
victims (and their dependents).
Access to Integrated Health Care Services.--The Committee
supports the proposal to partner health care providers with
domestic violence service providers to provide families with
access to primary health care, vaccinations, and behavioral
health services at a local shelter, transitional housing
program, or safe home. The recommendation includes $20,000,000,
as requested, for demonstration grants and technical assistance
for local domestic violence programs and Tribes to provide
access to integrated health care services, including mobile
health units for families experiencing domestic violence who
are living in shelters or placed in temporary housing within
their local 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 yet survivors of color have limited access to
services that incorporate culturally specific healing
modalities by providers who reflect their cultural community.
The Committee believes that the needs of women of color
intersect with broader public health and social issues
including access to health care, transportation, safe and
affordable housing, and economic equity, and includes
$35,000,000 for culturally specific communities of color
organizations to develop or enhance appropriate services that
are specific to their community.
National Domestic Violence Prevention Action Plan.--The
Committee recognizes that the fiscal year 2022 Congressional
Budget Justification invests in efforts to end gender-based
violence across multiple Federal agencies, and notes that the
United Nations has urged countries to adopt national action
plans to combat gender-based violence and violence against
women, including domestic violence. The Committee directs ACF
to coordinate with CDC to create a National Domestic Violence
Prevention Action Plan to expand, intensify, and coordinate
domestic violence prevention efforts among Federal, State,
local, and tribal government agencies and with other relevant
stakeholders to ensure a whole-of-government, goal-oriented,
community-informed, forward looking approach in addressing
domestic violence prevention in the U.S. and report the plan to
the Committee no later than one year after enactment of this
Act.
Native Hawaiian Resource Center on Domestic Violence.--
Within the recommendation, the Committee includes $1,000,000
for a 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.
Program Direction
The Committee recommends $227,000,000 for Program
Direction, which is $19,500,000 above the fiscal year 2021
enacted level and equal to the fiscal year 2022 budget request.
PROMOTING SAFE AND STABLE FAMILIES
Appropriation, fiscal year 2021....................... $427,515,000
Budget request, fiscal year 2022...................... 451,000,000
Committee Recommendation.............................. 451,000,000
Change from enacted level......................... +23,485,000
Change from budget request........................ - - -
The Committee recommends $345,000,000 in mandatory funds
and $106,000,000 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.
The recommendation includes $30,000,000 for formula grants
to States and tribal agencies operating title IV-E programs to
develop, enhance, or evaluate Kinship Navigator programs, and
$7,000,000 for Regional Partnership Grants (RPGs), as
requested. In addition, the Committee provides $9,000,000 for
the Prevention Services Clearinghouse and to support evaluation
and technical assistance relating to the evaluation of child
and family serving programs and services.
PAYMENTS FOR FOSTER CARE AND PERMANENCY
Appropriation, fiscal year 2021....................... $7,011,538,000
Budget request, fiscal year 2022...................... 6,963,000,000
Committee Recommendation.............................. 6,963,000,000
Change from enacted level......................... -48,538,000
Change from budget request........................ - - -
The Committee also recommends an advance appropriation of
$3,200,000,000 for the first quarter of fiscal year 2023 to
ensure timely completion of first quarter grant awards.
Adoption and Foster Care Analysis and Reporting System
(AFCARS) Data Elements.--The Committee believes that collecting
LGBTQ and Indian Child Welfare Act (ICWA) data would help HHS
track and improve outcomes for foster youth and families living
at the intersections of race, sexual orientation, gender, and
tribal affiliation and encourages HHS to incorporate LGBTQ and
ICWA data elements into AFCARS.
Mental Health Screenings for Foster Youth.--The Committee
recognizes that States are required to develop a plan for the
ongoing oversight and coordination of health care services for
any child in a foster care placement and emphasizes the
importance of including mental health as part of these
screenings within the first 30 days of entering foster care.
The Committee urges HHS to provide technical assistance to
States as they incorporate mental health screenings into State
oversight plans.
Administration for Community Living
AGING AND DISABILITY SERVICES PROGRAMS
Appropriation, fiscal year 2021....................... $2,206,000,000
Budget request, fiscal year 2022...................... 2,953,665,000
Committee Recommendation.............................. 3,047,414,000
Change from enacted level......................... +841,414,000
Change from budget request........................ +93,749,000
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 $550,574,000 for Home and
Community-Based Supportive Services, which is $158,000,000
above the fiscal year 2021 enacted level and equal to the
fiscal year 2022 budget request. This program provides formula
grants to States and territories to fund a wide range of social
services that enable seniors to remain independent in their
homes for as long as possible.
Preventive Health Services
The Committee recommends $31,339,000 for Preventive Health
Services, which is $6,491,000 above the fiscal year 2021
enacted level and $5,000,000 above the fiscal year 2022 budget
request. This program funds activities that help seniors remain
healthy and avoid chronic diseases.
Protection of Vulnerable Older Americans
The Committee recommends $34,944,000 for activities to
protect vulnerable older Americans, which is $11,286,000 above
the fiscal year 2021 enacted level and equal to the fiscal year
2022 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. The Committee provides an $11,000,000 increase to the
Long-Term Care Ombudsman program, as requested, to build on
funding provided in the American Rescue Plan, to safely
transition State Long-Term Care Ombudsman programs from virtual
back to in person contact and visitation in facilities, and to
expand coverage to other residential care facilities.
Family Caregiver Support Services
The Committee recommends $249,936,000 for the National
Caregiver Support program, which is $61,000,000 above the
fiscal year 2021 enacted level and equal to the fiscal year
2022 budget request. 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.
Youth Caregivers.--The Committee appreciates that ACL has
included caregiving youth in its review and activities of the
RAISE Family Caregiver Advisory Council and looks forward to
reviewing the recommended actions reflecting the unique issues
and needs of youth caregivers in the forthcoming National
Family Caregiving Strategy.
Native American Caregiver Support Services
The Committee recommends $15,806,000 for the Native
American Caregiver Support program, which is $5,000,000 above
the fiscal year 2021 enacted level and equal to the fiscal year
2022 budget request. This program provides grants to Tribes for
the support of American Indian, Alaskan Native, and Native
Hawaiian families caring for older relatives with chronic
illness or disabilities.
Congregate and Home-Delivered Nutrition Services
The Committee recommends a total of $1,387,773,000 for
senior nutrition. The recommendation includes: $515,342,000 for
Congregate Nutrition Services; $703,431,000 for Home-Delivered
Meal Services; and $169,000,000 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 $70,208,000 for Native American
Nutrition and Supportive Services, which is $35,000,000 above
the fiscal year 2021 enacted level and equal to the fiscal year
2022 budget request. This program provides grants to Tribes to
promote the delivery of nutrition and home and community-based
supportive services to Native American, Alaskan Native, and
Native Hawaiian elders.
Aging Network Support Activities
The Committee recommends $27,446,000 for Aging Network
Support Activities, which is $10,985,000 above the fiscal year
2021 enacted level and $8,000,000 above the fiscal year 2022
budget request. This program supports activities that expand
public understanding of aging and the aging process.
Direct Care Workforce Demonstration.--The 2020 Older
Americans Act Reauthorization authorized ACL, in coordination
with the Secretary of Labor, to implement a 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. The Committee recognizes the
success of the PCTI-based programs that have been implemented
through the Holocaust Survivor Assistance Program, and includes
an additional $5,000,000 in fiscal year 2022 for the program to
expand its application to other adults that have been exposed
to traumatic events, including aging military veterans, first
responders, victims of childhood and domestic violence, and
survivors of man-made or natural disasters, including aging
survivors of the COVID-19 pandemic.
Alzheimer's Disease Program
The Committee recommends $34,700,000 for the Alzheimer's
disease program, which is $7,200,000 above the fiscal year 2021
enacted level and $4,640,000 above the fiscal year 2022 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 $3,000,000 for the National
Alzheimer's Call Center.
Respite Care
The Committee recommends $14,220,000 for Respite Care,
which is $7,110,000 above the fiscal year 2021 enacted level
and equal to the fiscal year 2022 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 $5,000,000 to be transferred from
the PPH Fund to ACL for the Falls Prevention program, which is
equal to the fiscal year 2021 enacted level and the fiscal year
2022 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 2021 enacted level
and the fiscal year 2022 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 $19,400,000 for Elder Rights
Support Activities, which is $1,526,000 above the fiscal year
2021 enacted level and equal to the fiscal year 2022 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.
Aging and Disability Resource Centers
The Committee recommends $23,457,000 for Aging and
Disability Resource Centers (ADRCs), which is $15,338,000 above
the fiscal year 2021 enacted level and equal to the fiscal year
2022 budget request. These centers provide information,
counseling, and access for individuals to learn about the
services and support options available to seniors and the
disabled so they may retain their independence.
State Health Insurance Assistance Program
The Committee recommends $57,115,000 for the State Health
Insurance Assistance Program, which is $5,000,000 above the
fiscal year 2021 enacted level and $1,873,000 above the fiscal
year 2022 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 $9,000,000 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 2021
enacted level and equal to the fiscal year 2022 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 $15,321,000 for the Traumatic
Brain Injury program, which is $4,000,000 above the fiscal year
2021 enacted level and $3,434,000 above the fiscal year 2022
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. The Committee
provides increased funding for the program to sustain and
expand existing programs, and to award funding to additional
States.
Developmental Disabilities State Councils
The Committee recommends $88,480,000 for State Councils on
Developmental Disabilities, which is $9,480,000 above the
fiscal year 2021 enacted level and equal to the fiscal year
2022 budget request. 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 $46,798,000 for Developmental
Disabilities Protection and Advocacy, which is $5,014,000 above
the fiscal year 2021 enacted level and equal to the fiscal year
2022 budget request. This formula grant program provides
funding to States to establish and maintain protection and
advocacy systems to protect the legal rights of persons with
developmental disabilities.
The Committee 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 $12,963,000 for Voting Access for
Individuals with Disabilities program, which is $5,000,000
above the fiscal year 2021 enacted level and $3,000,000 above
the fiscal year 2022 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 $13,100,000 for Developmental
Disabilities Projects of National Significance, which is
$850,000 above the fiscal year 2021 enacted level and equal to
the fiscal year 2022 budget request. 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 $47,173,000 for University Centers
for Excellence in Developmental Disabilities, which is
$5,054,000 above the fiscal year 2021 enacted level and equal
to the fiscal year 2022 budget request. 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 $148,228,000 for the Independent
Living program, of which $28,423,000 is for the Independent
Living State Grants program and $119,805,000 is for the Centers
for Independent Living program. This funding level is
$32,045,000 above the fiscal year 2021 enacted level and equal
to the fiscal year 2022 budget request. Independent Living
programs maximize the leadership, empowerment, independence,
and productivity of individuals with disabilities.
National Institute on Disability, Independent Living, and
Rehabilitation Research
The Committee recommends $124,800,000 for the National
Institute on Disability, Independent Living, and Rehabilitation
Research (NIDILRR), which is $11,830,000 above the fiscal year
2021 enacted level and $6,181,000 above the fiscal year 2022
budget request. 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
recommendation includes funds to increase annual grant funding
to competitively funded model systems centers, and a $100,000
increase for the Traumatic Brain Injury Model Systems National
Data and Statistical Center (NDSC).
Spinal Cord Injury Model Systems (SCIMS).--The Committee is
concerned with the growing number of people living with a
spinal cord injury in the U.S. and recommends $2,000,000 to
increase the number of Federally-funded SCIMS Centers.
Assistive Technology
The Committee recommends $44,000,000 for Assistive
Technology, which is $6,500,000 above the fiscal year 2021
enacted level and equal to the fiscal year 2022 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 $47,063,000 for Program
Administration, which is $6,000,000 above the fiscal year 2021
enacted level and equal to the fiscal year 2022 budget request.
This funding supports Federal administrative costs associated
with administering ACL's programs.
Congressional Budget Justification Accessibility.--The
Committee appreciates efforts by ACL to make Congressional
Budget Justifications compliant with section 508 of the
Rehabilitation Act of 1973. However, in recent fiscal years,
such justifications have not been made available online at the
same time as justifications for the other operating divisions
of HHS. The Committee requests ACL post on its website a
version of its fiscal year 2023 Congressional Budget
Justification at the same time other justifications for other
operating divisions of HHS become available, and to post
justifications compliant with section 508 as soon as
practicable thereafter.
Interagency Committee on Disability Research.--In 2014,
Congress enacted bipartisan legislation mandating the design
and implementation of a Government-Wide Strategic Plan for
Disability, Independent Living, and Rehabilitation Research
(``the Plan'') to maximize the Federal return on investment in
this crucial area of research. Congress directed the Secretary
of Health and Human Services in his capacity as chair of the
Interagency Committee on Disability Research to fulfill this
mandate. The Committee urges the Secretary to emphasize ICDR's
importance to the field of disability research and to continue
to acknowledge role in promoting interagency collaboration to
carry out the Administration's priorities including the
Executive Order on Advancing Racial Equity. The Committee also
urges the ICDR to promote the work of the Federal Equitable
Data Working Group to coordinate the collection of disability-
specific data.
Simplifying State Program Reports.--As a result of the
COVID-19 pandemic, States and area agencies on aging face an
unprecedented reporting challenge during fiscal year 2022.
These entities will be responsible for reporting on Federal
fiscal year 2020 and fiscal year 2021 regular appropriations
spending, as well as spending related to the four COVID-19
emergency funding packages. The Committee urges ACL to explore
ways to facilitate and simplify reporting requirements to
alleviate burdens that could impact the important work of
providing needed services to older adults.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
Appropriation, fiscal year 2021....................... $550,622,000
Budget request, fiscal year 2022...................... 661,309,000
Committee Recommendation.............................. 657,809,000
Change from enacted level......................... +107,187,000
Change from budget request........................ -3,500,000
Of the funds provided, $74,828,000 shall be derived from
evaluation set-aside funds available under section 241 of the
Public Health Service Act, which is $10,000,000 above the
fiscal year 2021 enacted level and $9,500,000 below the fiscal
year 2022 budget request.
This appropriation supports activities that are associated
with the Secretary's roles as policy officer and general
manager of the Department of Health and Human Services (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 2023 Congressional Budget Justification:
expenditures for fiscal year 2021 and expected expenditures for
fiscal year 2023 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.
Autism Related Programs.--The Committee is aware that
treatment regimens and care plans for autism will continue
throughout the life of the patient and that clinicians often
spend additional time on patient care by providing supportive
services or helping caregivers connect with additional
specialists and resources. These additional services are not
typically reimbursable. The Committee directs the Secretary to
identify the supportive services that are most beneficial to
improved outcomes for autism patients, review existing coverage
policies for these services, and provide a report on its
interim findings no later than 180 days after the date of
enactment of this Act.
Behavioral Science and the COVID-19 National Strategy.--The
Committee applauds the Administration's robust National
Strategy for the COVID-19 Response and Pandemic Preparedness
and appreciates that the strategy reflects the best advice of
scientists and public health experts. As our success in these
areas depends on our scientific understanding of human
behavior, the Committee urges the Department to include
psychological scientists at every level of the Department's
response to COVID-19 and future public health emergencies to
most effectively meet these common goals.
Cancer Risk Study on Populations Near Commercial Nuclear
Power Plants.--The Committee encourages the Department to
contract with the National Academy of Sciences (NAS) to carry
out a pilot study of cancer risk in populations near nuclear
facilities, which was recommended by the NAS in a May 2012
study entitled ``Analysis of Cancer Risks in Populations Near
Nuclear Facilities.''
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, and American Indian/
Alaska Native families. Data shows that COVID-19 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), USAID and other federal agencies to
address these pressing problems. To foster greater
coordination, collaboration, and transparency on child policy
across agency lines, the Committee directs the Secretary to
establish a Children's Interagency Coordinating Council. Among
other tasks, the Council shall enter into an agreement with the
NAS 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.
COVID-19 Services for Medically Underserved Communities.--
The Committee is concerned about the high rate of COVID-19-
related cases, hospitalizations, and deaths of historically
medically underserved communities. According to HRSA, more than
18 million people reside in medically underserved areas or
populations across the United States. The Committee recognizes
that targeted resources and services--such as mobile and pop-up
clinics and connections to housing, food, and other forms of
support--for communities most affected by COVID-19 is essential
to enable many low-income individuals to successfully isolate
and quarantine. In addition, to deliver on vaccine equity,
outreach, and social determinants of health, investment in
trusted messengers such as faith leaders, community health
workers, direct care workers, social support specialists, and
navigators employed by community-based organizations, faith-
based organizations, and nonprofit organizations are necessary
to reach medically underserved communities. The Committee urges
the Secretary develop a strategy to dedicate a specific
percentage of COVID-19 funding to community-based organizations
proportional to the needs of people living in medically
underserved areas.
Data Collection to Measure Disparities.--The Committee
recognizes that geographic place is a powerful predictor of
social determinants of health. The Committee is concerned that
due to residential segregation and subsequent disinvestment,
the lack of access to health care, safe recreational
facilities, quality education, and other resources, is often
magnified in highly segregated communities. To fully assess
population health, distribution of disease, and the extent of
health disparities, health services data should be collected
based on residency as opposed to where services are provided. A
similar approach was taken to address the HIV/AIDS epidemic.
The Committee recommends that all health services data include
racial and ethnic data by subgroup, geographic indicators to
the lowest levels (i.e., zip code tabulation area),
nationality, sex, age, and primary language. This data should
be collected in a standardized, uniform manner and include with
it the capacity for linkages to various federal data sets. The
Committee requests a report within 120 days of enactment of
this Act describing the specific steps taken to ensure that
geographic disparities were measured in COVID-19 data
collection, documentation, and reporting from health care
providers to public health agencies. The report shall also
include recommendations to sustain data harmonization efforts
to expand reporting for all infectious diseases and chronic
health conditions and to address emergency prevention
preparedness and response in the event of additional future
pandemics and other catastrophes.
Early Detection of 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 H. Rept. 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
consult with appropriate stakeholders to develop a strategy for
disseminating information about the best practices and begin
implementing this strategy within one year after 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.
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.
Fair Access to Science and Technology Research.--The
Committee commends the HHS agencies--the Administration for
Community Living (ACL), Agency for Healthcare Research and
Quality, Assistant Secretary for Preparedness and Response
(ASPR), Centers for Disease Control (CDC), Food and Drug
Administration (FDA), and National Institutes for Health
(NIH)--that have issued plans in response to the White House
Office of Science and Technology Policy Directive issued on
February 22, 2013. The Committee urges these agencies to
continue their efforts toward full implementation of the plan
and requests an update in the fiscal year 2023 Congressional
Budget Justification.
Global Alzheimer's Disease and Dementia Action Plan.--The
Committee urges the Secretary to enter into negotiations with
the World Health Organization to implement a plan for
addressing Alzheimer's Disease and other forms of dementia
globally, to be known as the Global Alzheimer's Disease and
Dementia Action Plan, focused on the following areas: research,
including the development of a stable and sustained
international commitment to research; regulatory issues;
clinical care; supportive services for patients and caregivers,
including innovative technologies; prevention and health
promotion; public awareness and education, particularly efforts
aimed at reducing stigmas, and increasing the inclusion of
persons with Alzheimer's disease and dementia within civil
society.
Global Health Research.--The Committee requests an update
in the fiscal year 2023 Congressional Budget Justification on
how 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 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.
Impact of COVID-19 on Health Care Personnel.--The Committee
recognizes the incredible sacrifice that health care and direct
care workers have made on the frontlines to care for Americans
with COVID-19. Investigative journalists have revealed through
tracking obituaries that 3,600 U.S. health care workers died
from COVID-19. Two-thirds of these casualties are among people
of color. Lower paid workers, including nurses, support staff,
and nursing home employees, were the most likely to pass away
from COVID-19. During the pandemic, the federal government did
not comprehensively track the number of lives lost among health
care workers and support staff. The Committee directs HHS to
undertake a comprehensive count of the total number of lives
lost among health care workers and direct service workers at
health care facilities, nursing homes, and long-term care
facilities and emergency care providers, including paramedics
and medical personnel who transport patients to the hospital.
The Committee directs HHS, in coordination with OSHA, to
develop and submit to the Committee a plan within 90 days of
enactment of this Act for how it will collect, record, and
report health care worker mortality and morbidity data
associated with COVID-19, including suicides connected to the
mental health impact of the pandemic. The Committee further
directs the Secretary to submit a report within 180 days of
enactment of this Act on initial findings of the long-term
health impacts of the pandemic on health care workers,
including physical health, mental trauma leading to disability,
and contraction of COVID-19.
Improving Accuracy of Diagnosis of Rare Diseases.--The
Committee is aware that the lack of a precise diagnostic code
makes disease surveillance, including understanding the true
prevalence of a condition, more difficult and hinders
diagnosis, treatment, and access to approved therapies. The
Committee encourages HHS to work with federal agency partners
to establish a pathway for rare disease stakeholders to pursue
a diagnosis code, including resources to advise stakeholders as
to data and other needs and to help facilitate the application
process for rare disease codes.
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. The Committee looks forward to receiving
the multi-year plan outlining innovation initiatives for
conquering Lyme disease, which is due in December 2021.
Maximizing Syringe Safety.--The Committee is concerned that
on COVID-19 vaccine deployment, administrative inconsistencies
with procured syringes have resulted in wasted vaccine doses
while potentially exposing front line health care workers to
bloodborne pathogens; both of which could impede efforts for a
thorough, safe, and timely administration of FDA-authorized
COVID-19 vaccines. The Committee directs the Secretary, in
consultation with relevant agencies within HHS who maintain
jurisdiction in the administration of vaccines including FDA,
NIH, ASPR, Office of Minority Health, and Office on Women's
Health to submit a report within 90 days of enactment of this
Act on the specific steps the Department is taking to ensure
that procurement of syringes for the deployment and
administration of COVID-19 vaccines provide the maximum dose
while ensuring our frontline health care workers remain safe
from the risk of exposure to bloodborne pathogens.
Mental Health Parity.--The Committee continues to be
concerned that 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 Department of Labor (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 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 Secretaries shall also report annually 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 strongly supports efforts to advance health equity
and reduce disparities for communities of color. Persistent
racial and ethnic health disparities can be largely attributed
to poor social and physical determinants of health in these
communities. Advancing health equity requires a multifactorial
response to address issues such as high unemployment,
inadequate housing, lack of quality education, and inability to
access health care. Reducing health disparities also requires
solutions that are informed by and tailored to the specific
racial, ethnic, socioeconomic, and geographic communities at
which they are aimed. The Committee supports the Office of
Minority Health (OMH) and its efforts to advance health
equity--however, the Committee believes the OMH currently lacks
sufficient capacity to lead a broad and bold effort to address
health disparities and that HHS should establish a National
Center on Antiracism and Health Equity (Center) 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. The Committee
directs the Secretary to submit a report, not later than 180
days after enactment of this Act, that provides detailed
proposals to establish a National Center on Antiracism and
Health Equity within the Department. The proposals shall
include (1) a charter and goals for a National Center on
Antiracism and Health Equity; (2) rationale for creating a new
entity within the Department or restructuring an existing
entity; (3) budgetary resources necessary to establish the
Center; (4) the number of full-time equivalent employees needed
to effectively carry out the Center's mission; (5) the
resources needed for the Center to establish, through grants or
cooperative agreements, at least three regional centers of
excellence, located in racial and ethnic minority communities;
(6) the resources needed to award grants and cooperative
agreements to eligible public and nonprofit private entities,
including community-based organizations, to collaborate with
underserved communities and for research and collection,
analysis, and reporting of data on the public health impacts of
health disparities; and (7) the resources needed for the Center
to work with eligible public and nonprofit private entities,
including community-based organizations, to provide information
and education to the public on the public health impacts of
health disparities and on health equity interventions, among
other details.
National Health Care Workforce Commission.--The Committee
includes $3,000,000 to establish the National Health Care
Workforce Commission, as authorized by the Affordable Care Act.
The Commission is intended to serve as a resource on health
care workforce policy for Congress, the Administration, States,
and localities and is tasked with evaluating health care
workforce needs, assessing education and training activities,
identifying barriers to improved coordination at the Federal,
State, and local levels and recommending changes to address
those barriers.
National Poverty Center Cooperative Agreement.--The
Committee includes sufficient funding for the Office of the
Assistant Secretary for Planning and Evaluation to fund a
Poverty Research Center cooperative agreement in fiscal year
2022, in an amount not less than the current level of funding.
One Health Federal Interagency Network.--The Committee
understands that despite unprecedented efforts to address the
COVID-19 pandemic, many questions remain about the prevention
of future pandemics, especially those caused by zoonotic
disease transmission. The Committee recognizes that current
federal efforts regarding a One Health approach to preventing
and responding to pandemics stemming from zoonotic disease,
vector-borne disease, and antimicrobial-resistant pathogens is
inadequate, fragmented, and associated with limited
coordination and collaboration within and across Federal
agencies. The Committee supports a One Health approach to
pandemic prevention that recognizes that human, animal, and
environmental health are fundamentally interconnected. The
Committee directs the Secretary or his designee to formalize
the One Health Network and to provide a professional judgement
within 180 days of enactment of this Act regarding the
Network's funding and resource requirements. This report shall
also include an assessment of current agency capabilities, as
well as current and planned activities related to pandemic
preparedness and One Health, particularly regarding the
Network's efforts to expand, integrate, and enhance support for
global surveillance efforts to effectively and efficiently
implement early detection and rapid response measures. The
Committee further directs HHS to include a cross-cut budget of
current One Health activities being implemented.
Pain Management.--The Committee has previously expressed
concern about the public health epidemic of acute and chronic
pain, including its inter-relationship with the opioid crisis.
The COVID-19 pandemic has exacerbated each of these problems.
As recommended in the CARA-mandated HHS Pain Management Best
Practices Inter-Agency Task Force report, the Committee urges
the Department to coordinate with the Department of Defense
(DOD) and the VA to launch a public awareness campaign to
educate Americans about the differences between acute and
chronic pain and available evidence-based non-opioid treatment
options. The Committee again urges the Department to widely
disseminate the report's recommendations, including the
importance of individualized, multidisciplinary, patient-
centered care in the treatment of pain to health care providers
and other public health stakeholders, and to update relevant
pain management policies and educational tools to reflect Task
Force recommended best practices across all relevant HHS
agencies, including the CDC, CMS and SAMHSA. The Committee
urges the Department to include an update on dissemination of
these materials and progress on the public awareness campaign
in the fiscal year 2023 Congressional Budget Justification.
Plasma Protein Therapies.--The Committee recognizes that
plasma protein therapies are unique and non-interchangeable
treatments for individuals afflicted with a variety of rare
chronic and life-threatening conditions. The availability of
plasma protein therapies is dependent on the collection of
donated plasma which is developed into plasma protein
therapies. The Committee urges the Department to conduct an
education and awareness campaign on the importance of source
plasma donation and the safety of the process as part of the
larger campaign around the safety of blood donation broadly.
Polycystic Ovary Syndrome.--The Committee requests a
report, not later than one year after enactment of this Act,
outlining the number of women in America currently suffering
from polycystic ovary syndrome (PCOS); the annual cost to
patients for treatment of PCOS; the annual cost to patients
resulting from misdiagnosis or missed diagnosis of PCOS; the
economic burden of PCOS on the United States; the effectiveness
of current testing methods for PCOS; recommended ages for
testing of PCOS; cost benefits of testing all women at
recommended age; and feasibility of testing for PCOS before
symptoms are present.
Post-Acute COVID-19 Syndrome Advisory Committee.--The
Committee encourages HHS to foster interagency and stakeholder
collaboration in addressing the crisis of post-acute COVID-19
syndrome by forming the Post-Acute COVID-19 Syndrome Advisory
Committee.
Preventing Mental Health and Substance Use Crises.--The
Committee recognizes that the severity of the mental health and
substance use crises has worsened during the COVID-19 public
health emergency. Research showing increases in anxiety,
depression, suicidal ideation, and substance use warrant
further examination and the development of a response plan for
the next public health emergency. The Committee requests an
assessment of the response of the Federal government with
respect to mental health and substance use during and after the
onset of the COVID-19 public health emergency, as well as
recommendations for a national strategy for preventing mental
health and substance use crises during a future public health
emergency.
Repatriation.--An April 2021 GAO report on HHS's COVID-19
emergency repatriation efforts found that HHS experienced
coordination and safety issues that put repatriates, HHS
personnel, and nearby communities at risk. The Committee
directs HHS to revise or develop emergency preparedness and
response plans to include the U.S. Repatriation Program and
other human services programs, and to further clarify agency
roles and responsibilities, including safety protocol for an
evacuation and quarantine, during a pandemic. The Committee
also directs the Department to plan and conduct regular
exercises with relevant stakeholders--including federal
partners, State, local, territorial, and tribal governments--to
test repatriation plans in response to a pandemic and update
relevant plans based on lessons learned.
Report on the Effects of Social Media Use.--The Committee
continues to support efforts by the Secretary to investigate
whether there is a relationship between the use of social media
and negative social and individual outcomes, including clinical
and undiagnosed depression; self-harm, such as suicide,
attempted suicide, and suicidal ideation; harm to others; cyber
bullying; chronic anxiety; or social isolation. Such
investigation should consider the role of content and
presentation in social media that is linked to negative
outcomes, as well as the design of algorithms to prioritize
user engagement. In addition, the report should include
consideration of the following questions: what type of content
drives user participation on these platforms; how is that
content most frequently presented to users on these platforms;
and does that presentation lead to negative physical, mental or
emotional health outcomes; what types of emotions characterize
social media interactions; how do these companies design their
algorithms to engage users; and is that design prioritizing
engagement over user well-being. The Committee encourages the
Secretary to provide a report within 90 days of enactment of
this Act on the continued progress in this research area.
Research on Pregnant and Lactating Women.--The Committee
encourages the Secretary to work with the NIH, FDA, the Office
of Human Research Protections (OHRP), and other relevant
agencies to implement recommendations from the Task Force on
Research Specific to Pregnant Women and Lactating Women
(PRGLAC). The Committee encourages the Secretary to direct NIH
and FDA to implement guidance and templates surrounding the
inclusion of pregnant and lactating individuals within clinical
trials in order to require justification for the exclusion of
these populations within clinical trials, and to clarify that
exclusion of these populations within clinical trials should
not be the default practice in the development and evaluation
of drugs and therapeutics. The Secretary should work with OHRP
and FDA to harmonize FDA regulations with changes to the
protected status of pregnant women in federally funded research
included in the 2018 revisions to the Federal Policy for the
Protection of Human Subjects.
Social Determinants of Health Council.--The Committee
directs the Social Determinants Council created by H. Rpt. 116-
450 to continue to provide technical assistance to State,
local, and tribal jurisdictions seeking to develop Social
Determinants Accelerator Plans. The Committee directs a report
be submitted, no later than 30 days after enactment of this
Act, regarding the status of the selection of all Council
members outlined in H. Rpt. 116-450.
Stigmatizing Language.--The Committee recognizes stigma and
discrimination against individuals with a substance use
disorder is a barrier to accessing treatment and supports
removing stigmatizing language from the U.S. Code and federal
agency and program names. To support these efforts, the
Committee encourages the Secretary to identify names of
agencies, institutes, centers, and programs that include
stigmatizing language and to develop a strategy to remove
language with a negative bias from these names.
Stillbirth Task Force.--Stillbirth affects one in 160
pregnancies, with 24,000 babies stillborn each year. Despite
medical advances, the rate of early stillbirth has remained the
same over the past 30 years. The Committee provides $1,000,000
for the Secretary to develop a task force on stillbirth in the
United States. The task force should include the CDC, NIH,
outside specialty organizations, and maternal and fetal
medicine specialists. The task force should focus on the
current barriers to collecting data on stillbirths throughout
the United States, communities at higher risk of stillbirth,
the psychological impact and treatment for mothers following
stillbirth, and known risk factors for stillbirth. The task
force should provide a report on these issues within one year
of enactment of this Act.
Study on Animal Abuse and Future Acts of Violence.--The
Committee is concerned about the link between animal abuse and
future violence, and recognizes the need for further study into
the underlying factors that contribute to acts of violence
against animals and animal violence as a predictor of future
violence against humans. The Committee directs the Secretary to
enter into an agreement with the National Academy of Sciences,
Engineering, and Medicine (NASEM), and includes $1,000,000 for
the NASEM to conduct a study on the underlying factors that
contribute to one's decision to commit acts of violence against
animals; and analyzes acts of violence against animals as a
predictor of future violence against humans.
Study on Child Marriages.--The Committee requests a report,
within one year of enactment of this Act, on the status of
child marriages in the United States, including information on
the prevalence of child marriages that have received exceptions
through parental consent, judicial approval, emancipation, or
pregnancy. The report should include information on the
prevalence of child marriages that take place under force,
fraud, or coercion and a study of provisions that States have
enacted to help identify and prevent the marriage of minors due
to force, fraud, or coercion. Finally, the report shall outline
the impact of state-wide legislative reforms on the number of
marriage licenses given to minors. The Committee requests a
briefing on the report findings within 30 days of its
submission.
Study on the Manufacture and Sale of Nitrous Oxide.--The
Committee understands that more than one million adolescents
and young adults in the United States have used nitrous oxide
illicitly for recreational purposes. This can cause headaches,
drowsiness, breathing difficulty, or asphyxia, which can lead
to a lapse into unconsciousness or death. The FDA's Office of
Criminal Investigations has investigated businesses that
purport to sell nitrous oxide for car racing applications but
knowingly sell it for recreational drug use. The Committee
believes that studying the effectiveness of state laws
prohibiting the recreational use of nitrous oxide is a
necessary first step in examining what role the Federal
government should play to protect the public health in regard
to recreational use of nitrous oxide. The Committee directs the
Department, in consultation with CDC, FDA, SAMHSA, EPA, and
CPSC, to submit a report containing (1) the results of a study
of State regulatory requirements with respect to nitrous oxide
that is manufactured and sold for use in consumer applications
and (2) recommendations for Federal requirements with respect
to such manufacture and sale that are needed to protect human
health and safety.
Supporting Community Violence Intervention Programs.--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 can be
used to support community-based violence intervention programs
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.
Tardive Dyskinesia (TD).--The Committee understands that TD
is a persistent, irreversible, and potentially disabling
neurological condition that is associated with prolonged
exposure to antipsychotics and other dopamine receptor blocking
agents. It is characterized by involuntary movements and
affects at least 500,000 people in the U.S. TD can
significantly disrupt a patient's life, not only due to the
symptoms themselves, but also the impact these symptoms have on
social and emotional well-being and mental health. The
Committee encourages HHS to prioritize the importance of
screening, diagnosing, and treating TD as part of one's mental
health. The Committee directs the Secretary to submit a report,
no later than 180 days after the enactment of this Act, which
(1) outlines the Department's existing resources for patients,
providers, and caregivers related to TD, (2) identifies
opportunities to update and expand such resources, and (3) lays
out the Department's strategy to carry out this paragraph.
Teacher Stress.--The Committee is concerned about the high
levels of stress our nation's teachers have gone through both
before and during the COVID-19 pandemic. The Committee directs
the Secretary, in coordination with the Secretary of Education,
to conduct a study within one year of enactment of this Act on
teacher stress and increasing teacher retention and well-being.
This study should look at the effectiveness of some of the
following programs in reducing stress and increasing retention:
workplace wellness programs that improve teacher health, social
emotional learning programs, mentoring and induction programs
for teachers throughout the year, other evidence based
approaches to reducing stress and increasing well-being.
Telehealth Standards.--The Committee believes that the
flexibility afforded to telehealth providers has played an
essential role in ensuring that Americans receive timely and
quality care throughout the COVID-19 pandemic; however, quality
standards remain important no matter the health care delivery
method to ensure quality and safety. The Committee urges the
Secretary to establish an advisory group to study issues
relating to the provision of telehealth and associated quality
of care. Such a study should generate recommendations regarding
the applicability of telehealth modalities for various clinical
scenarios. The Secretary shall assemble a technical advisory
group that includes experts in the delivery of telehealth
services. The advisory group shall also evaluate whether equity
exists in access to appropriate telehealth modalities
throughout the country, including broadband, computers,
smartphones, landline telephones, and cell phones that only
allow for audio-only communications. The Committee requests the
Secretary deliver a report from the advisory group, no later
than one year after enactment of this Act, with recommendations
as to whether quality of care criteria should be applied to the
specific use of any telehealth modality in different clinical
scenarios.
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 $3,000,000 as a tribal set-aside within
the Minority HIV/AIDS Prevention and Treatment program.
U.S.-Mexico Border Health Commission Vaccine Deployment
Strategy.--The Committee recognizes the impact the COVID-19
pandemic has had on communities along the Southern border,
which are interconnected with their Mexican sister cities, with
thousands of people and billions of dollars in trade crossing
daily regardless of border closures. To ensure a full economic
recovery both in border communities and nationally, the U.S.
must work with Mexico to implement a binational COVID-19
strategy. 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.
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 $2,000,000 for
the Commission, an increase of $900,000. Further, the Committee
urges the Secretary to build upon the framework established by
Healthy Border 2020 for border region public health goals and
the actions needed to improve the health of U.S. and Mexico
border residents, and to commence work on Healthy Border 2030
as part of the Department's Healthy People 2030 initiative with
a focus on addressing health disparities and to help border
communities become more resilient to public health threats.
USPSTF Clinical Data.--The Committee encourages the United
States Preventive Services Task Force (USPSTF) to ensure that
its recommendations further public health for all Americans and
address health inequities. USPSTF should strive to provide
timely recommendations, be fully transparent, and allow for
public comment. USPSTF's methodologies should be firmly
grounded in evidence and consider data specific to health
equity and racial diversity to inform its decision making.
Furthermore, USPSTF should review a recommendation upon a
showing of new evidence. In addition, USPSTF's composition
should reflect an appropriate breadth of practicing physician
expertise, including specialist expertise, as well as public
input reflecting diverse patient populations.
Viral Hepatitis National Strategic Plan.--The Committee
applauds the Department's update of the Viral Hepatitis
National Strategic Plan, which was released in January 2021.
The Viral Hepatitis Plan sets clear goals on how the United
States can prevent, diagnose, treat, and manage viral
hepatitis. The Committee urges the Department to implement the
strategies laid out in this plan to reverse the rates of viral
hepatitis, prevent new infections, improve care and treatment,
and ultimately eliminate viral hepatitis as a public health
threat.
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.
Zoonotic and Vector-Borne Disease Prevention, Early
Detection, and Warning System Strategy.--The Committee directs
the Secretary or his designee to work with the One Health
Network to establish a 5-year strategy and framework for
contributing to the building and implementation of the Zoonotic
and Vector-Borne Disease Prevention, Early Detection, and
Warning System (System), and to report on the status of such
effort within 120 days of enactment of this Act. The strategy
should identify the knowledge and information needs that the
System will meet; key indicators (including indicators that
span human, animal, and ecological determinants of spillover);
existing domestic and international data sources (including
basic data sources such as wastewater monitoring); knowledge
and data gaps; plans for harnessing and strengthening existing
domestic and international data sources; plans for building and
strengthening new domestic and international data sources,
triangulating data, plans for making the System and its data
and analyses widely available and easily accessible to policy
and programming decision makers and the general public; plans
for strengthening the capacity of intergovernmental, nonprofit
and other institutions to collect, analyze, and use relevant
data and the overall system, especially in low- and middle-
income countries; plans for harnessing and contributing to
global private and public activities and partnerships; and
plans for communicating findings, especially when a spillover
event is imminent or detected. The Committee recognizes that
some countries are not accessible or open to data collection,
and therefore encourages partnerships with other organizations,
including intergovernmental organizations, to support data
collection and collaboration.
Office of the Assistant Secretary for Health
Commissioned Corps of the U.S. Public Health Service
(USPHS).--The Committee urges the Department to ensure that the
Commissioned Corps' policies on the inclusion of employees with
chronic hepatitis B are consistent with up-to-date medical
knowledge and that the USPHS adopt comprehensive, evidence-
based HBV policies consistent with CDC recommendations for
current and incoming personnel.
Dietary Guidelines for Americans.--The Committee recognizes
the importance of communicating the new 2020-2025 Dietary
Guidelines for Americans to health care providers in order to
achieve the intended population impact, particularly given the
introduction of new nutrition recommendations for children from
birth through 24 months and pregnant and lactating women. The
Committee encourages the Department to develop materials for a
comprehensive public education campaign aimed at educating
health care professionals on how to talk with their patients
about aligning their dietary choices with the Dietary
Guidelines. The campaign should be informed by scientific
research on health behavior change, as well as input from key
stakeholder groups, including nutrition assistance program
participants and administrators, health care providers,
community leaders, and health and nutrition advocates. The
campaign should incorporate educational materials representing
wide diversity of cultural food preferences and should be
available in languages that meet the needs of populations at
risk for diet-related disease. The Office of Disease Prevention
and Health Promotion should work in collaboration with the USDA
Center for Nutrition Policy and Promotion to develop this
campaign.
Health and Housing Initiatives.--The Committee is aware of
promising initiatives developed by non-profit community groups
in collaboration with local health systems and housing
authorities that are targeted at homeless and precariously
housed individuals who are high utilizers of medical care
provided at hospital emergency departments. These programs work
across different areas of core competency to provide safe,
affordable housing together with ancillary medical, behavioral,
substance use disorder, nutritional and employment or job
training services. Participants demonstrate significant
improvements in their health, sustainable incomes, and reduced
use of emergency department and other expensive medical
services. The Committee encourages the Department to support
these types of initiatives through research, innovation models,
health workforce and homeless programs, and other appropriate
initiatives.
National Strategy for Herpes Simplex Virus (HSV), Types 1
and 2.--The Committee recognizes that an estimated 1 in 3
Americans has Herpes, and that most Americans with HSV do not
have symptoms and do not realize they have it. In light of the
national prioritization of ending the HIV/AIDS epidemic,
maternal health, neonatal health, and the all-time high of
STIs, the Committee urges the Assistant Secretary for Health to
develop a national strategy and strategic plan for the
treatment and prevention of HSV types 1 and 2.
Public Health Service Corps Eligibility Requirements.--The
Committee is concerned that the Office of the Surgeon General
has not complied with language in the Joint Explanatory
Statement for P.L. 116-260 which encouraged the Secretary to
update accreditation and eligibility requirements for the
Public Health Service Corps to allow access to the best
qualified applicants, including those who graduate from
Psychological Clinical Science Accreditation System programs.
The Committee urges the Department to make the necessary
changes to its eligibility requirements.
Teen Pregnancy Prevention.--The Committee strongly supports
the Teen Pregnancy Prevention (TPP) Program and provides
$130,000,000, an increase of $29,000,000 over 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 Assistant Secretary for
Planning and Evaluation to reactivate the TPP Evidence Review.
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 $75,835,000 for the Office of
Minority Health (OMH), which is $14,000,000 above the fiscal
year 2021 enacted level and the fiscal year 2022 budget
request. The OMH works with U.S. Public Health Service agencies
and other agencies of the Department to address the health
status and quality of life for racial and ethnic minority
populations in the United States. OMH develops and implements
new policies; partners with States, tribes, and communities
through cooperative agreements; supports research,
demonstration, and evaluation projects; and disseminates
information.
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 $3,000,000, an increase of $1,000,000 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.
Public Health Pilot Program to Address Structural Racism in
Public Health.--The Committee strongly supports OMH grant
programs that support public and non-profit entities, including
community-based organizations, to build and strengthen
coalitions focused on addressing structural racism in public
health. The Committee directs the OMH to establish a pilot
program to advance these goals and includes $10,000,000 to fund
20 eligible applicants. The OMH Director shall submit a report
to the Committee, not later than 180 days of enactment of this
Act, on the progress of this pilot program.
The Committee is concerned that current grants to advance
health equity and reduce disparities are not as targeted as
necessary to address structural racism in public health and
promote policies and practices that counter the disparate
impact on the health and well-being of communities of color.
Therefore, the Committee directs the Secretary to submit a
report, not later than 90 days after enactment of this Act,
providing details on entities awarded funding in prior fiscal
years for efforts that address structural racism in public
health, selection criteria used, and the funding amount for
each grant or contract. In addition, the report shall detail
steps the OMH plans to take to ensure grant funding is awarded
to public and non-profit entities, including community-based
organizations, that demonstrate the ability to implement
innovative models to address structural racism.
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 Committee requests a briefing on this
initiative within 180 days of enactment of this Act.
Physician Shortage Report.--The Committee directs the
Advisory Committee on Minority Health to issue a report
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. 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.
Vaccine and Testing Equity Study.--The Committee recognizes
that Hispanic and immigrant communities face unique barriers
regarding COVID-19 vaccination and testing, including a lack of
reliable information in their languages, misinformation, and
fear of deportations. The Committee requests a study by the
Advisory Committee on Minority Health, within 120 days of
enactment of this Act, on further steps and recommendations
that can help HHS address vaccine and testing equity in
Hispanic and immigrant communities during the COVID-19
pandemic.
Office on Women's Health
The Committee includes $42,140,000 for the Office on
Women's Health (OWH), which is $7,000,000 above the fiscal year
2021 enacted level and the fiscal year 2022 budget request.
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. In addition, the Committee continues to recommend OWH
create a State-level pilot program to incentivize substance use
disorder treatment providers to be trained on intimate partner
violence.
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 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.
MEDICARE HEARINGS AND APPEALS
Appropriation, fiscal year 2021....................... $191,881,000
Budget request, fiscal year 2022...................... 196,000,000
Committee Recommendation.............................. 196,000,000
Change from enacted level......................... 4,119,000
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.
Bond Hearings and Placement Reviews.--The Committee
believes it is incumbent upon HHS to ensure that children's
rights to placement in the least restrictive setting are
protected, and strongly supports the right of an unaccompanied
child (UC) to challenge their placement in restrictive settings
in front of the HHS Departmental Appeals Board (DAB) with
representation of legal counsel, and with an ORR-appointed
child advocate. The Committee expects that the HHS DAB will
ensure that the Administrative Law Judges (ALJs) for UC
hearings will operate separate and apart from all ORR staff who
take part in, review, or adjudicate placement of unaccompanied
children and that they will have training and expertise on the
Flores Settlement Agreement, the Trafficking Victim Protection
Reauthorization Act, and the particular vulnerabilities of
unaccompanied children.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH
INFORMATION TECHNOLOGY
Appropriation, fiscal year 2021....................... $62,367,000
Budget request, fiscal year 2022...................... 86,614,000
Committee Recommendation.............................. 86,614,000
Change from enacted level......................... +24,247,000
Change from budget request........................ - - -
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.
Accessibility of Online Telehealth Platforms.--The
Committee recognizes that the COVID-19 pandemic led to the
increased use of online portals and web services for patients
seeking information, scheduling, and accessing remote services.
However, the Committee is concerned that many online platforms
are not user-friendly, especially for less digitally literate
communities, including seniors. The Committee urges the
Secretary, working through ONC, to coordinate with the Agency
for Healthcare Research & Quality (AHRQ), the Centers for
Medicare & Medicaid Services (CMS), and Office for Civil Rights
(OCR) on any Federal efforts that can be made to evaluate the
accessibility of digital health platforms for Federally-
supported providers, including any assessments of how seniors
and persons with disabilities are included in the design and
testing of the platforms. Further, the Committee directs the
Secretary, working through ONC, AHRQ, CMS, and OCR, to
establish best practices for healthcare providers to improve
their online telehealth platforms for seniors, individuals with
disabilities, and individuals with limited English proficiency.
Public Health Data Utility.--The Committee notes the COVID-
19 pandemic has exposed serious gaps in our health care system
and the challenges of responding to major public health
threats. Real-time data is essential for responding to a
pandemic and for improving public health outcomes broadly. The
Committee acknowledges some States have advanced capacities to
collect and share real-time data and effectively respond to
public health threats through their Health Information Exchange
(HIE). These States can lead the way by maximizing current
capabilities and sharing across the Nation. The Committee
encourages the Office of the National Coordinator, in
coordination with the Assistant Secretary for Preparedness and
Response, to coordinate with State-based health data utilities
to better plan and prepare for a public health threat.
Recording Vaping in Electronic Health Records.--The
Committee understands that despite the prevalence of e-
cigarette use among youths and the potential risk of serious
side effects, consensus on how to screen adolescents for e-
cigarette use is lacking. Providers may not ask about use of
these devices, and electronic health records (EHRs) currently
do not provide options for recording use of e-cigarettes, water
pipes, and other types of smoking in consistent computable
ways, potentially resulting in underreporting, and a dearth of
data that can be used to understand long-term health outcomes.
The Committee urges the Secretary, working through the Centers
for Disease Control and Prevention, Food and Drug
Administration, and ONC, to consider developing strategies to
enhance accurate data collection and timely reporting of e-
cigarette use, including consideration of the role of EHRs, as
aligned with applicable clinicalpractice guidelines.
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 2021....................... $80,000,000
Budget request, fiscal year 2022...................... 100,000,000
Committee Recommendation.............................. 100,000,000
Change from enacted level......................... +20,000,000
Change from budget request........................ - - -
The Committee recommends $100,000,000 for the Office of
Inspector General (OIG), which is $20,000,000 above the fiscal
year 2021 enacted level and equal to the fiscal year 2022
budget request. The bill includes language making a portion of
funding available for two years, as requested in the
Congressional Budget Justification, for the investigation and
enforcement of information blocking.
In addition, within the Health Care Fraud and Abuse Control
(HCFAC) program discretionary appropriations for fiscal year
2022, the Committee provides the OIG with $109,145,000.
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 2021....................... $38,000,000
Budget request, fiscal year 2022...................... 47,931,000
Committee Recommendation.............................. 47,931,000
Change from enacted level......................... +9,133,000
Change from budget request........................ - - -
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.
Disability Ombudsperson.--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 long-term services and support
options and choices are made available.
Rehabilitation Act.--The Committee directs the Secretary to
fully enforce the Rehabilitation Act of 1973 and the Americans
with Disabilities Act. The Committee requests a report within
180 days of enactment of this Act on enforcement of section 504
of the Rehabilitation Act. Where available, the Department
shall disaggregate data by age.
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
Appropriation, fiscal year 2021....................... $653,023,000
Budget request, fiscal year 2022...................... 656,504,000
Committee Recommendation.............................. 656,504,000
Change from enacted level......................... +3,481,000
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 2021....................... $2,847,458,000
Budget request, fiscal year 2022...................... 3,523,116,000
Committee Recommendation.............................. 3,518,036,000
Change from enacted level......................... +670,578,000
Change from budget request........................ -5,080,000
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.
In addition, the Coronavirus Response and Relief
Supplemental Appropriations Act, 2021 (P.L. 116-260) provided
$19,695,000,000 for the manufacturing and procurement of
vaccines and therapeutics, as well as ancillary supplies
necessary for the administration of vaccines and therapeutics.
The American Rescue Plan (P.L. 117-2) provided $6,050,000,000
for research, development, manufacturing, production, and the
purchase of vaccines, therapeutics, and ancillary medical
products and supplies to prevent, prepare, or respond to COVID-
19 or any disease with potential for creating a pandemic.
Office of the Assistant Secretary for Preparedness and Response
The Committee provides $2,997,937,000 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.
BARDA and BioShield Professional Judgement Budget.--The
Committee directs ASPR to submit a report to the Committee in
conjunction with the fiscal year 2023 Congressional Budget
Justification detailing a professional judgement on the
necessary budget and infrastructure requirements to fully
operationalize these programs in fiscal year 2023. This report
shall also include an assessment of current agency
capabilities, as well as current and planned activities related
to pandemic preparedness.
Cold Chain Technologies.--The Committee recognizes the
limitations that are presented by cold chain requirements for
vaccine distribution and storage. The Committee directs the
Secretary 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 on such efforts in the fiscal year
2023 Congressional Budget Justification.
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 encourages
the further development of freeze-dried hemostatic products,
especially platelet-derived products, to include a wide range
of indications.
Modeling and Simulation.--The Committee encourages ASPR to
support the development and study of in silico approaches to
accelerate vaccines for emerging infectious diseases including,
but not limited to, computational simulation, data analytics,
and the digital patient model, with the objective of reducing
the time to market for virus vaccines.
Pandemic Preparedness.--The Committee encourages efforts to
partner with one or more academic health centers leading
regional coordination efforts through the existing Regional
Disaster Health Response System. The Committee encourages
efforts to expand cooperative agreements for pilots to advance
comprehensive regional preparedness built on real time data and
convening of relevant stakeholders from local, State, and
Federal governments, and civic and corporate leaders to improve
pandemic preparedness and response. These pilots would allow
for an integrated plan for preparedness and response including
recommendations for table-top exercises to assure future
systems are in place to respond to pandemics. In addition, the
Committee encourages the consideration of improved airborne
infectious disease monitoring capabilities.
State Emergency Operations Centers.--The Committee urges
ASPR, in coordination with other relevant agencies, to conduct
a study to examine the differences in State emergency operation
center responses to the COVID-19 pandemic to identify best
practices to inform future public health emergency preparedness
and response.
Operations
The Committee includes $32,176,000, an increase of
$1,238,000, 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.
Preparedness and Emergency Operations
The Committee includes $25,640,000, an increase of
$986,000, 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 $91,807,000, an increase of
$28,403,000, 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 $5,000,000 for
civilian trauma centers to train and incorporate military
trauma care providers and teams into care centers.
Pediatric Disaster Care.--The Committee includes $6,000,000
for the continuation pediatric disaster care program.
Hospital Preparedness Program
The Committee includes $319,777,000, an increase of
$39,222,000, 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 $240,000,000, an increase of $8,500,000, for
critical support to State, local and regional partners to
advance health care system preparedness and response.
Locally-based Health Response.--The Committee recognizes
the lack of essential health services is often a significant
impediment to economic development and prosperity for low-
income communities located in rural areas and regions of
persistent poverty. Strategically placed and locally driven
health response stations could help these communities overcome
barriers. The Committee encourages ASPR to address health
disparities in emergency health response.
National Special Pathogen System.--The Committee recognizes
that our national health care readiness capacity and
capabilities were severely tested by the COVID-19 pandemic. The
Committee commends ASPR for establishing the National Special
Pathogen System of Care (NSPS), working with the National
Emerging Special Pathogens Training and Education Center
(NETEC) to set the NSPS strategy and implementation plan. To
ensure coordination, the Committee directs NETEC to serve as
the coordinating body. The Committee includes $8,000,000, an
increase of $3,000,000, for the NETEC. In addition, given the
knowledge and expertise generated over the course of the
pandemic, now is an opportune time to expand the regional
network to include additional centers with a proven track
record in combatting emerging infectious diseases. To that end,
the Committee includes $31,000,000, an increase of $25,000,000,
to increase the number of Regional Ebola and Other Special
Pathogen Treatment Centers (RESPTCs) to improve preparedness
for future pandemic threats. The RESPTC expansion shall be a
competitive process and health care entities applying to join
the RESPTC system must demonstrate a commitment to health
equity and delivery of health care services to diverse and
under-served low-income populations; an emphasis on population
health; the capacity to serve pediatric patients; and the
ability to translate lessons observed and health systems
research into actionable health care emergency response
implementation plans. The Committee requests both a written
report and a briefing, within 90 days of enactment of this Act,
on progress in establishing a robust NSPS and integrating NSPS
with other health care delivery systems of care for
emergencies, such as the trauma system.
Biomedical Advanced Research and Development Authority
The Committee includes $823,380,000, an increase of
$226,680,000, for the Biomedical Advanced Research and
Development Authority (BARDA). BARDA, through the Strategic
Investor Program and other efforts, 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 has played
an essential role in the response to COVID-19. The Committee
encourages BARDA to expand its portfolio of partnerships for
broader success.
Active Pharmaceutical Ingredients.--The Committee is
concerned with the national security risk of our increased
reliance on foreign-based sources of active pharmaceutical
ingredients, their chemical components, and off-shore drug
production. The Committee recognizes the importance of domestic
drug manufacturing and onshore production of medicine and
provided supplemental emergency funding in pandemic relief
legislation to support increased U.S.-based manufacturing
capabilities. The successful work of BARDA in addressing public
health vulnerabilities and securing a national stockpile of
drugs has unique potential to consider program expansion to
include at-risk drug ingredients. The Committee urges BARDA to
engage in public-private partnerships for U.S.-based advanced
manufacturing for active pharmaceutical ingredients including
their chemical precursors for the Strategic National Stockpile.
The Committee directs BARDA to provide a report within 180 days
of enactment of this Act detailing their efforts to promote
domestic drug manufacturing, including efforts during the
COVID-19 public health emergency, and recommendations for
Congress to support onshore pharmaceutical production.
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.
At-Home Rapid COVID Tests.--The Committee urges BARDA to
continue efforts on Rapid Acceleration of Diagnostics (RADx) to
continue innovation to make at-home rapid COVID tests
accessible.
Broad Spectrum Antimicrobials and CARB-X.--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. BARDA's Broad Spectrum
Antimicrobials program is developing medical countermeasures
that counter identified biothreats and address healthcare and
community-acquired multi-drug resistant pathogens.These
programs leverage public/private partnerships to develop
products that directly support the government wide National
Action Plan for Combating Antibiotic Resistant Bacteria and
have a proven track record in developing new FDA approved
antibiotics.
Ebola.--The Committee recognizes BARDA's efforts to address
the threat of Ebola with an active portfolio of therapeutics,
diagnostics, and vaccines.
Pathogen-Reduced Red Blood Cell Technology.--The Committee
recognizes BARDA's investments for clinical trial development
of nucleic acid targeted pathogen reduction technology to
improve red blood cell transfusion safety. Such investments
will ensure protection for blood products in the nation's blood
supply. The Committee requests an update of these activities in
the fiscal year 2023 Congressional Budget Justification.
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. The COVID-19 pandemic
demonstrated the weaknesses in the U.S. supply chain and the
dependence of the U.S. healthcare system on other countries.
The Committee remains concerned that there could be shortages
of products and components, including elastomeric components.
The Committee is also concerned about the emergence of
counterfeit personal protective equipment products. This is a
safety and public health risk. The Committee recognizes the
importance of domestic manufacturing and raw materials,
supported by $10,000,000,000 in the American Rescue Plan (P.L.
117-2) for the Defense Production Act, and urges HHS to
undertake efforts to ensure a long-term sustainable domestic
supply chain for medical products.
Use of Funds.--The Committee awaits the results of the HHS
internal review of the use of advanced research and development
funding, and the external audit of the use of ASPR funds for
administrative services. The Committee requests a briefing on
the findings, recommendations, and corrective action plan no
later than 30 days after enactment of this Act.
Policy and Planning
The Committee includes $19,917,000, an increase of
$5,040,000, 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 $770,000,000 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 $905,000,000, an increase of
$200,000,000, for the Strategic National Stockpile (SNS). In
addition, the CARES Act (P.L. 116-136) included up to
$16,000,000,000 and the Coronavirus Response and Relief
Supplemental Appropriations Act, 2021 (P.L. 116-260) included
$3,250,000,000 for the 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.
COVID-19 Variant Therapeutics.--The Committee recognizes
that COVID-19 variants present a public health challenge even
as more Americans become vaccinated. The Committee encourages
the SNS to have a sufficient stockpile of monoclonal antibody
therapeutics for the treatment of COVID-19 emerging variants,
and strongly encourages the acquisition of therapeutics that
will provide effective treatment for the broadest possible
range of new variants.
Influenza Antivirals.--The Committee remains concerned
about the perennial threat of pandemic influenza. In addition
to vaccines, antivirals are a critical medical countermeasure.
Currently, the SNS includes only one type of influenza
antiviral. The Committee urges ASPR to review this strategy.
Re-Envisioning the Strategic National Stockpile.--The
Committee is concerned about the mission and operations of the
SNS. Early in the pandemic, there was extensive confusion about
the role of the SNS, the content of the SNS inventory, and
policies and processes for distribution of SNS inventory. The
U.S. must maintain transparent, elastic, and highly available
health assets, medical countermeasures framework and associated
supply chains to effectively plan and respond as needed. The
Committee is aware of current review efforts being conducted by
the HHS Office of Inspector General, Government Accountability
Office, and non-governmental entities. To benefit from these
external reviews and to improve efforts, the Committee directs
the Secretary to engage in a re-envisioning process considering
a variety of topics including real-time inventory transparency;
data and analytics to enhance evidenced-based policy decisions
and risk mitigation strategies; elasticity to readily scale
responses; modeling and simulation to plan and exercise; supply
chain risk management, including the identification and
mitigation of over-reliance on foreign sources of critical
supplies; and revolving management of inventory. The Committee
requests a report and briefing on these efforts, including a
timeline of key activities and an update on activities required
by Executive Order 14001 within 60 days of enactment of this
Act.
Saline.--The Committee encourages the review of the
stockpile quantity of normal IV saline and related medical
supplies, and to include an update in the fiscal year 2023
Congressional Budget Justification.
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, an increase of $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
$2,000,000, for a bilateral cooperative program with the
Government of Israel for the development of health
technologies.
Cybersecurity
The Committee provides $159,116,000, an increase of
$101,296,000, for information technology cybersecurity in the
Office of the Chief Information Officer and HHS-wide to
strengthen the Department's cybersecurity posture. The
Committee does not include funding to continue HHS Protect, as
capabilities shall no longer be duplicated at the Departmental
level or shall be delegated to the appropriate operating
division.
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 $17,000,000 for preparedness and
readiness.
Interagency COVID-19 Testing Strategy.--The Committee
provided significant investments for COVID-19 testing in
multiple supplemental appropriations bills, including the
American Rescue Plan (P.L. 117-2), and understands a robust
COVID-19 testing strategy is necessary for sustained normalcy
and to prevent and respond to future outbreaks. Therefore, the
Committee urges HHS to develop an interagency testing strategy.
Recognizing the importance of partnerships and coordination
across agencies, and the vital accomplishments of the Testing
and Diagnostics Working Group, including the Industry
Engagement and Industrial Base Expansion teams, coordination
across HHS and with other departments is necessary to ensure
corresponding comprehensive guidance.
Readiness and Training Programs.--The Committee requests an
assessment of HHS deployable personnel, including but not
limited to Public Health Service Commission Corps Officers and
National Disaster Medical System intermittent personnel. The
assessment should include the coordination of established
forces and identification of remaining gaps. The report is to
be submitted with the fiscal year 2023 Congressional Budget
Justification.
Pandemic Influenza Preparedness
The Committee includes $335,000,000, an increase of
$48,000,000, 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.
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
enacted level for 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 $3,500,000 per project with a total limit for NIH of
$45,000,000.
(TRANSFER OF FUNDS)
Sec. 217. The Committee continues a provision transferring
one percent of the funding made available for National
Institutes of Health National Research Service Awards to the
Health Resources and Services Administration.
Sec. 218. The Committee continues the Biomedical Advanced
Research and Development Authority ten year contract authority.
Sec. 219. The Committee continues specific report
requirements for CMS's Health Insurance Exchange activities in
the fiscal year 2020 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 2022, 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 2022 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 9,500,000
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 14,000,000
Program.
CDC............................. Preventive Health 160,000,000
and Health
Services Block
Grant.
CDC............................. Tobacco............ 117,100,000
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.
------------------------------------------------------------------------
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 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 alien 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 alien children.
Sec. 232. The Committee continues a provision requiring
monthly reporting on unaccompanied alien 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 alien 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 alien 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 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.
Sec. 237. The Committee modifies a provision related to the
Nonrecurring Expenses Fund.
Sec. 238. The Committee includes a new provision
authorizing the use of funds for a Separated Families Services
Fund, for children, parents, and legal guardians who were
separated at the United States-Mexico border in connection with
the Zero-Tolerance Policy.
Sec. 239. The Committee includes a new provision related to
facilities at CDC.
Sec. 240. The Committee includes a new provision related to
premium pay authority.
Sec. 241. 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. 242. The Committee includes a new provision related to
reimbursable agreements.
Sec. 243. The Committee includes a new provision
prohibiting funds from being used to award a contract for the
CMS Medicare Contact Center Operations with a total period of
performance that exceeds 24 months.
Sec. 244. The Committee includes a new provision related to
notification requirements in the Social Security Act.
Sec. 245. The Committee includes a new provision to
continue NIH transfer authority.
Sec. 246. The Committee includes a new provision to
increase flexibility for grantees of the Ryan White HIV/AIDS
program.
Sec. 247. The Committee includes a new provision requiring
institutions that receive NIH grants to notify NIH if personnel
funded by the grant are disciplined due to concerns about
harassment.
Sec. 248. The Committee includes a new provision extending
the availability of multi-year grant funding for research
projects that were delayed due to COVID-19.
TITLE III--DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
Appropriation, fiscal year 2021....................... $17,226,790,000
Budget request, fiscal year 2022...................... 37,246,790,000
Committee Recommendation.............................. 36,756,790,000
Change from enacted level......................... +19,530,000,000
Change from budget request........................ -490,000,000
This account provides foundational funding to help ensure
all children receive a fair, equitable and high-quality
education.
Of the total amount available, $25,813,490,000 is
appropriated for fiscal year 2022 for obligation on or after
July 1, 2023 and $10,841,177,000 is appropriated for fiscal
year 2022 for obligation on or after October 1, 2023.
Grants to Local Educational Agencies
For fiscal year 2022, the Committee recommends
$36,036,802,000 for Title I grants to LEAs, an increase of
$19,500,000,000 over the fiscal year 2021 enacted level and
$500,000,000 below the fiscal year 2022 budget request. 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 Local
Educational Agencies (LEAs or school districts), which is the
same as the fiscal year 2021 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, 2021, 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 2021
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 $14,107,550,000 for Title I
Targeted Grants, which is $9,750,000,000 above the fiscal year
2021 enacted level. Targeted Grants provide higher payments to
school districts with high numbers or percentages of low-income
students.
The Committee recommends $14,107,550,000 for Title I
Education Finance Incentive Grants (EFIGs) which is
$9,750,000,000 above the fiscal year 2021 enacted level. EFIGs
provide payments to States and school districts that
incorporate equity and effort factors to improve the equity of
State funding systems.
Equity.--The Committee is supportive of the fiscal year
2022 budget request's goals of improving educator compensation,
expanding access to high-quality pre-K, and improving the
equity and adequacy of State and local school finance systems.
In addition, the Committee strongly supports the Department's
efforts to close funding gaps between high- and low-poverty
school districts and schools. The Committee agrees there is
merit in exploring how State and local funding structures
impact school resource equity, which approaches have most
effectively decreased inequities, and what reforms could help
further address longstanding equity and opportunity gaps
experienced by students from low-income backgrounds and
students of color in high-poverty districts and schools. The
Committee therefore encourages the Department to continue its
efforts in this area and to develop further recommendations,
including recommendations on effective methods for promoting a
more equitable distribution of State and local funds.
Reservation for Homeless Students.--The Committee urges
that the Department support LEAs' development of plans under
section 1112(b)(6) of the Elementary and Secondary Education
Act (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 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.
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.
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 is 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 directs 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.
Comprehensive and Targeted Support and Improvement.--The
Committee notes that an increase in Title I funding overall
also increases aid for the Section 1003 Title I set-aside which
provides funding for schools identified for comprehensive and
targeted support and improvement. The Committee notes that
funds under Section 1003 can be used to support socioeconomic
and racial integration in schools as an evidence-based strategy
to improve schools identified for improvement under ESEA. The
Committee encourages the Department to provide technical
assistance to school districts on how Section 1003 funds can be
used to make progress on these critical goals.
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 undeserved students, the
Committee encourages the Department to resume collecting data
on passing rates for all Advanced Placement subject areas.
Comprehensive Literacy Development Grants
The Committee recommends $192,000,000 for Comprehensive
Literacy Development Grants, which is the same as the fiscal
year 2021 enacted level and the 2022 budget request. 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 $3,000,000 above the
fiscal year 2021 enacted level and the fiscal year 2022
request. 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 the fiscal year 2022 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 $382,626,000 for the State Agency
Program for Migrant Education, which is $7,000,000 above the
fiscal year 2021 enacted level and the fiscal year 2022
request. This program supports special educational and related
services for children of migrant agricultural workers and
fishermen, including: (1) supplementary academic education; (2)
remedial or compensatory instruction; (3) English for limited
English proficient students; (4) testing; (5) guidance
counseling; and (6) other activities to promote coordination of
services across States for migrant children whose education is
interrupted by frequent moves.
State Agency Programs: Neglected and Delinquent
For the State Agency Program for Neglected and Delinquent
Children, the Committee recommends $48,239,000, the same as the
fiscal year 2021 enacted level and the fiscal year 2022
request. This formula grant program supports educational
services for children and youth under age 21 in State-run
institutions, attending community day programs, and in
correctional facilities. A portion of these funds is provided
for projects that support the successful re-entry of youth from
the criminal justice system into postsecondary and vocational
programs.
Special Programs for Migrant Students
The Committee recommends $66,123,000 for the Special
Programs for Migrant Students, which is $20,000,000 above the
fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. These programs make grants to colleges,
universities, and nonprofit organizations to support
educational programs designed for students who are engaged in
migrant and other seasonal farm work. The High School
Equivalency Program (HEP) recruits migrant students age 16 and
over and provides academic and support services to help those
students obtain a high school equivalency certificate and
subsequently to gain employment or admission to a postsecondary
institution or training program. The College Assistance Migrant
Program (CAMP) provides tutoring and counseling services to
first-year, undergraduate migrant students and assists those
students in obtaining student financial aid for their remaining
undergraduate years.
IMPACT AID
Appropriation, fiscal year 2021....................... $1,501,112,000
Budget request, fiscal year 2022...................... 1,541,112,000
Committee Recommendation.............................. 1,552,112,000
Change from enacted level......................... +51,000,000
Change from budget request........................ +11,000,000
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 $1,404,242,000 for Basic Support
Payments to LEAs, which is $50,000,000 above the fiscal year
2021 enacted level and $10,000,000 above the fiscal year 2022
budget request. Basic Support Payments compensate school
districts for lost tax revenue and are made on behalf of
Federally-connected children, such as children of members of
the uniformed services who live on Federal property.
Payments for Children with Disabilities
The Committee recommends $48,316,000 for Payments for
Children with Disabilities, which is the same as both the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request. These payments compensate school districts for the
increased costs of serving Federally-connected children with
disabilities.
Facilities Maintenance
The Committee recommends $4,835,000 for Facilities
Maintenance, which is the same as both the fiscal year 2021
enacted level and the fiscal year 2022 budget request. These
capital payments are authorized for maintenance of certain
facilities owned by the Department.
Construction
The Committee recommends $17,406,000 for the Construction
program, which is the same as both the fiscal year 2021 enacted
level and the fiscal year 2022 budget request. 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 $77,313,000 for Payments for
Federal Property, which is $1,000,000 above the fiscal year
2021 enacted level and the fiscal year 2022 budget request.
Funds are awarded to school districts to compensate for lost
tax revenue as the result of Federal acquisition of real
property since 1938.
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 appreciates the Department's
assessment of Impact Aid surveying flexibilities for the 2020-
2021 school year included in the fiscal year 2022 Congressional
Budget Justification and requests that the Department assess
the merits of such flexibilities in future years, along with
other potential process modifications, in the fiscal year 2023
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 2021....................... $5,444,217,000
Budget request, fiscal year 2022...................... 5,532,675,000
Committee Recommendation.............................. 5,803,539,000
Change from enacted level......................... +359,322,000
Change from budget request........................ +270,864,000
The Committee recommendation includes $5,803,539,000 for
the School Improvement Programs account.
Supporting Effective Instruction State Grants
The Committee recommends $2,293,080,000 for Supporting
Effective Instruction State Grants (Title II-A), which is
$150,000,000 above the fiscal year 2021 enacted level and
$144,500,000 above the fiscal year 2022 budget request. 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.
Whole Child Professional Development.--The Committee notes
that Title II, Part A funds can be targeted toward effective
preparation and professional development designs that enable
teachers and school leaders to expand their knowledge and
skills regarding the sciences of child and adolescent learning
and development, including teaching challenging content,
teaching diverse learners, and supporting social-emotional and
academic development in culturally and linguistically
responsive ways.
Materials from Teacher Professional Development.--Given the
importance of funds under Title II, Part 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. But the funding streams for professional development
and associated instructional materials are misaligned,
particularly in science, technology, engineering, and math
(STEM) fields, which can result in teachers participating in
professional development programs that they are unable to share
with their students. The Committee supports efforts by the
Secretary to offer guidance on how an LEA may use Title II,
Part A funds on instructional materials that are directly
connected to teacher professional development training. In
addition, the Committee notes the benefits of posting guidance
online and communicating about guidance with outside
stakeholders, particularly district superintendents.
Supplemental Education Grants
The Committee recommends $23,021,000 for Supplemental
Education Grants to the Federated States of Micronesia and the
Republic of the Marshall Islands, which is $6,322,000 more than
the fiscal year 2021 enacted level and $3,364,000 more than the
fiscal year 2022 budget request. The Compact of Free
Association Amendments Act of 2003 (P.L. 108-188) authorizes
these entities to receive funding for general education
assistance. The Committee provides sufficient funding to meet
authorized funding levels established in P.L. 108-188.
Nita M. Lowey 21st Century Community Learning Centers
The Committee recommends $1,359,673,000 for Nita M. Lowey
21st Century Community Learning Centers, $100,000,000 more than
the fiscal year 2021 enacted level and $50,000,000 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 $100,000,000 increase over fiscal year 2021 will help
communities providing afterschool programs serve 120,000 more
students than in fiscal year 2021.
State Assessments
The Committee recommends $378,000,000 for State
Assessments, which is the same as the fiscal year 2021 enacted
level and the fiscal year 2022 budget request. Funds are
available to develop and implement academic standards and
assessments. The program includes a set-aside for audits to
identify and eliminate low-quality or duplicative assessments.
Education for Homeless Children and Youth
The Committee recommends $116,500,000 for the Education for
Homeless Children and Youth program, which is $10,000,000 more
than the fiscal year 2021 enacted level and the fiscal year
2022 budget request. 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 both the fiscal year 2021 enacted
level and the fiscal year 2022 budget request. Title IV-A
authorizes technical assistance and training services for
school districts to address problems associated with
desegregation on the basis of race, sex, or national origin.
The Department awards three-year grants to regional Equity
Assistance Centers (EACs) located in each of the 10 Department
of Education regions. The EACs provide services to school
districts upon request. Typical activities include
disseminating information on successful education practices and
legal requirements related to nondiscrimination on the basis of
race, sex, and national origin in educational programs.
Countering Anti-Semitism.--The Committee supports efforts
by the Department to ensure the services available through EACs
include training, developing materials, strategies, and
professional development activities to assist schools and
communities in preventing and countering anti-Semitic
harassment.
Education for Native Hawaiians
The Committee recommends $40,397,000 for the Education for
Native Hawaiian program, which is $3,000,000 more than the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request. Funds are used to provide competitive awards for
supplemental education services to the Native Hawaiian
population.
Alaska Native Education Equity
The Committee recommends $36,453,000 for the Alaska Native
Education Equity program, which is the same as the fiscal year
2021 level and the fiscal year 2022 budget request. Funds are
used to provide competitive awards for supplemental education
services to the Alaska Native population.
Rural Education
The Committee recommends $192,840,000 for Rural Education
programs, which is $5,000,000 more than the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request. 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 $52,000,000 for Comprehensive
Centers, which is the same as the fiscal year 2021 enacted
level and the fiscal year 2022 budget request. 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. The Committee notes the
critical role Comprehensive Centers play in helping States vet
evidence and strategies to implement ESEA and provide children
with a high-quality education.
Student Support and Academic Enrichment State Grants
The Committee recommends $1,305,000,000 for Student Support
and Academic Enrichment (SSAE) State Grants, which is
$85,000,000 above the fiscal year 2021 enacted level and the
fiscal year 2022 budget request. 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
encourages 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 supports
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. The Committee
directs the Secretary to provide technical assistance to LEAs
and SEAs on effective strategies for offering information about
free menstrual product programs, as an option for safe and
healthy student programming under SSAE.
Safe and Healthy Learning Environments.--The Committee
continues to note that SEAs and LEAs can use SSAE funds for
activities that contribute to a well-rounded education,
including supports for safe, culturally responsive classroom
communities. The Committee also notes that SSAE funds can
support implementation of the effective community school model
by using funds for designating a site resource coordinator at a
school or LEA, expanding school-based mental health services,
and providing integrated systems of student and family support.
The Committee believes the use of funds on strategies that
improve school climate are vital in reducing harmful,
disproportionate suspensions, expulsions, and arrests of
students of color.
Computer Science and Art.--The Committee notes that States
and school districts may use funds available under the SSAE
grant program to strengthen instruction in science, technology,
engineering, arts, and mathematics (STEAM) fields, including
computer science, and improve access to Pre-K 12 computer
science and STEAM programming for underserved students, such as
minorities, girls, and youth from families living at or below
the poverty line. The Committee recognizes that supporting
education in the STEAM fields, particularly computer science,
is critical to ensuring that our nation continues to lead in
innovation. As computer science is a basic skill in the 21st
century global economy, the Committee intends for investments
in Title IV-A to reduce the computer science enrollment and
achievement gaps.
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.
INDIAN EDUCATION
Appropriation, fiscal year 2021....................... $181,239,000
Budget request, fiscal year 2022...................... 186,239,000
Committee Recommendation.............................. 187,739,000
Change from enacted level......................... +6,500,000
Change from budget request........................ +1,500,000
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 $5,000,000 above the fiscal year
2021 enacted level and same as the fiscal year 2022 budget
request. This program provides assistance through formula
grants to school districts and schools supported or operated by
the Bureau of Indian Education. The purpose of this program is
to improve elementary and secondary school programs that serve
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 $67,993,000 for Special Programs
for Indian Children, which is the same as the fiscal year 2021
enacted level and the fiscal year 2022 budget request. These
programs make competitive awards to improve the quality of
education for American Indian students. The program also funds
the American Indian Teacher Corps and the American Indian
Administrator Corps to recruit and support American Indians as
teachers and school administrators.
National Activities
The Committee recommends $9,365,000 for National
Activities, which is $1,500,000 above the fiscal year 2021
enacted level and the fiscal year 2022 budget request. The
fiscal year 2022 increase to National Activities is directed to
support the Department's Native American language immersion
grant program and to the State-Tribal Education Partnership
program.
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.
INNOVATION AND IMPROVEMENT
Appropriation, fiscal year 2021....................... $1,114,250,000
Budget request, fiscal year 2022...................... 1,284,250,000
Committee Recommendation.............................. 1,385,286,000
Change from enacted level......................... +271,036,000
Change from budget request........................ +101,036,000
The Committee recommends $1,385,286,000 for programs within
the Innovation and Improvement account.
Education Innovation and Research
The Committee recommends $254,000,000 for the Education
Innovation and Research (EIR) program, which is $60,000,000
above the fiscal year 2021 enacted level and the fiscal year
2022 budget request. This program makes competitive grants to
support the replication and scaling-up of evidence-based
education innovations.
Social and Emotional Learning.--Within the total for EIR,
the agreement includes $112,000,000, $45 million above the
fiscal year 2021 enacted level, to provide grants for social
and emotional learning (SEL) interventions and provide
evidence-based, field-initiated innovations that address
student social, emotional, and cognitive needs. A 2019 National
Commission on Social, Emotional and Academic Development report
chronicles decades of research showing ``that the social,
emotional, and cognitive dimensions of learning are deeply
linked'' and that educating the whole student involves
integrating and sustaining these dimensions throughout the day.
In addition, the Collaborative for Academic, Social, and
Emotional Learning found that students who received SEL
interventions showed lasting positive impacts on variables such
as high school graduation rates and college attendance and
lower likelihoods of being arrested or being diagnosed with a
clinical mental health disorder. Further, RAND Corporation
finds that there are at least 60 SEL interventions that have
been evaluated and that meet the Every Student Succeeds Act
(ESSA) evidence requirements.
The Committee is encouraged by the robust, growing evidence
base behind SEL strategies, trauma-informed services, and whole
child approaches to learning, and makes funding for these
interventions a top priority. Children across the country have
been significantly impacted by disruptions related to COVID-19.
The increase to EIR in fiscal year 2022 for SEL is intended to
address these concerns and provide additional support for the
SEL initiative, which can include trauma-informed practices and
services within schools.
To fulfill the SEL set-aside, the Committee urges
prioritization of SEL or 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
to the Committees at least seven days before grantees are
announced.
STEAM and Computer Science.--In addition, within the total
for EIR, the Committee recommendation includes $82,000,000 for
States, school districts, and school-based afterschool programs
to provide or strengthen instruction in STEAM fields, including
computer science, $15 million above the fiscal year 2021
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.
Publicizing Research Findings.--Given the significant
Federal investment in the EIR program (and its predecessor
program, Investing in Innovation), the Committee encourages the
Department to take stronger steps to publicly release and
widely publicize the research findings from this critical
program. More specifically, the Department is encouraged to
post research findings on its own website and issue related
press releases and Dear Colleague letters. The Department is
also encouraged to provide summaries of the research findings
to the Committees on Appropriations. The Committee encourages
the Secretary to better showcase those programs that have
demonstrated, through rigorous research as required by the
ESEA, that their innovations show specific evidence of
achievement in educational outcomes. The Department is also
encouraged to communicate any research findings that
demonstrate successful outcomes to outside stakeholders,
particularly chief State school officers and district
superintendents. The Committee believes that publicizing these
research findings will provide critical information for State
governments, State and local education agencies, and others,
particularly in unserved and underserved communities.
Educator Preparation.--Within EIR, the Committee is
supportive of efforts to provide grants to eligible
institutions that will seek to reform educator preparation at
institutions of higher education for preservice teachers and
leaders or to reform professional development for current
educators by applying research about student learning and
development to their preparation and professional development.
The Committee is supportive of efforts for grantees to develop
partnerships between state education agencies, the Bureau of
Indian Education or high-need local education agencies and
institutions of higher education with educator preparation
programs.
Teacher and School Leader Incentive Grants
The Committee recommends $200,000,000 for the Teacher and
School Leader Incentive Grants program, which is the same as
the fiscal year 2021 enacted level and the fiscal year 2022
budget request. This program provides grants to States, school
districts, and partnerships to develop, implement, improve, or
expand human capital management systems or performance-based
compensation systems in schools.
American History and Civics Academies
The Committee recommends $6,500,000 for American History
and Civics Academies, which is $3,250,000 more than the fiscal
year 2021 enacted level and the fiscal year 2022 budget
request.
American History and Civics National Activities
The Committee recommends $4,000,000 for American History
and Civics National Activities, which is $2,000,000 more than
the fiscal year 2021 enacted level and the fiscal year 2022
budget request.
Diverse Representations in History.--The Committee
recognizes the importance of incorporating diverse stories of
American history and leaders that have been absent in history
and civics education. Accurate portrayals of history that
include diverse representation are essential for combating
stereotypes and myths about racial and ethnic groups.
Therefore, the Committee encourages the Department to promote
diversity in the teaching of American history and civics
programs.
Supporting Effective Educator Development
The Committee recommends $90,000,000 for the Supporting
Effective Educator Development (SEED) grant program, which is
$10,000,000 more than the fiscal year 2021 level and the fiscal
year 2022 budget request. 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.--Within SEED, the Department
is directed to support professional development that helps
educators incorporate SEL practices into teaching, and to
support pathways into teaching that provide a strong foundation
in child development and learning, including skills for
implementing SEL strategies in the classroom. The Committee is
supportive of the Department's competitive preference priority
for SEL in the fiscal year 2020 SEED competition and directs
the Department to include a similar competitive preference
priority in any new SEED competition in fiscal year 2022.
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 to the Committees at least
seven days before grantees are announced.
Diverse Entities.--The Committee encourages the Department
to ensure that SEED grants are awarded to a diverse set of
eligible entities, including national nonprofit organizations
implementing evidence-based activities (as defined in section
8101(21)(A)(i) of the ESEA) across a number of sites which can
help bring to scale evidence-based programs of national
significance across the country.
Computer Science and Native Students.--The Committee
encourages the Department, through the SEED program, to fund
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 2021 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 Committee is concerned by a
recent report that identified more than 440 charter schools
operated by for-profit entities that received CSP grants
totaling approximately $158 million between 2006 and 2017. The
Committee believes that Federal funding for K-12 education
should strengthen and improve our public systems and should not
enrich private entities with a profit motive. In response, the
Committee includes new bill language preventing Federal funds
from being awarded to charter schools run by for-profit
entities.
GAO Mandate from House Report 116-450.--The Committee is
supportive of GAO's initial 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 supports 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.
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.
National Activities.--The Committee recognizes that one
purpose of CSP is to evaluate the impact of charter schools on
student achievement, families, and communities, and share best
practices between charter schools and other public schools. The
Committee encourages the Department to use funding within CSP
National Activities to prepare a report summarizing grant
recipients responses to reporting requirements in ESEA,
regarding the identification or sharing of best practices
between charter schools and other public schools, and the
extent to which such practices were adopted and implemented by
other public schools. The Committee encourages the Department
to examine these responses in light of the student populations
served.
Students with Disabilities.--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.
Magnet Schools Assistance
The Committee recommends $149,000,000 for the Magnet
Schools Assistance program (MSAP), which is $40,000,000 more
than the fiscal year 2021 enacted level and the same as the
fiscal year 2021 budget request. This program makes competitive
grants to support the establishment and operation of magnet
schools that are a part of a court-ordered or Federally-
approved voluntary desegregation plan.
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
directs the Department to include a priority for applicants
seeking to establish new inter-district magnet schools.
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 $31,776,000 for Ready to Learn
Programming, which is $2,276,000 more than the fiscal year 2021
enacted level and the fiscal year 2022 budget request. This
program supports the development and distribution of
educational video programming for preschool and elementary
school children and their parents, caregivers, and teachers.
Arts in Education
The Committee recommends $33,000,000 for Arts in Education,
which is $2,500,000 more than the fiscal year 2021 level and
the fiscal year 2022 budget request. This program provides
competitive grants to support professional development and the
development of instructional materials and programming that
integrate the arts into the curricula.
Javits Gifted and Talented Education
The Committee recommends $15,500,000 for the Javits Gifted
and Talented Education Program, which is $2,000,000 more than
the fiscal year 2021 enacted level and the fiscal year 2022
budget request. 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 $13,500,000 for the Statewide
Family Engagement Centers program, which is $1,000,000 more
than the fiscal year 2021 enacted level and the fiscal year
2022 budget request. 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 same as the
fiscal year 2022 budget request. 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, 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.
Fund for the Improvement of Education
The Committee includes $88,010,000 for early learning,
elementary, and secondary education activities. The bill
includes funding for the following projects in the following
amounts:
------------------------------------------------------------------------
Project Amount
------------------------------------------------------------------------
Achievable Dream, Newport News, VA for extended $900,000
learning and whole child supports...................
Albright College, Reading, PA for STEAM learning..... 1,450,000
Aliento Education Fund, Mesa, AZ for student support 300,000
and college access programs.........................
An Achievable Dream Certified Academy at Highland 1,500,000
Springs Elementary, Highland Springs, VA for student
wrap-around services and supports...................
Arab Community Center for Economic & Social Services, 1,000,000
Dearborn, MI for integrated services, literacy
education, and social and emotional learning........
Austin People's Action Center, Chicago, IL for 450,000
technology skills instruction.......................
Bayshore Jointure Commission, Tinton Falls, NJ for a 60,000
life skills and training program....................
Best Buddies International, Friday Harbor, WA for 75,000
services for students with intellectual and
developmental disabilities..........................
Best Buddies International, Las Vegas, NV for 125,000
inclusion programs supporting students with
intellectual and developmental disabilities.........
Best Buddies, Spokane, WA for a mentor program....... 55,000
Big Brothers, Big Sisters, Santa Fe, NM for mentoring 225,000
services and social programs........................
Boys & Girls Club of Burbank and Greater East Valley, 250,000
Burbank, CA for education technology................
Boys & Girls Club of San Fernando Valley, Pacoima, CA 450,000
for STEM and SEL programs...........................
Boys & Girls Clubs of Dundee Township, 250,000
Carpentersville, IL for an academic and SEL support
program.............................................
Boys & Girls Clubs of Greater Anaheim-Cypress, 1,000,000
Cypress, CA for academic support and youth
engagement..........................................
Boys & Girls Clubs of the Los Angeles Harbor, San 500,000
Pedro, CA for the Wilmington College Bound Program..
Boys & Girls Club of Palm Beach County, West Palm 525,000
Beach, FL for its College and Work Readiness STEM
program.............................................
Boys & Girls Clubs of Rochester, NY for a 100,000
comprehensive afterschool and summer program........
Bright Leadership Institute, Chicago, IL for youth 500,000
mentoring and enrichment activities.................
Broward County Public Schools, Ft. Lauderdale, FL for 500,000
a peer mentoring program............................
California State University, Long Beach, CA for 500,000
teacher development and student academic support....
CDF Action, Clarkston, GA for the READY School 325,000
initiative..........................................
Chicago Public Schools, Chicago, IL for arts and STEM 500,000
education...........................................
Chicago Public Schools, Chicago, IL for arts and STEM 500,000
education...........................................
Chicago Public Schools, Chicago, IL for arts and STEM 500,000
education...........................................
Chicago Public Schools, Chicago, IL for arts and STEM 500,000
education...........................................
Chicago Public Schools, Chicago, IL for arts and STEM 500,000
education...........................................
Chicago Zoological Society, Chicago, IL for the King 825,000
Conservation Leadership Academy.....................
Children's Museum, Oak Lawn, IL for the Wee Ones 50,000
program.............................................
City of Commerce, CA for a homework help and online 300,000
learning initiative.................................
City of Long Beach, CA for early childhood education 250,000
and literacy programs at the Michelle Obama Library.
City of Long Beach, NY for early childhood learning.. 400,000
City of Rancho Cordova, CA for the Rancho Cordova 350,000
Youth Center........................................
Clark County School District, Las Vegas, NV for 950,000
school social workers...............................
Common Threads, Chicago, IL for food nutrition 65,000
education programs..................................
Common Threads, Staten Island, NY for culinary and 50,000
nutrition education.................................
Commonwealth of the Northern Mariana Islands Public 350,000
School System, Saipan, MP for indigenous language
immersion...........................................
Commonwealth of the Northern Mariana Islands Public 150,000
School System, Saipan, MP for school library
expansion...........................................
Commonwealth of the Northern Mariana Islands Public 150,000
School System, Saipan, MP for student health and
well-being..........................................
Communities in Schools of San Antonio, TX for 500,000
wraparound services and whole-child supports........
Community Bridges, Silver Spring, MD for academic 80,000
enrichment and wrap-around services.................
Contra Costa County Office of Education, Pleasant 900,000
Hill, CA for internet connectivity..................
dA Center for the Arts, Pomona, CA for early learning 125,000
and arts education..................................
DeKalb County Regional Office of Education, Dekalb, 150,000
IL for kindergarten readiness.......................
Desert Research Institute, Las Vegas, NV for STEM 975,000
education...........................................
Dr. Phillips Center for the Performing Arts, Orlando, 250,000
FL for arts education...............................
DuPage Regional Office of Education, Wheaton, IL for 250,000
high school work-based learning.....................
Early Learning Coalition of Palm Beach County, 125,000
Boynton Beach, FL for an early learning program.....
East Bay Performing Arts, Oakland, CA for music 500,000
education...........................................
Eastern Michigan University, Ypsilanti, MI for early 300,000
childhood educational services......................
Eastern Queens Alliance, Springfield Gardens, NY for 350,000
environmental education.............................
Edward M. Kennedy Institute for the United States 1,000,000
Senate, Boston, MA for civics education.............
El Puente de Williamsburg, Brooklyn, NY for 500,000
environmental studies programming...................
ESP Education & Leadership Institute, Long Beach, CA 50,000
for STEM education and college access...............
Evanston/Skokie District 65, Evanston, IL for a 600,000
teacher residency program...........................
Finishing Trades Institute of the Upper Midwest, 2,000,000
Little Canada, MN for apprenticeship pathways for
middle and high school students.....................
Forsyth County School District, Cumming, GA for the 750,000
Spark! Igniting Learning, Birth and Beyond program..
Friends of Marcy Houses, Brooklyn, NY for tutoring 150,000
and mentoring.......................................
Ft. Smith School District, Ft. Smith, AR for a 400,000
student training program............................
Futures Without Violence, San Francisco, CA for 1,000,000
trauma-informed social and emotional learning
programs............................................
Gannon University, Erie, PA for a science technology 500,000
engineering and mathematics pathway program.........
Genesee Intermediate School District, Flint, MI for a 1,000,000
school nursing pilot program........................
George Mason University, Fairfax, VA for the Quantum 650,000
Science Workforce initiative........................
Georgia Family Connection Partnership, Atlanta, GA 1,500,000
for the Get Georgia Reading Campaign................
Groton Public Schools, Groton, CT for a high school 150,000
career pathways program.............................
Guilford County Schools, Greensboro, NC for an 2,000,000
intensive tutoring program..........................
Gwinnett County Schools Foundation, Suwanee, GA for 775,000
an early childhood education initiative.............
Hamilton Area Young Men's Christian Association, 200,000
Hamilton, NJ for a supplementary education program..
Harry S. Truman Middle College, Chicago, IL for 25,000
career pathways and vocational education............
Hazleton Integration Project, Hazleton, PA for a 1,150,000
STEAM-based education program.......................
Henry Ford College, Dearborn, MI for technology and 2,000,000
manufacturing education.............................
Highline Public Schools, Burien, WA for maritime 1,050,000
education...........................................
Holocaust Memorial Center, Farmington Hills, MI for 550,000
Holocaust education and teacher training............
Houston Independent School District, Houston, TX for 1,000,000
social and emotional learning supports..............
I Have A Dream Foundation, Newark, NJ for STEAM 500,000
education...........................................
Illinois Central College, Peoria, IL for its Cradle 500,000
to Career Initiative................................
Jamel Gaines Creative Outlet, Brooklyn, NY for arts 750,000
education...........................................
Kennedy Krieger Institute, Baltimore, MD for an early 1,250,000
childhood education program.........................
Kent Intermediate School District, Grand Rapids, MI 900,000
for equipment.......................................
Leader Valley Foundation, Waterloo, IA for training, 50,000
curriculum, course materials, and expanding program
access..............................................
Leo High School, Chicago, IL for STEM and robotics 150,000
education...........................................
Life Camp, Jamaica, NY for a youth engagement program 2,000,000
Livermore Valley Joint Unified School District. 375,000
Livermore, CA for a community and parent engagement
program.............................................
Lone Star Flight Museum, Houston, TX for student 615,000
education programs..................................
Madera Unified School District, Madera, CA for 625,000
English learner academic support....................
Mahoning County High School, Youngstown, OH for a 850,000
community learning center...........................
Mass Audubon, Boston, MA for an environmental 250,000
education program...................................
Middlesex County, New Brunswick, NJ for agricultural 300,000
and acquacultural training..........................
Milwaukee Public Schools, Milwaukee, WI for mental 600,000
health services and driver's education..............
Mount Holyoke College, South Hadley, MA for teacher 250,000
professional development in social and emotional
learning and mental health needs....................
National Atomic Testing Museum, Las Vegas, NV for 2,000,000
STEM education and technology.......................
New Directions for Youth, Los Angeles, CA for 125,000
education technology................................
New Haven Public Schools, New Haven, CT for a 2,000,000
manufacturing education and pathways program........
New Mexico Black Leadership Council, Albuquerque, NM 125,000
for enrichment and youth development................
New York Sun Works, New York, NY for STEM and 800,000
sustainability education............................
Niswonger Foundation, Greeneville, TN for a literacy 345,000
tutoring program....................................
Norristown Area School District, Norristown, PA for 200,000
high school library technology and education
programs............................................
North Carolina State University, Raleigh, NC for 350,000
computer science professional development...........
NYC Mission Society, New York, NY for its Level Up 1,100,000
program.............................................
Oceanside Museum of Art, Oceanside, CA for literacy 150,000
instruction and arts education......................
Old Colony YMCA, Brockton, MA for early education 800,000
curriculum and teacher training.....................
Old Dominion University, Norfolk, VA for a maritime 1,000,000
trades magnet school................................
P.E.A.C.E. Afterschool Program, Hempstead, NY for 100,000
afterschool and summer STEAM programs...............
Pace Center for Girls, Jacksonville, FL for 500,000
educational services, counseling, and training......
Pasadena Independent School District, Pasadena, TX 2,000,000
for education technology............................
PAST Foundation, Columbus, OH for its STEM 2022 500,000
program.............................................
Pioneer Works Art Foundation, Brooklyn, NY for youth 1,000,000
development programs................................
Queens Community House, Queens, NY for family support 225,000
counselors..........................................
Randolph Public Schools, Randolph, MA for culturally 275,000
relevant digital literacy...........................
Riverside County Office of Education Division of 1,000,000
Early Learning Services, Riverside, CA for early
learning and literacy...............................
Rohingya Culture Center, Chicago, IL for a homework 50,000
help program........................................
Saint Peter's University, Jersey City, NJ for 1,100,000
educator development and training...................
Salt Creek School District 48, Villa Park, IL, for an 80,000
afterschool program.................................
School District of Osceola, St. Cloud, FL for STEM 450,000
education...........................................
Skokie-Morton Grove School District 69, Skokie, IL 375,000
for community school supports, technology, and
academic enrichment.................................
South Kitsap School District 402, Port Orchard, WA 450,000
for the West Sound STEM Network.....................
Southern Methodist University, Dallas, TX for its 900,000
learning loss program for underserved students......
Southwestern Ohio Council for Higher Education, 1,000,000
Dayton, OH for an internship program................
Spelman College, Atlanta, GA for a student literacy 325,000
initiative..........................................
Sunnyside Community Services, Sunnyside, NY for a 100,000
student support and college access program..........
Sylvester Broome Empowerment Village, Flint, MI for a 650,000
youth empowerment and afterschool program...........
Syrian Community Network, Chicago, IL for hybrid 100,000
learning support....................................
Texas State University, San Marcos, TX for workforce 1,000,000
research initiative and educator professional
development focused on science, technology,
engineering, and mathematics........................
Toledo City School District, Toledo, OH for a high 1,250,000
school auto mechanic training program...............
Town of Milton, MA for assessment resources and 100,000
instructional tools.................................
Town of Monroe, CT for STEM education and technology. 200,000
U.S. Space & Rocket Center, Huntsville, AL for 400,000
equipment and outreach..............................
United Way of Central Jersey, Milltown, NJ for the 550,000
Summer STEAM Stars program..........................
United Way of Forsyth County, Winston-Salem, NC for 450,000
tutoring and enrichment programs....................
United Way of Greater Lehigh Valley, Allentown, PA 575,000
for summer enrichment and technology supports.......
United Way of Northern New Jersey, Cedar Knolls, NJ 1,100,000
for early childhood education.......................
United Way of the Titusville Region, Titusville, PA 55,000
for a literacy program..............................
University of Central Florida, Orlando, FL for early 500,000
learning and parent engagement......................
University of North Carolina at Greensboro, NC for 1,500,000
the High-Speed Education Network Access Pilot.......
University of South Florida, Tampa, FL for STEM 1,000,000
teacher preparation.................................
Urban Transformation Network, Chicago, IL for the 275,000
Urban Youth Green Afterschool program...............
Virginia Commonwealth University, Richmond, VA for a 400,000
teacher residency program...........................
West Indian American Day Carnival Association, 1,000,000
Brooklyn, NY for Caribbean culture, arts, and
history education programs..........................
Whittier Public Library Foundation, Whittier, CA for 450,000
youth services and early learning...................
Wildlife Conservation Society, Bronx, NY for STEM 300,000
learning and career exploration.....................
Wilmington Area School District, New Wilmington, PA 55,000
for computer and robotics equipment.................
Wood Dale Public Library District, Wood Dale, IL for 225,000
early childhood learning............................
YMCA Mid Valley, Van Nuys, CA for learning recovery 1,000,000
activities, including online and in-person tutoring
supports............................................
YMCA of Greater Houston, TX for the Early Childhood 700,000
English Language Learner Initiative.................
YMCA of Greater New York, NY for youth development 1,000,000
programs............................................
YMCA of New Rochelle, NY for its Educational 500,000
Achievement Gap Project.............................
Youth Development, Albuquerque, NM for student and 850,000
family wraparound services..........................
YWCA Metropolitan Chicago, IL, for early childhood 500,000
learning............................................
------------------------------------------------------------------------
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Appropriation, fiscal year 2021....................... $217,000,000
Budget request, fiscal year 2022...................... 1,650,000,000
Committee Recommendation.............................. 1,666,000,000
Change from enacted level......................... +1,449,000,000
Change from budget request........................ +16,000,000
The Committee recommends a total of $1,666,000,000 for
activities to promote safe schools, healthy students, and
citizenship education, which is $1,449,000,000 more than the
fiscal year 2021 enacted level and $16,000,000 more than the
fiscal year 2022 budget request.
Promise Neighborhoods
The Committee recommends $96,000,000 for Promise
Neighborhoods, which is $15,000,000 above the fiscal year 2021
enacted level and $5,000,000 above the fiscal year 2022 budget
request. Promise Neighborhoods supports grants to nonprofit,
community-based organizations for the development of
comprehensive neighborhood programs designed to combat the
effects of poverty and improve educational outcomes for
children and youth, from birth through college.
Planning Grants.--Within the funding provided for Promise
Neighborhoods, the Committee recommendation includes $5,000,000
and new bill language for planning grants intended to
strengthen communities' abilities to scale city and regional
reinvestment strategies and allow for direct services. These
planning grants will support the alignment of resources and
efforts across multiple sectors and focus on measurable shared
goals.
School Safety National Activities
The Committee recommends $1,127,000,000 for School Safety
National Activities, which is $1,021,000,000 more than the
fiscal year 2021 enacted level and $11,000,000 more than the
fiscal year 2022 budget request. 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 2022 budget request for
school-based mental health professionals to the Mental Health
Services Professional Demonstration Grants program established
in the Department of Education Appropriations Act, 2019 and the
School-Based Mental Health Services Grants program established
in the Department of Education Appropriations Act, 2020.
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
the fiscal year 2022 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. 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 requests a briefing within 90 days of
enactment of this Act on plans for carrying out the fiscal year
2022 Mental Health Services Professional Demonstration Grants
and the School-Based Mental Health Services Grants
competitions. In addition, the Department shall provide notice
to the Committees at least seven days before grantees are
announced.
Project SERV.--The Project SERV program provides counseling
and referral to mental health services as well as other
education-related services to LEAs and IHEs in which the
learning environment has been disrupted by a violent or
traumatic crisis. The Committee directs the Department to
report to the Committees on Appropriations within 180 days of
enactment of this Act on how fiscal years 2018, 2019, and 2020
grant recipients used Project SERV funds; recommendations from
grant recipients on how the program could be improved; and,
information on how these funds helped them recover from a
violent or traumatic crisis.
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 the fiscal year
2022 increase to School Safety National Activities, the
Committee recommends $10,000,000 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. 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.
Adverse Childhood Experience.--The Committee recognizes
that the ratio of school-based mental health care professionals
to students is not sufficient to meet students' mental health
needs in schools. Research shows one in three children under 18
has suffered at least one adverse childhood experience (ACE) in
their lifetime and 14 percent experienced two or more ACEs.
However, only about 20 percent of children with mental,
emotional, or behavioral disorders receive care from a
specialized mental health care provider. The Committee
encourages the Department to develop strategies to increase the
training and hiring of counselors and other mental health
providers in educational settings.
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 recognizes
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 strongly urges 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.
Grants for Student Trauma Support and Mental Health.--The
Committee notes that the SUPPORT Act (P.L. 115-271) created new
grants to expand evidence-based trauma support services in
schools to improve access to research-supported interventions.
The SUPPORT Act authorizes the Secretary, in coordination with
the Assistant Secretary of Mental Health and Substance Use, to
use grants to link educational agencies with mental health
systems, increasing student access to evidence-based services
to help prevent and mitigate trauma that youth experience. The
Committee encourages the Department to support these activities
in fiscal year 2022.
Full-Service Community Schools
The Committee recommends $443,000,000 for Full-Service
Community Schools, which is $413,000,000 more than the fiscal
year 2021 level and the same as the fiscal year 2022 budget
request. This program makes competitive grants to support
school-based comprehensive services for students, families, and
communities.
Technical Assistance.--The Full-Service Community Schools
program supports evidence-based models to meet the holistic
needs of children and families. The Committee is encouraged by
research that shows comprehensive community schools as a
strategy that can improve educational quality and equity for
students from diverse backgrounds. Therefore, the Committee
urges the Department to provide technical assistance to SEAs
and LEAs that are interested in leveraging Full-Service
Community Schools grants to meet local school improvement
needs.
ENGLISH LANGUAGE ACQUISITION
Appropriation, fiscal year 2021....................... $797,400,000
Budget request, fiscal year 2022...................... 917,400,000
Committee Recommendation.............................. 1,000,000,000
Change from enacted level......................... +202,600,000
Change from budget request........................ +82,600,000
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 in fiscal year 2022, which is $202,600,000
above the fiscal year 2021 enacted level and $82,600,000 above
the fiscal year 2022 budget request. 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 $60,000,000; 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 2022.
Office of English Language Acquisition (OELA).--The
Committee understands that the nation's EL student population
is rapidly growing and becoming more diverse. The Committee is
deeply concerned by the academic achievement gap that persists
between ELs and their peers and understands that addressing
this challenge has been difficult for many States. These States
rely on Federal technical assistance in crafting and
administering their State and local plans under Title III of
the ESEA, and the Committee recognizes the need to provide them
with timely, accurate guidance. OELA already disseminates
research and resources for teaching ELs and has the expertise
needed to provide this guidance to States. Therefore, the
Committee strongly encourages all assistance duties required
under section 6823(f) of the ESEA to be conducted by OELA.
Children from Puerto Rico.--The Committee is aware that
children and youth who relocate from the U.S. territory of
Puerto Rico, where Spanish is the primary language of
instruction, to one of the 50 States or the District of
Columbia are not counted in the statutory formula used to make
English Language Acquisition allotments to States, set forth in
section 3111(c) of the ESEA.
Seal of Biliteracy Programs.--The Committee recognizes that
State seal of biliteracy programs, adopted and implemented in
more than 80 percent of the States, enrich society by
encouraging bilingual and multilingual education and
demonstrating to employers and higher education institutions
that students have attained proficiency in English and one
other language. The Committee recognizes that ELs and heritage
language learners lag behind world language students in
attaining seals of biliteracy. To that end, the Committee is
strongly supportive of LEAs using funds available under ESEA
for costs associated with seal of biliteracy benchmark
proficiency assessments and final assessments for EL and
heritage language learners. The Committee notes that funds
available under ESEA may be used to purchase the hardware and
software necessary to administer these critical assessments.
Translation and Interpretation Services.--The Committee
recognizes 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 OELA to support LEAs and SEAs in providing robust
translation and interpretation services for parents and
guardians of ELs.
SPECIAL EDUCATION
Appropriation, fiscal year 2021....................... $14,070,743,000
Budget request, fiscal year 2022...................... 17,193,256,000
Committee Recommendation.............................. 17,200,256,000
Change from enacted level......................... +3,129,513,000
Change from budget request........................ +7,000,000
Of the total amount available, $7,488,516,000 is available
for obligation on July 1, 2022, and $9,283,383,000 is available
for obligation on October 1, 2022. 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 $15,537,429,000 for Part B Grants
to States, which is $2,599,972,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request.
Preschool Grants
The Committee recommends $502,620,000 for Preschool Grants,
which is $105,000,000 above the fiscal year 2021 enacted level
and the same as the fiscal year 2022 budget request. 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 $731,850,000 for Grants for
Infants and Families, which is $250,000,000 above the fiscal
year 2021 enacted level and the same as the fiscal year 2022
budget request. These funds provide additional assistance to
States to help them make free, appropriate public education
available to children with disabilities from birth through age
2.
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 promote
continuity of services for eligible infants and their families.
IDEA National Activities
The Committee recommends $428,357,000 for IDEA National
Activities, which is $174,541,000 above the fiscal year 2021
enacted level and $7,000,000 more than the fiscal year 2022
budget request. 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 $31,547,000 for Educational Technology,
Media, and Materials, which is $2,000,000 above the fiscal year
2021 enacted level and the fiscal year 2022 budget request.
This program makes competitive awards to support the
development, demonstration, and use of technology and
educational media activities of educational value to children
with disabilities.
The Committee continues to recognize the ongoing progress
made with the tools and services provided under this program
that have allowed more than 620,000 students with disabilities
free access to more than 700,000 books in digitally accessible
formats. The Committee strongly encourages continued effort to
expand this program's reach to K-12 students in underserved
areas.
Parent Information Centers.--The Committee recommends
$30,152,000 for Parent Information Centers, which is $2,741,000
above the 2021 enacted level and the same as the fiscal year
2022 budget request. This program makes awards to parent
organizations to support Parent Training and Information
Centers, including community parent resource centers. These
centers provide training and information to meet the needs of
parents of children with disabilities living in the areas
served by the centers, particularly underserved parents and
parents of children who may be inappropriately identified.
Technical assistance is also provided under this program for
developing, assisting, and coordinating centers receiving
assistance under this program.
Personnel Preparation.--The Committee recommends
$250,000,000 for Personnel Preparation, which is $159,800,000
above the fiscal year 2021 enacted level and the same as the
fiscal year 2022 budget request. This program supports
competitive awards to help address State-identified needs for
qualified personnel to work with children with disabilities,
and to ensure that those personnel have the necessary skills
and knowledge to serve children with special needs. Awards
focus on addressing the need for leadership and personnel to
serve low-incidence populations. Funds are included to fully
support continuation costs for grants made in prior years. 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.
The Committee is strongly supportive of the fiscal year
2022 proposed increase 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.
As LEAs make determinations about how to invest Elementary
and Secondary School Emergency Relief (ESSER) funds, the
Committee encourages the Department to provide technical
assistance to LEAs and highlight the benefits of partnerships
with educator preparation programs in higher education to
address the shortage of special educators. The Committee notes
that residency programs, grow-your-own programs, and special
education preparation programs are allowable uses of funds
under ESSER. Such programs allow candidates to be supported so
that school districts will be able to address their needs for
fully-prepared special educators.
State Personnel Development.--The Committee recommends
$38,630,000 for State Personnel Development, which is the same
as the fiscal year 2021 enacted level and the fiscal year 2022
budget request. This program supports grants to States to
assist with improving personnel preparation and professional
development related to early intervention and educational and
transition services that improve outcomes for students with
disabilities. Funds are included to fully support continuation
costs for grants made in prior years.
Technical Assistance and Dissemination.--The Committee
recommends $49,345,000 for Technical Assistance and
Dissemination, which is $5,000,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request. 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 $28,683,000 for Special Olympics Education Programs,
which is $5,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 budget request, 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.
Autism.--The Committee supports efforts by the Office of
Special Education and Rehabilitative Services (OSERS) to
disseminate research and best practices to LEAs and SEAs
regarding services and improving results for children with
autism. The Committee is supportive of efforts to share new
knowledge, integrate research and practice, and work with LEAs
and SEAs on high-quality implementation of research.
Assistive Technology Usage.--The Committee notes that
assistive technology (AT) is an essential tool for students
with disabilities. As mandated under IDEA, assistive technology
must be made available to all children with a disability
needing AT as determined by the team developing the student's
Individualized Education Program (IEP). However, too little is
known regarding access to and use of assistive technology for
students who require it. The Committee is concerned that
children with disabilities who could benefit from the use of AT
are not accessing these resources. The Committee encourages
OSERS to study State and district practices in making AT
available to students; the percentage of students with IEPs by
disability category accessing AT; the availability of training
for school personnel and parents to support a child's use of
AT; budgeting practices regarding the annual acquisition of AT
for eligible children; and, any other factors impacting the
policies and practices of providing AT so that all children
with disabilities have equitable access to grade-level
curriculum, assessments and the learning environment
commensurate with their peers. In addition, the Committee
encourages OSERS to issue guidance to States that: clarifies
the requirements of the IDEA regarding providing AT to children
with disabilities; assures States have updated plans to provide
technical assistance to district leaders in the financing and
acquisition of AT; provides training to IEP teams in
determining whether a child qualifies for AT; and trains all
school personnel involved, including the child's parents, on
the use of the AT to ensure children with disabilities have
equitable access to grade-level curriculum, assessment, and the
learning environment commensurate with their peers.
Special Education Expenditure Project.--The Committee notes
that no data has been collected by the Federal government on
special education expenditures since 2004 when the Department
released the Special Education Expenditure Project (SEEP). To
assist policymakers and advocates with critical questions
regarding special education spending, the Committee encourages
the Department to conduct a large-scale, nationally
representative study of special education expenditures of
similar scale, scope, and design as the 1999-2004 SEEP.
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.
REHABILITATION SERVICES
Appropriation, fiscal year 2021....................... $3,814,220,000
Budget request, fiscal year 2022...................... 3,894,820,000
Committee Recommendation.............................. 3,896,820,000
Change from enacted level......................... +82,600,000
Change from budget request........................ +2,000,000
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 $3,719,121,000 in mandatory
funding for Vocational Rehabilitation (VR) State Grants, which
is $44,100,000 above the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request.
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 2021 enacted
level and the fiscal year 2022 budget request. Client
Assistance State Grants support services for eligible
individuals and applicants of the VR State Grants program, and
other programs, projects, and services funded under the
Rehabilitation Act. These formula grants are used to help
persons with disabilities overcome problems with the service
delivery system and improve their understanding of services
available to them under the Rehabilitation Act.
Training
The Committee recommends $29,388,000 for the Training
program, which is the same as the fiscal year 2021 enacted
level and the fiscal year 2022 budget request. The program
supports long-term and short-term training, in-service
personnel training, and training of interpreters for deaf
persons. Projects in a broad array of disciplines are funded to
ensure that skilled personnel are available to serve the
vocational needs of persons with disabilities. Funds are
included to fully support continuation costs for grants made in
prior years.
Demonstration and Training Programs
The Committee recommends $40,796,000 for Demonstration and
Training Programs, which is $35,000,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. 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 2021 enacted level for
parent information and training programs.
Protection and Advocacy of Individual Rights
The Committee recommends $20,150,000 for Protection and
Advocacy of Individual Rights, which is $2,000,000 more than
the fiscal year 2021 enacted level and the fiscal year 2022
budget request. Grants are awarded to entities that have the
authority to pursue legal, administrative, and other
appropriate remedies to protect and advocate for the rights of
persons with disabilities.
Supported Employment State Grants
The Committee recommends $22,548,000 for Supported
Employment State Grants, which is the same as the fiscal year
2021 enacted level and the fiscal year 2022 budget request.
These formula grants assist States in developing collaborative
programs with public agencies and nonprofit agencies for
training and post-employment services leading to supported
employment. In supported employment programs, persons with the
most significant disabilities are given special supervision and
assistance to enable them to work in 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 both the fiscal year 2021 enacted level and the fiscal year
2022 budget request. Funds are distributed to States according
to a formula based on the population of individuals who are 55
or older and provide support for services to persons 55 years
old or over whose severe visual impairment makes gainful
employment extremely difficult to obtain, but for whom
independent living goals are feasible.
Helen Keller National Center
The Committee recommends $18,500,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults, which is
$1,500,000 more than the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request. These funds are
used for the operation of a national center that provides
intensive services for deaf-blind individuals and their
families at Sands Point, New York, and a network of ten
regional offices that provide referral, counseling, transition
services, and technical assistance to service providers.
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
Appropriation, fiscal year 2021....................... $256,292,000
Budget request, fiscal year 2022...................... 265,292,000
Committee Recommendation.............................. 265,292,000
Change from enacted level......................... +9,000,000
Change from budget request........................ - - -
The Committee recommends $265,292,000 for Special
Institutions for Persons with Disabilities, which is $9,000,000
above the fiscal year 2021 enacted level and the same as the
fiscal year 2022 budget request.
AMERICAN PRINTING HOUSE FOR THE BLIND
Appropriation, fiscal year 2021....................... $34,431,000
Budget request, fiscal year 2022...................... 37,431,000
Committee Recommendation.............................. 37,431,000
Change from enacted level......................... +3,000,000
Change from budget request........................ - - -
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.
The Committee applauds the Printing House for rapidly
developing training resources to assist schools, teachers,
parents, and students to adapt to the changes in education
brought about because of the COVID pandemic. The increase in
funding will help provide the resources necessary to develop
and distribute assistive technologies, books in accessible
formats and specially designed educational aids that will allow
students who are blind or visually impaired to fully
participate in and benefit from education programs.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriation, fiscal year 2021....................... $81,500,000
Budget request, fiscal year 2022...................... 84,500,000
Committee Recommendation.............................. 84,500,000
Change from enacted level......................... +3,000,000
Change from budget request........................ - - -
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 2021....................... $140,361,000
Budget request, fiscal year 2022...................... 143,361,000
Committee Recommendation.............................. 143,361,000
Change from enacted level......................... +3,000,000
Change from budget request........................ - - -
Gallaudet is a private, non-profit educational institution
Federally chartered in 1864 providing elementary, secondary,
undergraduate, and continuing education for deaf persons. In
addition, the University offers graduate programs in fields
related to deafness for deaf and hearing students, conducts
research on deafness, and provides public service programs for
deaf persons.
CAREER, TECHNICAL, AND ADULT EDUCATION
Appropriation, fiscal year 2021....................... $2,030,936,000
Budget request, fiscal year 2022...................... 2,183,936,000
Committee Recommendation.............................. 2,238,981,000
Change from enacted level......................... +208,045,000
Change from budget request........................ +55,045,000
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 $1,384,848,000 for Career and
Technical Education (CTE) State Grants, which is $50,000,000
above the fiscal year 2021 enacted level and $30,000,000 more
than the fiscal year 2022 budget request. Of these funds,
$593,848,000 will become available on July 1, 2022, and
$791,000,000 will become available for obligation on October 1,
2022.
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.
National Programs
The Committee recommends $115,421,000 for National
Programs, which is $108,000,000 more than the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget
request. The recommendation includes new language supporting
the Administration's proposal for Innovation and Modernization
grants.
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 career and technical education (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 IET models that blend basic
skills instruction and occupational training to expand
equitable access to skills training, high-quality credentials
and family-supporting careers.
Adult Basic and Literacy Education State Grants
The Committee recommends $700,000,000 for Adult Basic and
Literacy Education State Grants, which is $25,045,000 more than
the fiscal year 2021 enacted level and the fiscal year 2022
budget request. 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 $38,712,000 for National
Leadership Activities, which is $25,000,000 more than the
fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. This program supports applied research,
development, dissemination, evaluation, and program improvement
efforts to strengthen the quality of adult education services.
The Committee encourages the provision of technical
assistance to States to foster and scale IET models by ensuring
collaboration with CTE providers. IET is a service approach
that provides adult education and literacy activities
concurrently and contextually with workforce preparation for a
specific occupation or occupational cluster for the purpose of
educational and career advancement.
STUDENT FINANCIAL ASSISTANCE
Appropriation, fiscal year 2021....................... $24,545,352,000
Budget request, fiscal year 2022...................... 27,545,352,000
Committee Recommendation.............................. 27,187,352,000
Change from enacted level......................... +2,642,000,000
Change from budget request........................ -358,000,000
Pell Grants
The Committee recommends $24,725,352,000 in discretionary
funding for the Pell Grant program, which is $2,250,000,000
more than the fiscal year 2021 enacted level and $750,000,000
less than the fiscal year 2022 budget request. These funds will
support Pell grants to students for the 2022-2023 academic
year.
Combined with mandatory funding streams, the Committee
recommendation supports a maximum Pell Grant in academic year
2022-2023 of $6,895, a $400 increase over fiscal year 2021 and
the same as the fiscal year 2022 discretionary budget request.
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. In
keeping with the fiscal year 2022 budget request, the
recommendation includes new language extending eligibility for
DACA-eligible students.
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 Committee requests a briefing within 180 days
of enactment of this Act on expanding eligibility for Pell
Grants to provide better access to higher education
opportunities and better serve a modernized economy and diverse
workforce, including recent experimental site initiatives.
Second Chance Pell.--The Committee notes Pell grants are
now available for incarcerated individuals. The Committee
supports efforts to ensure those who are eligible are provided
opportunities to access the financial assistance. The Committee
requests an update on this effort in the fiscal year 2023
congressional justification.
Federal Supplemental Educational Opportunity Grants
The Committee recommends $1,028,000,000 for the Federal
Supplemental Educational Opportunity Grants (SEOG) program,
which is $148,000,000 more than the fiscal year 2021 enacted
level and the fiscal year 2022 budget request.
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
69 percent of dependent recipients have annual family incomes
under $30,000 and nearly 71 percent of independent SEOG
recipients have annual family incomes under $20,000.
Institutions must contribute a 25 percent match toward their
SEOG allocation.
Federal Work-Study
The Committee recommends $1,434,000,000 for the Federal
Work-Study program, which is $244,000,000 more than the fiscal
year 2021 enacted level and the fiscal year 2022 budget
request.
Federal Work-Study funds are provided through institutions
to students who work part-time. The funds assist with paying
for the cost of education. Approximately 3,200 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 25 percent 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.
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 1998, 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.
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 2021....................... $50,000,000
Budget request, fiscal year 2022...................... 25,000,000
Committee Recommendation.............................. 25,000,000
Change from enacted level......................... -25,000,000
Change from budget request........................ - - -
The Committee recommendation includes $25,000,000 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. While approximately $800,000,000
has been provided for TEPSLF since fiscal year 2018, only
$129,970,490 has been used for borrower discharges as of April
2021. The Committee encourages the Department to improve the
administration of this program.
The Committee appreciates the Department's briefing on
actions planned or taken to address and implement
recommendations outlined in a GAO report entitled ``Public
Service Loan Forgiveness: Improving the Temporary Expanded
Process Could Help Reduce Borrower Confusion'' (GA0-19-595).
The Committee directs the Department to include 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.
The Committee notes that many physicians are excluded from
receiving forgiveness under section 455(m)(3) of the HEA as
they are prohibited from direct employment with private, non-
physician, corporate entities within their States. As such, the
Committee encourages the Secretary to provide full-time
borrowers who are engaged in health care practitioner
occupations in such States, including California and Texas,
with loan cancellations that are consistent with the
Department's ongoing loan cancellations for health care
practitioners across the country. Further, the Committee
encourages the Department to explore this issue through
negotiated rulemaking this year.
Student Aid Administration
Appropriation, fiscal year 2021....................... $1,853,943,000
Budget request, fiscal year 2022...................... 2,053,943,000
Committee Recommendation.............................. 2,053,943,000
Change from enacted level......................... 200,000,000
Change from budget request........................ - - -
Programs administered under 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 $975,000,000 for salaries and
expenses, which is the same as the fiscal year 2021 enacted
level and the fiscal year 2022 request.
Loan Servicing Activities.--Within the total provided for
SAA, the Committee recommends $1,078,943,000 for Loan Servicing
Activities, which is $200,000,000 more than the fiscal year
2021 enacted level and the same as the fiscal year 2022
request.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $91,130,000 for administrative expenses to support
changes to the student aid programs to assist students and
borrowers in response to COVID-19.
State and Nonprofit Subcontracting--The Committee believes
that State and nonprofit organizations can assist Federal
student loan servicers in providing important services to
struggling borrowers who need access to more specialized
support services throughout their postsecondary education to
help them understand their financial decisions and act as
advocates to help struggling borrowers understand the student
loan repayment process and options that may be available to
them to help mitigate delinquencies and defaults. The Committee
urges the Department to explore incentives for Federal student
loan servicers to subcontract with qualified State and
nonprofit organizations as well as small businesses.
Next Generation Servicing Environment.--In 2017, the
Department initiated the Next Generation Processing and
Servicing Environment (Next Gen). Since that time, Congress has
provided significant resources for Student Aid Administration
activities, including the development and implementation of
Next Gen. Given these resources, the Committee remains
concerned with the current state of student loan servicing. The
recommendation continues to include bill language requiring FSA
to submit a detailed spend plan of anticipated uses.
Transparency in College Costs.--The Committee notes the
persistent lack of transparency around the costs of college and
its detrimental impact on the ability of individuals and
families to make informed financial decisions around higher
education. Therefore, the Committee urges the Department to
work with institutions of higher education to improve college
cost transparency, and requests a briefing on these efforts no
later than 120 days after enactment of this Act.
FAFSA Tax Data Retrieval Tool for the U.S. Territories.--
The Committee notes that students or parents who file a Puerto
Rico or other U.S. territory tax return are currently unable to
use the IRS Data Retrieval Tool to complete the Free
Application for Federal Student Aid (FAFSA) form. Instead, they
must enter their tax return information manually. The Committee
is interested in simplifying the FAFSA process for applicants
in Puerto Rico and the other U.S. territories, in the same
manner available to Internal Revenue Service (IRS) tax filers
residing in the 50 States and the District of Columbia. The
Committee therefore encourages the Department of Education to
work with the IRS and the tax authorities of the five U.S.
territories to explore options that would allow applicants in
these jurisdictions to import their tax income information
directly into the FAFSA form, including the feasibility of
utilizing the existing IRS Data Retrieval Tool or a similar
mechanism.
COVID-19 Impacts to PSLF.--The Committee directs the
Department to include an update in the fiscal year 2023
Congressional Budget Justification on how COVID-19 has impacted
the PSLF program and how the Department of Education is
addressing concerns of COVID-19's impact, if any, on an
applicant's ability to apply and qualify for PSLF.
HIGHER EDUCATION
Appropriation, fiscal year 2021....................... $2,541,661,000
Budget request, fiscal year 2022...................... 3,308,802,000
Committee Recommendation.............................. 3,430,757,000
Change from enacted level......................... +889,096,000
Change from budget request........................ +121,955,000
The American Rescue Plan Act (P.L. 117-2) included
$169,464,000,000 for the Education Stabilization Fund (ESF) to
prevent, prepare for, and respond to the coronavirus,
domestically or internationally. The ESF included
$39,584,570,000 in funding for higher education emergency
relief.
Strengthening Institutions
The Committee recommends $209,007,000 for the Part A,
Strengthening Institutions program, which is $100,000,000 more
than the fiscal year 2021 enacted level and the same as the
fiscal year 2022 budget request. 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.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $421,565,000 for the Strengthening Institutions
program to directly support students and institutions
addressing effects of COVID-19.
Developing Hispanic-Serving Institutions
The Committee recommends $236,732,000 for the Developing
Hispanic-Serving Institutions (HSI) program, which is
$88,000,000 more than the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request.
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.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $559,256,000 for the Developing HSIs program to
directly support students and institutions addressing effects
of COVID-19.
GAO report on Hispanic Serving Institution (HSI)
Facilities.--The Committee recognizes the importance of
underrepresented groups having access to institutions of higher
education that promote student achievement, workforce
development, and career opportunities. As such, the Committee
directs the GAO to provide a report to the Committee on
infrastructure needs--both physical and digital--at HSIs. In
this report, the GAO should include, but is not limited to, a
review and analysis of the condition of HSI facilities, capital
financing challenges facing HSIs, and how to help HSIs better
serve Hispanic communities. The Committee expects to receive
regular updates from GAO about the status of the report and any
initial critical findings that would allow the Committee to
address the financial needs of HSIs.
Graduation Rates.--The Committee notes that HSIs provide
many benefits and educational opportunities to their students.
However, the Committee is concerned that students at HSIs may
be graduating at lower rates than students at non-HSIs.
Therefore, the Committee directs the Department to provide an
update in the fiscal year 2023 Congressional Budget
Justification on graduation rates, retention rates, and
persistence rates for students at HSIs, including a strategy on
how to improve overall postsecondary completion at HSIs.
Promoting Postbaccalaureate Opportunities for Americans
The Committee recommends $28,845,000 for the Promoting
Postbaccalaureate Opportunities for Hispanic Americans program,
which is $15,000,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request. This
program provides expanded postbaccalaureate educational
opportunities for the academic attainment of Hispanic and low-
income students. In addition, it expands academic offerings and
enhances program quality at IHEs educating the majority of
Hispanic college students.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $50,179,000 for the Promoting Postbaccalaureate
Opportunities for Hispanic Americans program to directly
support students and institutions addressing effects of COVID-
19.
Strengthening Historically Black Colleges and Universities
The Committee recommends $402,619,000 for Strengthening
Historically Black Colleges and Universities (HBCUs), which is
$65,000,000 more than the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request. 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.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $1,269,503,000 for the Strengthening HBCUs program to
directly support students and institutions addressing effects
of COVID-19.
Strengthening Historically Black Graduate Institutions
The Committee recommends $102,313,000 for the Strengthening
Historically Black Graduate Institutions (HBGIs) program, which
is $15,000,000 more than the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request. 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.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $328,308,000 for the Strengthening HBGIs program to
directly support students and institutions addressing effects
of COVID-19.
Strengthening Predominantly Black Institutions
The Committee recommends $23,218,000 for the Strengthening
Predominantly Black Institutions (PBIs) program, which is
$9,000,000 more than the fiscal year 2021 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.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $51,583,000 for the Strengthening PBIs program to
directly support students and institutions addressing effects
of COVID-19.
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 program, which is $15,000,000 more than the fiscal
year 2021 enacted level and the same as the fiscal year 2022
budget request. This program provides grants to undergraduate
institutions that have an undergraduate student enrollment of
at least 10 percent Asian American or Native American Pacific
Islander.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $17,370,000 for the Strengthening Asian American and
Native American Pacific-Islander-Serving Institutions program
to directly support students and institutions addressing the
effects of COVID-19.
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 $6,000,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request.
Through the Strengthening Alaska Native and Native Hawaiian-
Serving Institutions program, the Department provides grants to
assist IHEs in serving Alaska Native and Native Hawaiian
students.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $71,607,000 for the Strengthening Alaska Native and
Native Hawaiian-Serving Institutions program to directly
support students and institutions addressing effects of COVID-
19.
Strengthening Native American Serving Non-Tribal Institutions
The Committee recommends $12,120,000 for the Native
American Serving Non-Tribal Institutions program, which is
$7,000,000 more than the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request. This program makes
grants to IHEs at which enrollment is at least 10 percent
Native American students and that are not Tribally Controlled
Colleges or Universities.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $17,370,000 for the Strengthening Native American
Serving Non-Tribal Institutions program to directly support
students and institutions addressing effects of COVID-19.
Strengthening Tribally Controlled Colleges and Universities
The Committee recommends $53,080,000 for the Strengthening
Tribally Controlled Colleges and Universities (TCCUs) program,
which is $15,000,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request. This
program makes grants to TCCUs to increase their capacity to
serve the academic needs of students.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $143,186,000 for the Strengthening TCCUs program to
directly support students and institutions addressing effects
of COVID-19.
Strengthening HBCU Masters Program
The Committee recommends $20,956,000 for the Strengthening
HBCU Masters Programs, which is $10,000,000 more than the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request. 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.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $38,915,000 for the Strengthening HBCU Masters Program
to directly support students and institutions addressing the
effects of COVID-19.
International Education and Foreign Language Studies
Domestic Programs.--The Committee recommends $79,353,000
for the Domestic Programs of the International Education and
Foreign Languages Studies program, which is $10,000,000 more
than the fiscal year 2021 enacted level and the fiscal year
2022 budget request. 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.
The Committee includes $3,000,000 to establish a Native
American Language Resource Center under the Language Resource
sections 601 and 603 of the HEA.
Overseas Programs.--The Committee recommends $13,811,000
for the Overseas Programs, which is $5,000,000 more than the
fiscal year 2021 enacted level and the fiscal year 2022 budget
request. 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 2021 enacted level and
the same as the fiscal year 2022 budget request. TPSID supports
grants to create model transition programs into postsecondary
education for students with intellectual disabilities.
Minority Science and Engineering Improvement
The Committee recommends $26,300,000 for the Minority
Science and Engineering Improvement Program, which is
$12,930,000 more than the fiscal year 2021 enacted level and
$7,930,000 more than the fiscal year 2022 budget request. This
program awards grants to improve mathematics, science, and
engineering programs at institutions serving primarily minority
students and to increase the number of minority students who
pursue advanced degrees and careers in those fields.
Tribally Controlled Postsecondary Career and Technical Institutions
The Committee recommends $15,644,000 for this program,
which is $5,010,000 more than the fiscal year 2021 enacted
level and the fiscal year 2022 budget request. 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 $200,761,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request. 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.
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 $40,000,000 more than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request. GEAR
UP provides grants to States and partnerships of low-income
middle and high schools, IHEs, and community organizations to
target entire grades of students and give them the skills,
encouragement, and scholarships to pursue successfully
postsecondary education.
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.
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 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, 2022, 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 $25,547,000 for the Graduate
Assistance in Areas of National Need (GAANN) program, which is
$2,000,000 more than the fiscal year 2021 enacted level and the
fiscal year 2022 budget request. 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.
The Committee encourages the Secretary to consider the
inclusion of ``Computer Science + X'' (CS+X) programs (also
referred to as Applied Computer Science and Data Literacy
Programs), aimed at integrating the humanities and computer
science, in order to provide technology-focused students in
need with the broader skill set required for high tech jobs.
Teacher Quality Partnership Grants
The Committee recommends $132,092,000 for the Teacher
Quality Partnerships (TQP) program, which is $80,000,000 more
than the fiscal year 2021 enacted level and the same as the
fiscal year 2022 budget request. 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.
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.
The Committee recognizes the needs of the nation's growing
English learner (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 recommends the Secretary support the development
and strengthening of high-quality teacher preparation programs
that enable graduates to meet licensure or certification
requirements to teach ELs.
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 of
Education to prioritize grants under the Teacher Quality
Partnership Grant Program for applicants that apply to fund
high-quality teacher residency programs as authorized under
Section 202(e) of the Higher Education Act. 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 $40,000,000
more than the fiscal year 2021 enacted level and the same as
the fiscal year 2022 budget request. This program makes
competitive grants to colleges and universities to support or
establish a campus-based childcare program primarily serving
the needs of low-income students enrolled at the institution.
Fund for the Improvement of Postsecondary Education
The Committee recommendation includes $168,015,000 for the
Fund for the Improvement of Postsecondary Education, which is
$127,015,000 more than the fiscal year 2021 enacted level and
$92,015,000 more than the fiscal year 2022 budget request.
Centers of Excellence for Student Veteran Success
Program.--The Committee includes $15,000,000 to support
existing and new grantees for the Centers of Excellence for
Student Veterans 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. Student Veteran 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.
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 $8,000,000
for competitive grants to at least eight institutions of higher
education, as defined by section 101 of the HEA, to support
programs that address the basic needs of students and report on
best practices. In order to qualify, grantees must use funds to
carry out or expand at least two of the following activities:
to fund basic needs programs that support temporary housing,
secure sleeping arrangements, provide free or subsidized food,
access to on-campus childcare, and/or other basic needs to
eligible students; conduct outreach to students to encourage
participation in basic needs 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 25 percent of grants must go to
community colleges. Grant priority will go to institutions with
25 percent or higher Pell enrollment, HBCUs, HSIs, and other
MSIs.
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 $1,000,000 to
provide a funding opportunity for organizations that work
directly with gang involved youth to help such youth pursue
higher education opportunities.
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 $12,000,000 to
continue the Open Textbook Pilot and fund a new grant
competition in fiscal year 2022. 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.
Center of Excellence in Spatial Computing.--The Committee
is increasingly concerned about the lack of highly-qualified
Americans available for hire within the high-tech labor pool.
The technology sector is the fastest growing market within the
United States, with a growing need for a spatial computing
workforce to remain competitive. Therefore, the Committee
includes $5,000,000 to establish a Center of Excellence in
Spatial Computing designation, allowing institutions of higher
education the opportunity to qualify for federal funding to
teach students the necessary skills to succeed in an ever-
evolving high tech economy.
In order to receive this designation, institutions must:
(i) create a consortium of multiple institutions of higher
education capable of supporting the advancement of spatial
computing in our nation's colleges and universities, including
the development of best practices and curricula that can be
shared with computer science and other relevant programs; (ii)
establish U.S. leadership and competitiveness by promoting
innovative processes for domestic manufacturing of spatial
computing technology products in a rapidly developing global
market; (iii) create educational and work placement opportunity
programs to recruit, train, and retain underserved populations
in the technology sector; and (iv) develop case studies and
skill-based workforce training and company-based education
programs in spatial computing.
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.
Distributed Higher Education Digital Infrastructure
Pilot.--The Committee includes $5,000,000 to establish a pilot
program for an institution of higher education with established
remote learning infrastructure to work with Minority-Serving
Institutions in the grantee's region to provide support and
technical assistance to expand MSI digital learning
infrastructure.
Community Project Funding.--Within the funds included in
this account, [$92,015,000] shall be used for the following
projects in the following amounts:
------------------------------------------------------------------------
Project Amount
------------------------------------------------------------------------
Adrian College, Adrian, MI for establishment of a $300,000
shared majors partnership program...................
African American History and Culture Foundation, Long 250,000
Beach, CA for college prepartion activities,
including scholarships..............................
Alamo Colleges District, San Antonio, TX for lab 95,000
equipment...........................................
Alvernia University, Reading, PA for programming and 2,000,000
classroom and technology upgrades...................
Arkansas Tech University, Russellville, AR for 675,000
nursing program simulation labs, including the
purchase of information technology..................
Austin Community College District, Austin, TX for 700,000
child care supports for student parents,
establishing an online Child Development Associate
program, and curriculum development.................
Baylor University, Waco, TX for cybersecurity 1,000,000
initiative and the purchase of information
technology..........................................
Be A Leader Foundation, Phoenix, AZ for a college 175,000
access and success program..........................
Bellarmine University, Louisville, KY for simulation 1,000,000
technology, equipment, and instruction, including
educational opportunities for K-12 students.........
Benjamin Franklin Institute of Technology (BFIT), 300,000
Boston, MA for a certificate program, including
equipment...........................................
Berkshire Community College, Pittsfield, MA for 350,000
technology and equipment............................
Bristol Community College, Fall River, MA for 2,000,000
curriculum development and equipment................
Brookdale Community College, Lincroft, NJ for 450,000
establishment of a center for excellence in
cybersecurity education, including the purchase of
equipment and information technology................
California State University Channel Islands, 250,000
Camarillo, CA for curriculum development............
California State University, Sacramento, Sacremento, 575,000
CA for lab equipment................................
California State University, Sacramento, Sacremento, 250,000
CA for equipment and classroom material.............
Cape Cod Community College, West Barnstable, MA for 1,950,000
an aviation program, including equipment............
Center for Employment Training, San Jose, CA for 325,000
equipment...........................................
Chapman University, Orange, CA for the Earth Systems 1,000,000
Science and Data Solutions Lab (EssDs), including
equipment, scholarships, and fellowships............
Christian Brothers University, Memphis, TN for 400,000
workforce development and educational opportunities,
including stipends and equipment....................
City College of New York, City University of New 1,500,000
York, New York, NY for workforce development
program, including equipment and stipends...........
City of Paramount, CA for student scholarships and 550,000
learning center technology and equipment upgrades...
College of Southern Maryland, La Plata, MD for 550,000
equipment...........................................
Colorado State University, Fort Collins, CO for a 1,000,000
college access and success initiative...............
Community College of Rhode Island, Warwick, RI for a 1,060,000
constituent relations management tool...............
Durham Technical Community College, Durham, NC for a 1,200,000
workforce development initiative....................
East Los Angeles College, Monterey Park, CA to 200,000
establish a collaborative partnership promoting
college access and success..........................
East-West University, Chicago, IL for technology 240,000
upgrades............................................
Eastern Kentucky University , Richmond, KY for a 505,000
center focused on science, technology, engineering,
and mathematics, including the purchase of
information technology..............................
El Camino College, Torrance, CA for student supports, 350,000
including stipends and scholarships.................
Elmira College, Elmira, NY for information technology 1,850,000
upgrades and equipment..............................
Framingham State University, Framingham, MA for an 600,000
early college program, including partnerships with
middle schools and high schools.....................
Georgia Gwinnett College, Lawrenceville, GA for 1,450,000
student support services, including scholarships and
equipment...........................................
Glen Oaks Community College, Centreville, MI for 900,000
information technology and equipment for distance
learning............................................
Grambling State University, Grambling, LA for a 2,000,000
teacher preparation program and equipment...........
Grand Valley State University, Allendale, MI for 1,000,000
curriculum, information technology, and equipment
for applied research program........................
Harris-Stowe State University, St. Louis, MO for an 1,000,000
entrepreneurship program and center.................
Hartwick College, Oneonta, NY for the Grain 300,000
Innovation Center, including equipment..............
Housatonic Community College, Bridegeport, CT for an 1,000,000
advanced manufacturing training program, including
scholarships and equipment..........................
Houston Community College, Houston, TX for program 2,000,000
development.........................................
Hudson County Community College, Union City, NJ for 975,000
technology and equipment............................
Illinois College, Jacksonville, IL for creation of an 330,000
online Master of Science in Nursing program and
equipment...........................................
Indian Hills Community College, Ottumwa, IA for 2,000,000
college and career transition counselors initiative.
Ivy Tech Community College--Lake County Campus, East 1,200,000
Chicago, IN for an academic and student support
initiative..........................................
Ivy Tech Community College, Indianapolis, IN for a 300,000
mobile unit to offer training and other services....
JobPath, Inc., Tucson, AZ to assist displaced workers 500,000
in enrolling in and completing degree and
certificate programs................................
Juniata College, Huntingdon, PA for a public health 995,000
educational and research program....................
Kankakee Area Career Center, Bourbonnais, IL for a 175,000
counselor, technology, and equipment................
KVCR Inland Future's Foundation, San Bernardino, CA 1,000,000
for public broadcasting opportunities for college
students, including curriculum development..........
Lackawanna College, Scranton, PA for technical and 2,000,000
vocational education program development, including
equipment...........................................
Lane Community College, Eugene, OR for equipment..... 500,000
Lehman College, City University of New York, New 250,000
York, NY for an economic recovery and revitalization
program for students, including financial assistance
Lincoln University, Lincoln University, PA for 175,000
curriculum development, including scholarships......
Los Angeles City College, Los Angeles, CA for basic 975,000
needs project.......................................
Los Angeles Community College District, Los Angeles, 400,000
CA for workforce development programs, including
equipment...........................................
Los Angeles Southwest College, Los Angeles, CA for 1,500,000
student support services............................
Louisiana State University at Alexandria, Alexandria, 120,000
LA to develop a program for young people with
developmental disabilities and the purchase of
information technology..............................
Louisiana Tech University, Ruston, LA for a cyber 2,000,000
education and training program......................
Marquette University, Milwaukee, WI for a college 750,000
access and success initiative.......................
Massachusetts Maritime Academy, Buzzards Bay, MA for 1,000,000
equipment and program development...................
McHenry County College, Crystal Lake, IL for dual 825,000
enrollment activities...............................
Mid-America Christian University, Oklahoma City, OK 850,000
for a mental health counselor training and
credentialing program and the purchase of equipment.
Minnesota State Northern Agricultural Center of 2,000,000
Excellence, Staples, MN for meat cutting and
butchery program, including the purchase of
equipment...........................................
Mitchell College, New London, CT for curriculum 550,000
development, including equipment....................
Moorpark College, Ventura County Community College 225,000
District, Moorpark, CA for workbased learning
opportunities, including student stipends...........
Morehouse College, Atlanta, GA for student support 900,000
services, including scholarships, curriculum
development, and summer bridge programs.............
Mt. San Antonio College, Walnut, CA for vocational 500,000
health training programs............................
New York University, New York, NY for a prison 300,000
education program, including stipends and
scholarships........................................
Nova Southeastern University, Ft. Lauderdale, FL for 1,950,000
technology and equipment............................
Oklahoma State University, Oklahoma City, OK for a 850,000
workforce development program.......................
Pima County Community College, Tucson, AZ for lab 1,000,000
equipment...........................................
Portland Community College, Portland, OR for 800,000
curriculum development, including equipment and
technology..........................................
Quinsigamond Community College, Worcester, MA for 975,000
technology..........................................
Red Rocks Community College, Lakewood, CO for a 300,000
credential attainment initiative related to STEM
fields..............................................
Rhode Island College, Providence, RI for developing 500,000
certificate programs................................
Riverside Community College District, Riverside, CA 1,500,000
for the Inland Empire Technical Trade Center........
Rowan University, Glassboro, NJ for the Wind Energy 500,000
Workforce Training Program, including equipment and
technology..........................................
Salt Lake Community College, Salt Lake City, UT for a 500,000
campus internship program...........................
San Carlos Apache College, San Carlos, AZ for library 875,000
and computer center modernization project...........
San Diego Community College District, San Diego, CA 975,000
for IT system upgrades and modernization project....
San Jacinto College, Houston, TX for aerospace 585,000
training programs and the purchase of equipment.....
Santa Clarita Community College District (College of 1,000,000
the Canyons), Santa Clarita, CA for equipment for
the advanced technology center......................
Seminole State College, Sanford, FL for simulation 475,000
laboratory equipment................................
Southern California College Access Network, Los 650,000
Angeles, CA for college and career advising support
services to residents in public housing.............
St. Catherine University, St. Paul, MN for technology 800,000
and equipment.......................................
St. Mary's College of Maryland, St. Mary's City, MD 900,000
for a marine sciences program, including purchase of
a research vessel and other associated equipment....
Stevens Institute of Technology, Hoboken, NJ for 750,000
college preparation and success activities,
including scholarships..............................
Sul Ross State University, Alpine, TX for an 1,000,000
archaeology, anthropology, and cultural research
initiative and the purchase of equipment............
TechUnited:NJ BetterFutureLabs, Hoboken, NJ for a 1,000,000
technology program, including curriculum development
Texas A&M University-Kingsville, Kingsville, TX for 500,000
teacher preparation and bridge programs.............
The Ohio State University, Columbus, OH for the Race, 475,000
Inclusion, and Social Equity (RAISE) Institute......
The University of Massachusetts Amherst, Amherst, MA 1,000,000
for a robotics program, including scholarships......
Tougaloo College, Tougaloo, MS for the Reuben V. 1,000,000
Anderson Institute for Social Justice...............
United Community Center, Milwaukee, WI for college 275,000
access and success initiative.......................
University of Colorado Boulder, Boulder, CO for 275,000
college access and success initiative...............
University of Idaho Rinker Rock Creek Ranch, Moscow, 1,325,000
ID for education, research training, and equipment
for rangeland management and animal science.........
University of Louisville, Louisville, KY for robotics 750,000
and manufacturing equipment and software............
University of Massachusetts Lowell, Lowell, MA for 500,000
student support services for first generation
students, including scholarships....................
University of North Carolina System Office, Chapel 225,000
Hill, NC for college preparation program for high
school students and their parents...................
University of Texas at Dallas, Richardson, TX for a 400,000
study related to the impact of COVID-19 on
postsecondary students..............................
University of Utah, Salt Lake City, UT for social 750,000
work fellowship program.............................
University of Utah, Salt Lake City, UT to pilot a 1,000,000
college access and degree completion initiative for
young adults exiting the foster care system and the
purchase of equipment...............................
University of Wisconsin-Milwaukee, Milwaukee, WI for 350,000
research and curriculum development.................
Utah State University, Logan, UT for academic, 585,000
research, and career development program............
Vermont State Colleges-Northern Vermont University-- 250,000
Lyndon, Lyndonville, VT for student support services
Wake Technical Community College, Raleigh, NC for 600,000
college preparation and success initiative..........
Walsh University, North Canton, OH for a workforce 500,000
program and the purchase of equipment and
information technology..............................
Warren County Community College, Washington, NJ to 750,000
develop a new education and training program........
Western Michigan University, Kalamazoo, MI for a 1,500,000
pipeline and workforce program focused on science,
technology, engineering, and mathematics, including
the purchase of information technology..............
Worcester State University, Worchester, MA for dual 1,000,000
enrollment activities...............................
York College, CUNY, Jamaica, NY for health 2,000,000
disparities initiative..............................
York College, CUNY, Jamaica, NY for workforce 525,000
development programs................................
------------------------------------------------------------------------
Augustus F. Hawkins Centers of Excellence
The Committee recommends $20,000,000 for the Hawkins
Centers of Excellence program, which is $20,000,000 more than
the fiscal year 2021 enacted level and the same as the fiscal
year 2022 budget request. This program will provide five year
competitive grants to eligible institutions (HBCUs, HSIs, TCUs,
and other Minority Serving Institutions) 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.
HOWARD UNIVERSITY
Appropriation, fiscal year 2021....................... $251,018,000
Budget request, fiscal year 2022...................... 261,018,000
Committee Recommendation.............................. 411,018,000
Change from enacted level......................... +160,000,000
Change from budget request........................ +150,000,000
Howard University is a leading research university located
in the District of Columbia and provides undergraduate liberal
arts, graduate and professional instruction to students.
Within the amount provided, the Committee recommends
$184,325,000 for the Howard University Hospital, which is
$150,000,000 more than the fiscal year 2021 enacted level and
the fiscal year 2022 budget request. 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 includes $150,000,000 to
modernize the hospital's facilities.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $35,000,000 for Howard University to prevent, prepare
for, and respond to coronavirus, including support for
students.
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM
Appropriation, fiscal year 2021....................... $435,000
Budget request, fiscal year 2022...................... 435,000
Committee Recommendation.............................. 435,000
Change from enacted level......................... - - -
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 2021....................... $48,484,000
Budget request, fiscal year 2022...................... 20,484,000
Committee Recommendation.............................. 24,484,000
Change from enacted level......................... -24,000,000
Change from budget request........................ +4,000,000
The Committee recommends $24,484,000 for the HBCU Capital
Financing program, which is $24,000,000 less than the fiscal
year 2021 enacted level and $4,000,000 more than the fiscal
year 2022 budget request. 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 $334,000 for the administrative
expenses to carry out the program and $24,150,000 for loan
subsidy costs, which will be sufficient to guarantee up to
$328,571,000 in new loans in fiscal year 2022, an increase of
$50,305,000 in new loan volume over the fiscal year 2021 budget
request. The FAFSA Simplification Act provided debt discharges
for approximately 45 HBCUs under the HBCU Capital Financing
program. In addition, the Consolidated Appropriations Act, 2021
provided two-year authority for deferments. As such, the
recommendation does not include deferments for fiscal year
2022.
INSTITUTE OF EDUCATION SCIENCES
Appropriation, fiscal year 2021....................... $642,462,000
Budget request, fiscal year 2022...................... 737,465,000
Committee Recommendation.............................. 762,465,000
Change from enacted level......................... +120,003,000
Change from budget request........................ +25,000,000
The Committee recommends $762,465,000 for the Institute of
Education Sciences (IES), $120,003,000 more than the fiscal
year 2021 enacted level and $25,000,000 more than the fiscal
year 2022 budget request.
In addition, the American Rescue Plan (P.L. 117-2) included
$100,000,000 for Institute of Education Sciences to carry out
research related to addressing learning loss caused by COVID-
19.
Research, Development, and Dissemination
The Committee recommends $260,880,000 for Research,
Development, and Dissemination, which is $63,003,000 more that
the fiscal year 2021 enacted level and $7,000,000 less than the
fiscal year 2022 budget request. 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.
Statistics
The Committee recommends $114,500,000 for the activities of
the National Center for Education Statistics (NCES), which is
$3,000,000 more than the fiscal year 2021 enacted level and the
fiscal year 2022 budget request. 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.
The Committee recommends that NCES collect and publish data
for Puerto Rico in the same manner it collects and publishes
data for States.
Regional Educational Laboratories
The Committee recommends $59,022,000 for Regional
Educational Laboratories (RELs), which is $2,000,000 more than
the fiscal year 2021 enacted level and the fiscal year 2022
budget request. 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 ESSA
and providing a high-quality education for more children.
Research in Special Education
The Committee recommends $59,500,000 for Research in
Special Education, which is $1,000,000 more than the fiscal
year 2021 enacted level and the fiscal year 2022 budget
request. This program supports competitive awards to produce
and advance the use of knowledge to improve services and
results for children with disabilities. The program focuses on
producing new knowledge, integrating research and practice, and
improving the use of knowledge.
Special Education Studies and Evaluations
The Committee recommends $21,318,000 for Special Education
Studies and Evaluations, which is $10,000,000 more than the
fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. This program awards competitive grants,
contracts and cooperative agreements to assess the
implementation of the IDEA and the effectiveness of State and
local efforts to provide special education and early
intervention programs and services to infants, toddlers, and
children with disabilities.
Statewide Data Systems
The Committee recommends $34,500,000 for Statewide Data
Systems, which is $1,000,000 more than the fiscal year 2021
enacted level and the fiscal year 2022 budget request.
Competitive grants under this authority are made to SEAs to
help them manage, analyze, disaggregate and use student data
consistent with the ESEA.
Assessment
The Committee recommends $212,745,000 for Assessment, which
is $40,000,000 more than the fiscal year 2021 enacted level and
$25,000,000 more than the fiscal year 2022 budget request. This
amount includes $7,745,000 for the National Assessment
Governing Board (NAGB), which is the same as both the fiscal
year 2021 enacted level and the fiscal year 2022 budget
request.
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,
civics, 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.
The Committee includes $25,000,000 to conduct the Civics
assessment in 2024 and to ensure this assessment has a
sufficient sample size to provide State-level data for each
State to better understand student performance in civics. The
provision of state level data from the NAEPs gives state and
local education policymakers the insights into student
achievement required to understand and respond to the need for
civic education in the communities they serve.
DEPARTMENTAL MANAGEMENT
Appropriation, fiscal year 2021....................... $624,000,000
Budget request, fiscal year 2022...................... 694,115,000
Committee Recommendation.............................. 694,115,000
Change from enacted level......................... +70,115,000
Change from budget request........................ - - -
These activities are authorized by the Department of
Education Organization Act (P.L. 96-88) and include costs
associated with the management and operation of the Department
as well as separate costs associated with the Office for Civil
Rights and the Office of Inspector General.
Program Administration
The Committee recommends $480,000,000 for Program
Administration, which is $50,000,000 more than the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. These funds support the staff and other costs of
administering programs and activities at the Department. Items
include personnel compensation, health, retirement, and other
benefits as well as travel, rent, telephones, utilities,
postage fees, data processing, printing, equipment, supplies,
technology training, consultants, and other contractual
services.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $15,000,000 for Program Administration to help
implement and administer grant programs supporting students and
schools responding to COVID-19.
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 2023
Congressional Budget Justification: Expenditures for fiscal
year 2021 and expected expenditures for fiscal years 2022 and
2023, 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 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 2019, 2020 and 2021
to serve K-12 students 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 K-12 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 2020
or 2021 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.
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 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 requests that the
Department report on ongoing efforts on these issues in the
fiscal year 2023 Congressional Budget Justification.
Reopening Schools.--In fiscal years 2020 and 2021 in
response to the COVID-19 pandemic, the Congress provided
significant Federal resources for schools to sustain operations
and continue providing quality education to students. Much of
this funding remains available to ensure schools can reopen
safely and responsibly in the fall. The Committee supports
efforts by the Department to ensure access to funds provided in
prior fiscal years for use in reopening schools safely for all
students in the fall.
Defense Education and Workforce Pipeline Strategy.--The
Committee recognizes that there are significant labor shortages
in manufacturing, engineering, and information technology
sectors and there is a need for the Federal government to
support the coordination of a pipeline of education and
workforce development programs in early childhood, K-12, and
higher education to prepare a sufficient national workforce. In
addition, the Committee recognizes the need for greater
coordination of existing federal CTE and STEAM programs and
funding to support the pipeline for such high-demand careers.
Moreover, the Committee recognizes the interdepartmental and
intergovernmental challenges the Department of Education,
Department of Labor, and State, local, and tribal governments
face keeping track of the status of relevant program
reauthorizations, annual funding levels, grant eligibility and
application processes, commonly-used terms in a field with
multiple definitions across programs or funding, and data
sharing practices. Therefore, the Committee encourages the
Department of Education, in coordination with the Department of
Labor, to provide technical assistance to State, local, and
Tribal governments to support curriculum development,
instruction materials, facilities, and assessments for a
pipeline of CTE, STEAM, and the intersection of CTE and STEAM
programs in early childhood, K-12, and higher education to
prepare a national workforce for high-demand careers in
manufacturing, engineering, and information technology.
Additionally, the Committee recognizes that there is an
acute need to improve the coordination of Federal efforts
around the preparation of our national security and defense
workforce. Therefore, the Committee strongly urges the
Department of Education, including the Office of the
Undersecretary, Office of Elementary and Secondary Education,
and Office of Career Technical and Adult Education, and the
Department of Labor, including the Employment and Training
Administration and Veterans Employment and Training Service, to
participate and coordinate as essential federal stakeholders
with the Department of Defense as it leads efforts to establish
a Defense Education and Workforce Pipeline Strategy.
Foreign Language and Cultural Competency.--The Committee is
concerned that federal foreign language and cultural competency
programs and funding do not adequately invest in civilian early
childhood, K-12, and higher education programs. The Committee
strongly encourages interdepartmental coordination between the
Department of Education and the Department of Defense on the
creation or modification of these programs, including efforts
to establish a Defense Foreign Language and Cultural Competency
Education and Workforce Pipeline Strategy.
National Center for Education Statistics Staffing.--The
Committee is deeply concerned about the ongoing staffing crisis
at NCES. The shortage of statisticians threatens the
administration and dissemination of data collections and
surveys that provide an assessment of and insight in the
nation's systems of education. Furthermore, these collections
and surveys guide policy and funding decisions made by
Congress. The Committee directs the Department to include an
update in its fiscal year 2023 Congressional Budget
Justification outlining how the Department will increase
staffing at NCES as well as an analysis of funding for IES
staff in an appropriations account outside of the Program
Administration account. Further, the Committee directs the
Department to provide quarterly updates on its efforts to carry
out the staffing plan.
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.
Open Data Formats.--The Department is encouraged to take
necessary planning steps to facilitate the publication of any
information that is publicly disclosed by the Department for
the purpose of comparing IHEs, programs, and credentials
(including their competencies) using open data standards, such
as formats, schemas, and description languages. Such steps
should enable public search and comparison through linked
public data assets. The Department is further encouraged to
submit a report to the Committees, within 120 days of enactment
of this Act, outlining a plan for providing such data,
including any challenges, barriers to implementation, as well
as anticipated costs for IHEs and the Department.
Evidence-based Grants and Policy.--The Committee requests
an update in the fiscal year 2023 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 (IHE) that receive any Federal funds and
grants administrated by the Department of Education. The
Committee encourages IHEs 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 2023 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 2023
Congressional Budget Justification.
Supporting Students with Disabilities.--The Committee
expresses concerns over the accommodations for education media
provided to students with disabilities. The Committee directs
the Department to include information detailing accommodations
for educational media that are available to students with
disabilities at Institutions of Higher Education (IHE) in its
fiscal year 2023 Congressional Budget Justification.
Pandemic Related Resources in Higher Education.--The
Committee is concerned with student challenges accessing mental
health services and academic or career counseling services
before and during the COVID-19 pandemic and the effect of this
problem on student retention and performance in higher
education programs. The Committee directs ED and SAMHSA to
provide technical assistance to state governments and higher
education institutions on the use of existing federal funds and
model programs to retain high-risk students or reach students
who dropped out during the COVID-19 pandemic.
Impediments to First Generation Students Graduating.--First
generation students comprise nearly a third of all college
students, yet 33 percent of first generation students drop out
of college by the three year mark. Given the Department's
vested interest in ensuring successful outcomes for first
generation students, the Committee directs the Department to
include an update in its fiscal year 2023 Congressional Budget
Justification on barriers to first generation college students
success and contributing factors that lead to first generation
students not graduating from college or university.
Women's Colleges & Universities.--The Committee recognizes
the long time role the nation's women's colleges and
universities play in advancing postsecondary diversity and
inclusion for underserved populations while creating unique
educational opportunities to empower women. Further, the
Committee is concerned with their financial stability and
institutional well-being, especially post-COVID-19. The
Committee directs the Department to include, in its fiscal year
2023 Congressional Budget Justification, information on the
challenges women's colleges and universities face and recommend
how federal resources may be best allocated to ensure their
resilience.
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.
OFFICE FOR CIVIL RIGHTS
Appropriation, fiscal year 2021....................... $131,000,000
Budget request, fiscal year 2022...................... 144,000,000
Committee Recommendation.............................. 144,000,000
Change from enacted level......................... +13,000,000
Change from budget request........................ - - -
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 $144,000,000, which
is $13,000,000 more than the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request.
Closing of Civil Rights Cases.--The Committee is concerned
by the number of civil rights cases, including racial
discrimination and sexual harassment, that are closed without
any findings of wrongdoing or corrective action, often due to
insufficient evidence. The Committee directs the Department to
include in its fiscal year 2023 Congressional Budget
Justification the following information, broken down by
jurisdiction: (1) the number of civil rights complaints
evaluated; (2) the number of civil rights complaints
investigated; (3) the number of civil rights complaints
monitored; (4) the number of civil rights complaints that
resulted in enforcement action; and, (5) the number civil
rights complaints not evaluated and the reason for not
evaluating.
Disaggregated Data Collection and Reporting on Bullying.--
The Committee is concerned about rates of bullying of Asian
American and Pacific Islander (AAPI) students during the COVID-
19 pandemic. There have been numerous reports of students being
bullied, shunned, verbally abused, and in some cases,
physically assaulted due to them being scapegoated for the
spread of COVID-19. The Committee recognizes data collections
by the Department, OCR and the NCES on student bullying
insufficiently reflect diversity of AAPI sub-ethnic groups.
However, AAPIs are diverse, and the U.S. Census Bureau reports
data on at least 25 distinct AAPI ethnic groups. The Committee
directs the Department to collect and report data on student
bullying disaggregated by all racial and ethnic groups and sub-
groups identified in the American Community Survey. The
Committee further directs the Department to provide a briefing
within 90 days of enactment of this Act if such data are unable
to be collected.
Title IX Resources and Remote Learning.--The Committee is
concerned with the accessibility of Title IX coordinators,
offices and resources during the period of remote learning
brought on by the pandemic. Recognizing that harassment still
occurs in virtual and remote learning environments, the
Committee urges the Department to analyze and report on the
rate of Title IX complaints filed, the number of investigations
opened, the number of resolutions reached, and the number of
student complainants who received services, accommodations, or
other supports during the 2020-2021 academic year from their
school or Title IX coordinator.
Racial and Economic Segregation in Schools.--The Committee
directs the Department to submit, not later than 180 days after
the date of the enactment of this Act, a report to the
Committee that examines levels of racial and economic
segregation within the United States education system, using
data collected by the Department of Education. The report
should include a description of the methodology and results of
the analysis as well as a summary of the data. The Department
of Education shall continue to update the Committee regarding
its timeline and process for analyzing data, disaggregated by
race and ethnicity for all the main categories of indicators
tracked, and for releasing the report publicly.
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, urges the Office for Civil Rights 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.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2021....................... $63,000,000
Budget request, fiscal year 2022...................... 70,115,000
Committee Recommendation.............................. 70,115,000
Change from enacted level......................... +7,115,000
Change from budget request........................ - - -
The Office of Inspector General (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
related to the availability of funds.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $5,000,000 for audit and oversight activities
supported with funds appropriated to the Department in response
to COVID-19.
The Committee continues to urge the OIG to ensure its focus
remains on the primary missions of the Office. The Committee
cautions the Office, when receiving requests from the
Department for investigations, to consider the most effective
and best use of its resources.
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, 2022 through September 30, 2023.
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 2021 mandatory funding to offset the mandatory
costs of increasing the discretionary Pell award and expanding
Pell Grant 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 regarding the
Department of Education Organization Act.
Sec. 312. The Committee includes a new provision related to
the 85-15 rule.
Sec. 313. The Committee includes a new provision related to
the use of electric shock devices and equipment.
Sec. 314. 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. 315. The Committee includes a new provision related to
the Fund for the Improvement of Education.
Sec. 316. The Committee includes a new provision regarding
research on marihuana.
Sec. 317. The Committee includes a new provision regarding
Pell Grant eligibility.
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 2021....................... $10,500,000
Budget request, fiscal year 2022...................... 12,000,000
Committee Recommendation.............................. 12,000,000
Change from enacted level......................... +1,500,000
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 continues
to request the reports listed under this heading in House
Report 115-244.
Office of Inspector General.--The Committee recommends not
less than $3,000,000 for the Office of Inspector General.
Corporation for National and Community Service
OPERATING EXPENSES
Appropriation, fiscal year 2021....................... $843,115,000
Budget request, fiscal year 2022...................... 921,120,000
Committee Recommendation.............................. 1,021,120,000
Change from enacted level......................... +178,005,000
Change from budget request........................ +100,000,000
The Committee recommends $1,021,120,000 for operating
expenses for the Corporation for National and Community Service
(CNCS), an increase of $178,005,000 over the fiscal year 2021
enacted level and $100,000,000 above the fiscal year 2022
budget request.
The increase supports the increased living allowance for
AmeriCorps State and National and VISTA members that began in
fiscal year 2021 and the increased hourly stipend for
AmeriCorps Seniors volunteers and daily food allowance for
AmeriCorps NCCC members, to begin this fiscal year.
In addition, the American Rescue Plan (P.L. 117-2) included
$770,000,000 in funding to both stabilize and expand the
national service programs that have been responding to
communities hard hit by COVID-19 and to increase the living
allowances of participants and volunteers.
Volunteers in Service to America
The Committee recommends $103,864,000 for Volunteers in
Service to America (VISTA), an increase of $6,500,000 over the
fiscal year 2021 enacted level. 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 $244,537,000 for the National
Senior Volunteer Corps programs, an increase of $19,520,000
over the fiscal year 2021 enacted level. 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 2022 Committee
------------------------------------------------------------------------
Foster Grandparents Program.......................... $130,914,000
Senior Companion Program............................. 58,518,000
Retired Senior Volunteer Program..................... 55,105,000
------------------------------------------------------------------------
AmeriCorps State and National Grants
The Committee recommends $601,096,000 for AmeriCorps State
and National Grants, an increase of $146,000,000 over the
fiscal year 2021 enacted level and $100,000,000 above the
fiscal year 2022 budget request. This program provides funds to
local and national organizations and agencies to address
community needs in education, public safety, health, and the
environment.
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 Deferred Action for
Childhood Arrivals (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.
Service Learning.--The Committee encourages CNCS to
continue to be a convener of the important work surrounding
service learning. The Committee requests a report not later
than 120 days after enactment of this Act detailing the steps
necessary to restart service learning programs such as Summer
of Service and Semester of Service on a broader scale.
AmeriCorps Digital Equity Activities.--The Committee
recognizes that digital equity needs persist in underserved or
marginalized communities, and recognizes the role that national
service organization volunteers through AmeriCorps could play
in helping to meet the IT needs of these communities across the
country. The Committee encourages CNCS to support volunteer
activities that address these digital equity concerns while
supporting IT skills development among participating
volunteers.
Innovation, Assistance, and Other Activities
The Committee recommends $10,100,000 for Innovation,
Assistance, and Other Activities, an increase of $500,000 over
the fiscal year 2021 enacted level and the same as the fiscal
year 2022 budget request.
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.
Evaluation
The Committee recommends $4,250,000 for evaluation, an
increase of $250,000 over the fiscal year 2021 enacted level
and the same as the fiscal year 2022 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 $4,235,000 over the fiscal year
2021 enacted level and the same as the fiscal year 2022 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 $1,000,000 over the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. Funds are used for formula grants to support State
oversight of service programs.
Payment to the National Service Trust
Appropriation, fiscal year 2021....................... $185,000,000
Budget request, fiscal year 2022...................... 191,000,000
Committee Recommendation.............................. 196,000,000
Change from enacted level......................... +11,000,000
Change from budget request........................ +5,000,000
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.
In addition, the American Rescue Plan (P.L. 117-2) included
$148,000,000 in funding for administration of the National
Service Trust and for payment to the Trust for the provision of
educational awards.
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $86,487,000
Budget request, fiscal year 2022...................... 91,186,000
Committee Recommendation.............................. 91,186,000
Change from enacted level......................... +4,699,000
Change from budget request........................ - - -
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.
In addition, the American Rescue Plan (P.L. 117-2) included
$73,000,000 in funding for administrative expenses to carry out
programs and activities funded by the American Rescue Plan.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2021....................... $6,500,000
Budget request, fiscal year 2022...................... 6,960,000
Committee Recommendation.............................. 6,960,000
Change from enacted level......................... +460,000
Change from budget request........................ - - -
The Committee recommends $6,960,000 for the Office of the
Inspector General (OIG), an increase of $460,000 over the
fiscal year 2021 enacted level and the same the fiscal year
2022 budget request.
The Committee supports the oversight efforts of the OIG
during the major, ongoing overhaul of operations at CNCS. In
addition, the American Rescue Plan (P.L. 117-2) included
$9,000,000 in funding to support necessary oversight and audit
of programs and activities funded by the American Rescue Plan.
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 includes a new provision related to
allowing VISTA members age 55 and older to transfer education
awards to eligible individuals in the same manner those age 55
and older may do following service in AmeriCorps' State and
National program.
Sec. 408. The Committee includes a new provision related to
allowing individuals with DACA status who successfully serve a
term in AmeriCorps State and National, NCCC, or VISTA, to be
eligible for a Segal AmeriCorps Education Award.
Corporation for Public Broadcasting
Appropriation, fiscal year 2023....................... $475,000,000
Budget request, fiscal year 2024...................... 475,000,000
Committee Recommendation.............................. 565,000,000
Change from enacted level......................... +90,000,000
Change from budget request........................ +90,000,000
The Committee recommends $565,000,000 as an advance
appropriation for fiscal year 2024, an increase of $90,000,000
over the fiscal year 2023 advance and the fiscal year 2022
budget request. In addition, the Committee recommendation
includes $20,000,000 in fiscal year 2022 for continued support
of CPB in replacing and upgrading the public broadcasting
interconnection system and further investing in system-wide
infrastructure and services.
In addition, the American Rescue Plan Act (P.L. 117-2)
included $175,000,000 for stabilization grants to maintain
programming 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.
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 2023/2025 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 2023/2025 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 the Corporation for
Public Broadcasting (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 the Corporation for Public Broadcasting
also supports the work of ITVS, the Committee urges the
Corporation for Public Broadcasting 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 2021....................... $48,600,000
Budget request, fiscal year 2022...................... 50,000,000
Committee Recommendation.............................. 50,000,000
Change from enacted level......................... +1,400,000
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 2021....................... $17,184,000
Budget request, fiscal year 2022...................... 17,539,000
Committee Recommendation.............................. 17,539,000
Change from enacted level......................... +355,000
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 2021....................... $257,000,000
Budget request, fiscal year 2022...................... 265,000,000
Committee Recommendation.............................. 282,000,000
Change from enacted level......................... +25,000,000
Change from budget request........................ +17,000,000
Within the total for the Institute of Museum and Library
Services (IMLS), the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2022
Budget Activity Committee
------------------------------------------------------------------------
Library Services Technology Act:
Grants to States................................. $176,803,000
Native American Library Services................. 6,263,000
National Leadership: Libraries................... 13,406,000
Laura Bush 21st Century Librarian................ 10,000,000
Museum Services Act:
Museums for America.............................. 33,899,000
Native American/Hawaiian Museum Service.......... 3,272,000
National Leadership: Museums..................... 8,113,000
African American History and Culture Act:
Museum Grants for African American History and 5,231,000
Culture.........................................
National Museum of the American Latino Act:
Museum Grants for American Latino History and 4,000,000
Culture.........................................
Museum and Library Services Act General Provisions:
Research, Analysis and Data Collection........... 4,513,000
Program Administration............................... 16,500,000
------------------------------------------------------------------------
In addition, the American Rescue Plan Act (P.L. 117-2)
included $200,000,000 to carry out museum and library services
in response to COVID-19.
Library Services and Technology
The Grants to State Library Agencies program provides funds
to State Library Administrative Agencies using a population-
based formula.
Program Administration
The Committee recommends $16,500,000 for Program
Administration, which is $1,000,000 more than the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget
request. These funds provide administrative and management
support for all programs administered by IMLS. The Committee
also includes $4,513,000 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 every month due to the advanced age of the
survivors. The Committee continues to commend the work museums,
libraries and archives are doing to preserve the 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.
Medicare Payment Advisory Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $12,905,000
Budget request, fiscal year 2022...................... 13,310,000
Committee Recommendation.............................. 13,310,000
Change from enacted level......................... +405,000
Change from budget request........................ - - -
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.
Medicaid and Chip Payment and Access Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $8,780,000
Budget request, fiscal year 2022...................... 9,350,000
Committee Recommendation.............................. 9,350,000
Change from enacted level......................... +570,000
Change from budget request........................ - - -
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 2021....................... $3,350,000
Budget request, fiscal year 2022...................... 3,750,000
Committee Recommendation.............................. 3,750,000
Change from enacted level......................... +400,000
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 2021....................... $274,224,000
Budget request, fiscal year 2022...................... 301,925,000
Committee Recommendation.............................. 316,925,000
Change from enacted level......................... +42,701,000
Change from budget request........................ +15,000,000
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 $316,925,000 for the NLRB, which is
$42,701,000 above the fiscal year 2021 enacted level and
$15,000,000 above the fiscal year 2022 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.
U and T Visa Certification.--The Committee believes that
ensuring all workers, regardless of immigration status, can
participate in NLRB investigations and exercise their workplace
rights is critical to the full and effective enforcement of
Federal labor laws. The Committee urges the NLRB, which
considers U and T visa certifications on behalf of victims of
crime and victims of trafficking in the workplace, to ensure
the efficient and timely processing and certification of all
certification requests. In addition, the Committee urges the
NLRB to expand outreach and education concerning U and T visas,
as well as to assess and improve upon accessibility for
workers, particularly those in remote areas and who require
multilingual support.
Accessibility.--The Committee notes the importance of
making sure all workers can access the NLRB'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 NLRB to
undertake efforts to improve accessibility of NLRB offices,
translate NLRB documentation and signage into languages spoken
by 5 percent or more of the population in a given NLRB region,
and translate the NLRB's online webpages, complaint forms, and
resources to match regional needs identified. In addition, the
Committee encourages NLRB 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 be otherwise 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
NLRB to increase its capacity to conduct outreach and
collaborate with community-based organizations.
National Mediation Board
SALARIES AND EXPENSES
Appropriation, fiscal year 2021....................... $14,300,000
Budget request, fiscal year 2022...................... 14,542,000
Committee Recommendation.............................. 15,542,000
Change from enacted level......................... +1,242,000
Change from budget request........................ +1,000,000
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 $15,542,000 for the NMB, which is
$1,242,000 above the fiscal year 2021 enacted level and
$1,000,000 above the fiscal year 2022 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 2021....................... $13,225,000
Budget request, fiscal year 2022...................... 15,028,000
Committee Recommendation.............................. 15,028,000
Change from enacted level......................... +1,803,000
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 2021....................... $13,000,000
Budget request, fiscal year 2022...................... 11,000,000
Committee Recommendation.............................. 11,000,000
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 2021....................... $150,000
Budget request, fiscal year 2022...................... 150,000
Committee Recommendation.............................. 150,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
LIMITATION ON ADMINISTRATION
Appropriation, fiscal year 2021....................... $123,500,000
Budget request, fiscal year 2022...................... 125,049,000
Committee Recommendation.............................. 130,049,000
Change from enacted level......................... +6,549,000
Change from budget request........................ +5,000,000
The Committee recommends $130,049,000 for Limitation on
Administration, an increase of $6,549,000 above the fiscal year
2021 enacted level and $5,000,000 above the fiscal year 2022
budget request. The recommendation does not include a set-aside
for RRB's fully funded information technology systems
modernization efforts, increasing funding for administrative
expenses by $15,549,000 over the fiscal year 2021 enacted
level. The increased funding is intended to support the
critical staffing needs at RRB.
In addition, the American Rescue Plan (P.L. 117-2) included
$27,975,000 in funding, of which $6,800,000 increased staffing
levels in the Bureau of Field Service and the Sickness and
Unemployment Benefits Sections of the Office of Programs in
order to manage increased workloads resulting from the pandemic
and $21,175,000 fully funded RRB's information technology
systems modernization efforts.
LIMITATION ON THE OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2021....................... $11,500,000
Budget request, fiscal year 2022...................... 12,650,000
Committee Recommendation.............................. 12,650,000
Change from enacted level......................... +1,150,000
Change from budget request........................ - - -
Social Security Administration
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
Appropriation, fiscal year 2021....................... $11,000,000
Budget request, fiscal year 2022...................... 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 2021....................... $40,158,768,000
Budget request, fiscal year 2022...................... 46,210,256,000
Committee Recommendation.............................. 46,167,573,000
Change from enacted level......................... +6,008,805,000
Change from budget request........................ -42,683,000
The Committee recommends $15,600,000,000 in advance funding
for the first quarter of fiscal year 2023, 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
2021 enacted level and the fiscal year 2022 budget request.
Administration
Within the appropriation for SSI, the Committee recommends
$4,785,431,000, which is $309,097,000 above the fiscal year
2021 enacted level and $42,683,000 below the fiscal year 2022
budget request. 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 2021....................... $11,219,945,000
Budget request, fiscal year 2022...................... 12,341,896,000
Committee Recommendation.............................. 12,219,945,000
Change from enacted level......................... +1,000,000,000
Change from budget request........................ -121,951,000
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 provides an increase of not less than
$650,000,000 to support frontline operations in field offices,
teleservice centers, and program service centers. In addition,
the recommendation includes the increase requested in the
budget to replace losses and build capacity at the State
Disability Determination Services (DDS) agencies that make
disability determinations for SSA.
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 considers
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.
Administrative Law Judge Selection.--The Committee
continues to be deeply concerned about the impact of
Presidential Executive Order 13843 (July 10, 2018) on the
judicial independence of administrative law judges (ALJs). The
Order eliminates the competitive hiring process for ALJs and
has the potential impact of converting independent adjudicators
to political appointees, undermining longstanding principles of
fair and unbiased consideration of matters of vital importance
to the American people. ALJs must be independent decision-
makers and it is the Committee's expectation that SSA maintain
the highest standards for appointment of ALJs.
Disability Case Processing System (DCPS).--The Committee
requests regular updates on the implementation of DCPS as
additional States enter new phases of production and rollout
schedules. The updates should include cost data and anticipated
timelines for the project. The Committee urges SSA to engage
stakeholders throughout the process to understand any remaining
barriers to implementation.
Disability Claims Backlog.--The Committee recognizes that
the pandemic disrupted progress SSA made with its initial
disability claims backlog, and remains concerned about the
adverse impacts disability claim hearings backlogs have on an
individual's ability to access their Social Security benefits.
Accordingly, the Committee urges the Commissioner to prioritize
the hiring of additional administrative law judges and
requisite staff to adjudicate backlogged claims. In addition,
the Committee directs the Commissioner to continue to
prioritize efforts to reduce wait time disparities across the
country by directing resources and workload assistance, as
necessary, and to provide the Committee annual reports on
efforts to reduce the hearing backlog for Hearing Offices in
the bottom twenty of national ranking by average processing
time.
Disability Determinations.--The Committee is concerned
about the time it takes SSA to effectuate favorable SSI and/or
SSDI disability determinations and directs SSA to submit a
report to the Committee within 180 days of enactment of this
Act, on SSA's procedures for paying past-due and ongoing
benefits after a claimant has been found disabled. The report
should include the average number of calendar days from the
date of the favorable decision to the date of the first monthly
payment, and the average number days from favorable decision
until retroactive benefits are paid (the first installment, for
SSI payable in installments) for SSI, SSDI, and concurrent
claims for each of the past five years plus the current year to
date. The report should also discuss trends in effectuation
time with respect to monthly benefits and past due benefits for
claims awarded upon initial application and at other stages of
appeal, the number of claimants who died between award and
effectuation each year, and any performance goals or
initiatives SSA has regarding effectuating favorable decisions
with respect to monthly benefits and past due benefits.
Evaluation and Statistics Retirement and Disability
Research Consortium (RDRC).--The Committee supports the
interdisciplinary extramural research program being conducted
at the Retirement and Disability Research Consortium, and is
particularly interested in the RDRC conducting more studies on
financial insecurity, the role of social insurance and how
public programs can better address wealth and income inequality
facing vulnerable families. The Committee provides an
additional $4,000,000 to increase funding at all four centers
by $1,000,000 to allow for an increase in the number of
projects across the RDRCs.
Guardianship Report.--The Committee is concerned about the
sharp rise in fraud perpetrated against senior citizens who are
wrongly brought under guardianship or have their assets,
including Social Security payments, mismanaged, or stolen. The
Committee directs SSA to submit a report to the Committee,
within 180 days of enactment of this Act and annually
thereafter, on the number of Social Security payments that are
being diverted to non-family members as representative payees,
and the number of cases of misuse of benefits by non-family
members as representative payees, as identified by SSA directly
or through the representative payee monitoring program
authorized under section 101 of the Strengthening Protections
for Social Security Beneficiaries Act of 2018, broken down by
State.
Information Technology.--The Committee continues to monitor
the Information Technology (IT) Modernization Plan and
encourages SSA to focus on improvements to customer service and
efficiency improvements for customers and employees as it makes
updates to the plan. In addition, SSA should take steps to
automate manual processes to reduce human error and improve
processing time. The Committee requests 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 is
concerned about reports that OHO recently consolidated duties
from several specialized legal assistants, causing affected
employees to perform more duties without increased
compensation. The Committee strongly urges SSA to examine the
position descriptions of legal assistants, pay and actual work
conducted since the consolidation, 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 2022, and to
include descriptions of pilots and associated pilot program
metrics in its fiscal year 2023 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 continues to support direct
payment of fees to representatives, encourages the Commissioner
to raise and index the cap on fees payable via fee agreement,
and requests that the Commissioner add a Performance Measure on
timely and accurate payment of representative fees to the
Fiscal Year 2022 and subsequent Annual Performance Plans.
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 2023
Congressional Budget Justification include a historical table
of costs and fiscal year 2023 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 understands that SSA has modified Public Service
Indicators to reflect challenges due to the COVID-19 pandemic.
The Committee directs SSA to submit to the Committee within 90
days of enactment of this Act a report on Public Service
Indicators for field offices and teleservice centers, providing
the indicators and performance for Fiscal Years 2016 to 2021
and describing how the agency sets and modifies indicators, any
changes made by the agency due the pandemic, and 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, which have
demonstrated benefits for human capital as well as continuity
of operations. The Committee expects SSA to implement telework
policies that support these goals while also strengthening
service to the American public, including in-person service in
community-based field offices. The Committee directs SSA to
submit a report within 90 days of enactment of this Act
detailing the agency's telework policies and identifying any
positions for which telework has not been provided or has been
reduced from pre-October 2019 levels, along with the reasons
for any telework reductions.
Video Hearings.--The Committee understands that during the
COVID-19 pandemic, SSA is providing claimants with the option
of a video hearing, a telephone hearing, or a postponement if
the individual would prefer to wait until an in-person hearing
is available. The Committee expects that once the COVID-19
pandemic ends, SSA will resume in-person hearings. The
Committee continues to encourage SSA to work with claimants who
need additional flexibility by 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. The Committee notes that
Federal Protection and Advocacy (P&A) systems provide legal
representation to people with disabilities in civil matters to
protect and enforce their legal, civil, and human rights. The
Committee understands that SSA recently changed security
clearance requirements for staff that charge time to PABSS
programs. Given the Federal and State laws required for P&A
staff, the Committee urges SSA to reconsider changes that would
require P&A staff to undergo any unnecessary SSA security
clearances, so that they may be treated like any other attorney
representing a person on SSA benefits.
Social Security Advisory Board
The Committee recommends $2,700,000 for the Social Security
Advisory Board (SSAB), $200,000 above the fiscal year 2021
enacted level and equal to the fiscal year 2022 budget request.
User Fees
In addition to the other amounts provided, the Committee
recommends $139,000,000 for administrative activities funded
from user fees. Of this amount, $138,000,000 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 $1,708,000,000 for program
integrity activities. This includes the maximum cap adjustment
authorized in the terms of section 1(k) of H. Res. 467 of the
117th Congress as engrossed in the House of Representatives on
June 14, 2021. The bill includes language allowing for the
transfer of up to $12,100,000 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 2021....................... $105,000,000
Budget request, fiscal year 2022...................... 112,000,000
Committee Recommendation.............................. 112,000,000
Change from enacted level......................... +6,500,000
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 2021.
Sec. 525. The Committee includes a new provision
prohibiting the use of funds for the Social Security
Administration to implement or enforce a rule related to
benefits appeals hearings.
House of Representatives Reporting Requirements
The following materials are submitted in accordance with
various requirements of the Rules of the House of
Representatives:
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, the following is a statement of
general performance goals and objectives for which this measure
authorizes funding: The Committee on Appropriations considers
program performance, including a program's success in
developing and attaining outcome-related goals and objectives,
in developing funding recommendations.
RESCISSION OF FUNDS
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following lists the rescissions
of unexpended balances included in the accompanying bill:
RESCISSIONS RECOMMENDED IN THE BILL
------------------------------------------------------------------------
Account Amount
------------------------------------------------------------------------
Department of Health and Human Services
Nonrecurring Expenses Fund....................... $500,000,000
Department of Education
Pell Grants...................................... 229,000,000
------------------------------------------------------------------------
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.
LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED AGENCIES
[Community Project Funding Items]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Agency Account Project Amount House Requestor
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education............... Elementary & Secondary Achievable Dream, Newport News, VA for $900,000 Luria
Education. extended learning and whole child
supports.
Department of Education............... Elementary & Secondary Albright College, Reading, PA for STEAM 1,450,000 Houlahan
Education. learning.
Department of Education............... Elementary & Secondary Aliento Education Fund, Mesa, AZ for 300,000 Stanton
Education. student support and college access
programs.
Department of Education............... Elementary & Secondary An Achievable Dream Certified Academy at 1,500,000 McEachin
Education. Highland Springs Elementary, Highland
Springs, VA for student wrap-around
services and supports.
Department of Education............... Elementary & Secondary Arab Community Center for Economic & 1,000,000 Dingell
Education. Social Services, Dearborn, MI for
integrated services, literacy
education, and social and emotional
learning.
Department of Education............... Elementary & Secondary Austin People's Action Center, Chicago, 450,000 Davis, Danny K.
Education. IL for technology skills instruction.
Department of Education............... Elementary & Secondary Bayshore Jointure Commission, Tinton 60,000 Smith (NJ)
Education. Falls, NJ for a life skills and
training program.
Department of Education............... Elementary & Secondary Best Buddies International, Friday 75,000 DelBene
Education. Harbor, WA for services for students
with intellectual and developmental
disabilities.
Department of Education............... Elementary & Secondary Best Buddies International, Las Vegas, 125,000 Horsford
Education. NV for inclusion programs supporting
students with intellectual and
developmental disabilities.
Department of Education............... Elementary & Secondary Best Buddies, Spokane, WA for a mentor 55,000 Rodgers (WA)
Education. program.
Department of Education............... Elementary & Secondary Big Brothers, Big Sisters, Santa Fe, NM 225,000 Leger Fernandez
Education. for mentoring services and social
programs.
Department of Education............... Elementary & Secondary Boys & Girls Club of Burbank and Greater 250,000 Schiff
Education. East Valley, Burbank, CA for education
technology.
Department of Education............... Elementary & Secondary Boys & Girls Club of San Fernando 450,000 Tony Cardenas
Education. Valley, Pacoima, CA for STEM and SEL
programs.
Department of Education............... Elementary & Secondary Boys & Girls Clubs of Dundee Township, 250,000 Casten
Education. Carpentersville, IL for an academic and
SEL support program.
Department of Education............... Elementary & Secondary Boys & Girls Clubs of Greater Anaheim- 1,000,000 Lowenthal
Education. Cypress, Cypress, CA for academic
support and youth engagement.
Department of Education............... Elementary & Secondary Boys & Girls Clubs of the Los Angeles 500,000 Nanette Diaz Barragan
Education. Harbor, San Pedro, CA for the
Wilmington College Bound Program.
Department of Education............... Elementary & Secondary Boys & Girls Club of Palm Beach County, 525,000 Frankel, Lois
Education. West Palm Beach, FL for its College and
Work Readiness STEM program.
Department of Education............... Elementary & Secondary Boys & Girls Clubs of Rochester, NY for 100,000 Morelle
Education. a comprehensive afterschool and summer
program.
Department of Education............... Elementary & Secondary Bright Leadership Institute, Chicago, IL 500,000 Davis, Danny K.
Education. for youth mentoring and enrichment
activities.
Department of Education............... Elementary & Secondary Broward County Public Schools, Ft. 500,000 Deutch
Education. Lauderdale, FL for a peer mentoring
program.
Department of Education............... Elementary & Secondary California State University, Long Beach, 500,000 Lowenthal
Education. CA for teacher development and student
academic support.
Department of Education............... Elementary & Secondary CDF Action, Clarkston, GA for the READY 325,000 Johnson (GA)
Education. School initiative.
Department of Education............... Elementary & Secondary Chicago Public Schools, Chicago, IL for 500,000 Kelly (IL)
Education. arts and STEM education.
Department of Education............... Elementary & Secondary Chicago Public Schools, Chicago, IL for 500,000 Quigley
Education. arts and STEM education.
Department of Education............... Elementary & Secondary Chicago Public Schools, Chicago, IL for 500,000 Rush
Education. arts and STEM education.
Department of Education............... Elementary & Secondary Chicago Public Schools, Chicago, IL for 500,000 Schakowsky
Education. arts and STEM education.
Department of Education............... Elementary & Secondary Chicago Public Schools, Chicago, IL for 500,000 Newman
Education. arts and STEM education.
Department of Education............... Elementary & Secondary Chicago Zoological Society, Chicago, IL 825,000 Jesus G. ``Chuy'' Garcia
Education. for the King Conservation Leadership
Academy.
Department of Education............... Elementary & Secondary Children's Museum, Oak Lawn, IL for the 50,000 Newman
Education. Wee Ones program.
Department of Education............... Elementary & Secondary City of Commerce, CA for a homework help 300,000 Roybal-Allard
Education. and online learning initiative.
Department of Education............... Elementary & Secondary City of Long Beach, CA for early 250,000 Nanette Diaz Barragan
Education. childhood education and literacy
programs at the Michelle Obama Library.
Department of Education............... Elementary & Secondary City of Long Beach, NY for early 400,000 Rice (NY)
Education. childhood learning.
Department of Education............... Elementary & Secondary City of Rancho Cordova, CA for the 350,000 Bera
Education. Rancho Cordova Youth Center.
Department of Education............... Elementary & Secondary Clark County School District, Las Vegas, 950,000 Lee (NV)
Education. NV for school social workers.
Department of Education............... Elementary & Secondary Common Threads, Chicago, IL for food 65,000 Rush
Education. nutrition education programs.
Department of Education............... Elementary & Secondary Common Threads, Staten Island, NY for 50,000 Maloney, Carolyn B.
Education. culinary and nutrition education.
Department of Education............... Elementary & Secondary Commonwealth of the Northern Mariana 350,000 Sablan
Education. Islands Public School System, Saipan,
MP for indigenous language immersion.
Department of Education............... Elementary & Secondary Commonwealth of the Northern Mariana 150,000 Sablan
Education. Islands Public School System, Saipan,
MP for school library expansion.
Department of Education............... Elementary & Secondary Commonwealth of the Northern Mariana 150,000 Sablan
Education. Islands Public School System, Saipan,
MP for student health and well-being.
Department of Education............... Elementary & Secondary Communities in Schools of San Antonio, 500,000 Castro (TX)
Education. TX for wraparound services and whole-
child supports.
Department of Education............... Elementary & Secondary Community Bridges, Silver Spring, MD for 80,000 Raskin
Education. academic enrichment and wrap-around
services.
Department of Education............... Elementary & Secondary Contra Costa County Office of Education, 900,000 DeSaulnier
Education. Pleasant Hill, CA for internet
connectivity.
Department of Education............... Elementary & Secondary dA Center for the Arts, Pomona, CA for 125,000 Torres (CA)
Education. early learning and arts education.
Department of Education............... Elementary & Secondary DeKalb County Regional Office of 150,000 Underwood
Education. Education , Dekalb, IL for kindergarten
readiness.
Department of Education............... Elementary & Secondary Desert Research Institute, Las Vegas, NV 975,000 Lee (NV)
Education. for STEM education.
Department of Education............... Elementary & Secondary Dr. Phillips Center for the Performing 250,000 Demings
Education. Arts, Orlando, FL for arts education.
Department of Education............... Elementary & Secondary DuPage Regional Office of Education, 250,000 Casten
Education. Wheaton, IL for high school work-based
learning.
Department of Education............... Elementary & Secondary Early Learning Coalition of Palm Beach 125,000 Frankel, Lois
Education. County, Boynton Beach, FL for an early
learning program.
Department of Education............... Elementary & Secondary East Bay Performing Arts, Oakland, CA 500,000 Lee (CA)
Education. for music education.
Department of Education............... Elementary & Secondary Eastern Michigan University, Ypsilanti, 300,000 Dingell
Education. MI for early childhood educational
services.
Department of Education............... Elementary & Secondary Eastern Queens Alliance, Springfield 350,000 Meeks
Education. Gardens, NY for environmental education.
Department of Education............... Elementary & Secondary Edward M. Kennedy Institute for the 1,000,000 Lynch
Education. United States Senate, Boston, MA for
civics education.
Department of Education............... Elementary & Secondary El Puente de Williamsburg, Brooklyn, NY 500,000 Nydia M. Velazquez
Education. for environmental studies programming.
Department of Education............... Elementary & Secondary ESP Education & Leadership Institute, 50,000 Lowenthal
Education. Long Beach, CA for STEM education and
college access.
Department of Education............... Elementary & Secondary Evanston/Skokie District 65, Evanston, 600,000 Schakowsky
Education. IL for a teacher residency program.
Department of Education............... Elementary & Secondary Finishing Trades Institute of the Upper 2,000,000 McCollum
Education. Midwest, Little Canada, MN for
apprenticeship pathways for middle and
high school students.
Department of Education............... Elementary & Secondary Forsyth County School District, Cumming, 750,000 Bourdeaux
Education. GA for the Spark! Igniting Learning,
Birth and Beyond program.
Department of Education............... Elementary & Secondary Friends of Marcy Houses, Brooklyn, NY 150,000 Nydia M. Velazquez
Education. for tutoring and mentoring.
Department of Education............... Elementary & Secondary Ft. Smith School District, Ft. Smith, AR 400,000 Womack
Education. for a student training program.
Department of Education............... Elementary & Secondary Futures Without Violence, San Francisco, 1,000,000 Pelosi
Education. CA for trauma-informed social and
emotional learning programs.
Department of Education............... Elementary & Secondary Gannon University, Erie, PA for a 500,000 Kelly (PA)
Education. science technology engineering and
mathematics pathway program.
Department of Education............... Elementary & Secondary Genesee Intermediate School District, 1,000,000 Kildee
Education. Flint, MI for a school nursing pilot
program.
Department of Education............... Elementary & Secondary George Mason University, Fairfax, VA for 650,000 Wexton
Education. the Quantum Science Workforce
initiative.
Department of Education............... Elementary & Secondary Georgia Family Connection Partnership, 1,500,000 Bishop (GA)
Education. Atlanta, GA for the Get Georgia Reading
Campaign.
Department of Education............... Elementary & Secondary Groton Public Schools, Groton, CT for a 150,000 Courtney
Education. high school career pathways program.
Department of Education............... Elementary & Secondary Guilford County Schools, Greensboro, NC 2,000,000 Manning
Education. for an intensive tutoring program.
Department of Education............... Elementary & Secondary Gwinnett County Schools Foundation, 775,000 Bourdeaux
Education. Suwanee, GA for an early childhood
education initiative.
Department of Education............... Elementary & Secondary Hamilton Area Young Men's Christian 200,000 Smith (NJ)
Education. Association, Hamilton, NJ for a
supplementary education program.
Department of Education............... Elementary & Secondary Harry S. Truman Middle College, Chicago, 25,000 Schakowsky
Education. IL for career pathways and vocational
education.
Department of Education............... Elementary & Secondary Hazleton Integration Project, Hazleton, 1,150,000 Cartwright
Education. PA for a STEAM-based education program.
Department of Education............... Elementary & Secondary Henry Ford College, Dearborn, MI for 2,000,000 Dingell
Education. technology and manufacturing education.
Department of Education............... Elementary & Secondary Highline Public Schools, Burien, WA for 1,050,000 Smith (WA)
Education. maritime education.
Department of Education............... Elementary & Secondary Holocaust Memorial Center, Farmington 550,000 Lawrence
Education. Hills, MI for Holocaust education and
teacher training.
Department of Education............... Elementary & Secondary Houston Independent School District, 1,000,000 Jackson Lee
Education. Houston, TX for social and emotional
learning supports.
Department of Education............... Elementary & Secondary I Have A Dream Foundation, Newark, NJ 500,000 Payne
Education. for STEAM education.
Department of Education............... Elementary & Secondary Illinois Central College, Peoria, IL for 500,000 Bustos
Education. its Cradle to Career Initiative.
Department of Education............... Elementary & Secondary Jamel Gaines Creative Outlet, Brooklyn, 750,000 Jeffries
Education. NY for arts education.
Department of Education............... Elementary & Secondary Kennedy Krieger Institute, Baltimore, MD 1,250,000 Mfume
Education. for an early childhood education
program.
Department of Education............... Elementary & Secondary Kent Intermediate School District, Grand 900,000 Meijer
Education. Rapids, MI for equipment.
Department of Education............... Elementary & Secondary Leader Valley Foundation, Waterloo, IA 50,000 Hinson
Education. for training, curriculum, course
materials, and expanding program access.
Department of Education............... Elementary & Secondary Leo High School, Chicago, IL for STEM 150,000 Rush
Education. and robotics education.
Department of Education............... Elementary & Secondary Life Camp, Jamaica, NY for a youth 2,000,000 Meeks
Education. engagement program.
Department of Education............... Elementary & Secondary Livermore Valley Joint Unified School 375,000 Swalwell
Education. District. Livermore, CA for a community
and parent engagement program.
Department of Education............... Elementary & Secondary Lone Star Flight Museum, Houston, TX for 615,000 Nehls
Education. student education programs.
Department of Education............... Elementary & Secondary Madera Unified School District, Madera, 625,000 Costa
Education. CA for English learner academic support.
Department of Education............... Elementary & Secondary Mahoning County High School, Youngstown, 850,000 Ryan
Education. OH for a community learning center.
Department of Education............... Elementary & Secondary Mass Audubon, Boston, MA for an 250,000 Keating
Education. environmental education program.
Department of Education............... Elementary & Secondary Middlesex County, New Brunswick, NJ for 300,000 Pallone
Education. agricultural and acquacultural training.
Department of Education............... Elementary & Secondary Milwaukee Public Schools, Milwaukee, WI 600,000 Moore (WI)
Education. for mental health services and driver's
education.
Department of Education............... Elementary & Secondary Mount Holyoke College, South Hadley, MA 250,000 Neal
Education. for teacher professional development in
social and emotional learning and
mental health needs.
Department of Education............... Elementary & Secondary National Atomic Testing Museum, Las 2,000,000 Titus
Education. Vegas, NV for STEM education and
technology.
Department of Education............... Elementary & Secondary New Directions for Youth, Los Angeles, 125,000 Sherman
Education. CA for education technology.
Department of Education............... Elementary & Secondary New Haven Public Schools, New Haven, CT 2,000,000 DeLauro
Education. for a manufacturing education and
pathways program.
Department of Education............... Elementary & Secondary New Mexico Black Leadership Council, 125,000 Melanie Stansbury
Education. Albuquerque, NM for enrichment and
youth development.
Department of Education............... Elementary & Secondary New York Sun Works, New York, NY for 800,000 Nydia M. Velazquez
Education. STEM and sustainability education.
Department of Education............... Elementary & Secondary Niswonger Foundation, Greeneville, TN 345,000 Harshbarger
Education. for a literacy tutoring program.
Department of Education............... Elementary & Secondary Norristown Area School District, 200,000 Dean
Education. Norristown, PA for high school library
technology and education programs.
Department of Education............... Elementary & Secondary North Carolina State University, 350,000 Ross
Education. Raleigh, NC for computer science
professional development.
Department of Education............... Elementary & Secondary NYC Mission Society, New York, NY for 1,100,000 Espaillat
Education. its Level Up program.
Department of Education............... Elementary & Secondary Oceanside Museum of Art, Oceanside, CA 150,000 Levin (CA)
Education. for literacy instruction and arts
education.
Department of Education............... Elementary & Secondary Old Colony YMCA, Brockton, MA for early 800,000 Lynch
Education. education curriculum and teacher
training.
Department of Education............... Elementary & Secondary Old Dominion University, Norfolk, VA for 1,000,000 Scott (VA)
Education. a maritime trades magnet school.
Department of Education............... Elementary & Secondary P.E.A.C.E. Afterschool Program, 100,000 Rice (NY)
Education. Hempstead, NY for afterschool and
summer STEAM programs.
Department of Education............... Elementary & Secondary Pace Center for Girls, Jacksonville, FL 500,000 Frankel, Lois
Education. for educational services, counseling,
and training.
Department of Education............... Elementary & Secondary Pasadena Independent School District, 2,000,000 Garcia (TX)
Education. Pasadena, TX for education technology.
Department of Education............... Elementary & Secondary PAST Foundation, Columbus, OH for its 500,000 Beatty
Education. STEM 2022 program.
Department of Education............... Elementary & Secondary Pioneer Works Art Foundation, Brooklyn, 1,000,000 Nydia M. Velazquez
Education. NY for youth development programs.
Department of Education............... Elementary & Secondary Queens Community House, Queens, NY for 225,000 Ocasio-Cortez
Education. family support counselors.
Department of Education............... Elementary & Secondary Randolph Public Schools, Randolph, MA 275,000 Pressley
Education. for culturally relevant digital
literacy.
Department of Education............... Elementary & Secondary Riverside County Office of Education 1,000,000 Takano
Education. Division of Early Learning Services,
Riverside, CA for early learning and
literacy.
Department of Education............... Elementary & Secondary Rohingya Culture Center, Chicago, IL for 50,000 Schakowsky
Education. a homework help program.
Department of Education............... Elementary & Secondary Saint Peter's University, Jersey City, 1,100,000 Payne
Education. NJ for educator development and
training.
Department of Education............... Elementary & Secondary Salt Creek School District 48, Villa 80,000 Krishnamoorthi
Education. Park, IL, for an afterschool program.
Department of Education............... Elementary & Secondary School District of Osceola, St. Cloud, 450,000 Soto
Education. FL for STEM education.
Department of Education............... Elementary & Secondary Skokie-Morton Grove School District 69, 375,000 Schakowsky
Education. Skokie, IL for community school
supports, technology, and academic
enrichment.
Department of Education............... Elementary & Secondary South Kitsap School District 402, Port 450,000 Kilmer
Education. Orchard, WA for the West Sound STEM
Network.
Department of Education............... Elementary & Secondary Southern Methodist University, Dallas, 900,000 Allred
Education. TX for its learning loss program for
underserved students.
Department of Education............... Elementary & Secondary Southwestern Ohio Council for Higher 1,000,000 Turner
Education. Education, Dayton, OH for an internship
program.
Department of Education............... Elementary & Secondary Spelman College, Atlanta, GA for a 325,000 Williams (GA)
Education. student literacy initiative.
Department of Education............... Elementary & Secondary Sunnyside Community Services, Sunnyside, 100,000 Ocasio-Cortez
Education. NY for a student support and college
access program.
Department of Education............... Elementary & Secondary Sylvester Broome Empowerment Village, 650,000 Kildee
Education. Flint, MI for a youth empowerment and
afterschool program.
Department of Education............... Elementary & Secondary Syrian Community Network, Chicago, IL 100,000 Schakowsky
Education. for hybrid learning support.
Department of Education............... Elementary & Secondary Texas State University, San Marcos, TX 1,000,000 Carter (TX)
Education. for workforce research initiative and
educator professional development
focused on science, technology,
engineering, and mathematics.
Department of Education............... Elementary & Secondary Toledo City School District, Toledo, OH 1,250,000 Kaptur
Education. for a high school auto mechanic
training program.
Department of Education............... Elementary & Secondary Town of Milton, MA for assessment 100,000 Pressley
Education. resources and instructional tools.
Department of Education............... Elementary & Secondary Town of Monroe, CT for STEM education 200,000 Himes
Education. and technology.
Department of Education............... Elementary & Secondary U.S. Space & Rocket Center, Huntsville, 400,000 Aderholt
Education. AL for equipment and outreach.
Department of Education............... Elementary & Secondary United Way of Central Jersey, Milltown, 550,000 Watson Coleman
Education. NJ for the Summer STEAM Stars program.
Department of Education............... Elementary & Secondary United Way of Forsyth County, Winston- 450,000 Manning
Education. Salem, NC for tutoring and enrichment
programs.
Department of Education............... Elementary & Secondary United Way of Greater Lehigh Valley, 575,000 Wild
Education. Allentown, PA for summer enrichment and
technology supports.
Department of Education............... Elementary & Secondary United Way of Northern New Jersey, Cedar 1,100,000 Sherrill
Education. Knolls, NJ for early childhood
education.
Department of Education............... Elementary & Secondary United Way of the Titusville Region, 55,000 Kelly (PA)
Education. Titusville, PA for a literacy program.
Department of Education............... Elementary & Secondary University of Central Florida, Orlando, 500,000 Murphy (FL)
Education. FL for early learning and parent
engagement.
Department of Education............... Elementary & Secondary University of North Carolina at 1,500,000 Manning
Education. Greensboro, NC for the High-Speed
Education Network Access Pilot.
Department of Education............... Elementary & Secondary University of South Florida, Tampa, FL 1,000,000 Castor (FL)
Education. for STEM teacher preparation.
Department of Education............... Elementary & Secondary Urban Transformation Network, Chicago, 275,000 Davis, Danny K.
Education. IL for the Urban Youth Green
Afterschool program.
Department of Education............... Elementary & Secondary Virginia Commonwealth University, 400,000 McEachin
Education. Richmond, VA for a teacher residency
program.
Department of Education............... Elementary & Secondary West Indian American Day Carnival 1,000,000 Clarke (NY)
Education. Association, Brooklyn, NY for Caribbean
culture, arts, and history education
programs.
Department of Education............... Elementary & Secondary Whittier Public Library Foundation, 450,000 Linda T. Sanchez
Education. Whittier, CA for youth services and
early learning.
Department of Education............... Elementary & Secondary Wildlife Conservation Society, Bronx, NY 300,000 Jeffries
Education. for STEM learning and career
exploration.
Department of Education............... Elementary & Secondary Wilmington Area School District, New 55,000 Kelly (PA)
Education. Wilmington, PA for computer and
robotics equipment.
Department of Education............... Elementary & Secondary Wood Dale Public Library District, Wood 225,000 Krishnamoorthi
Education. Dale, IL for early childhood learning.
Department of Education............... Elementary & Secondary YMCA Mid Valley, Van Nuys, CA for 1,000,000 Tony Cardenas
Education. learning recovery activities, including
online and in-person tutoring supports.
Department of Education............... Elementary & Secondary YMCA of Greater Houston, TX for the 700,000 Garcia (TX)
Education. Early Childhood English Language
Learner Initiative.
Department of Education............... Elementary & Secondary YMCA of Greater New York, NY for youth 1,000,000 Jeffries
Education. development programs.
Department of Education............... Elementary & Secondary YMCA of New Rochelle, NY for its 500,000 Bowman
Education. Educational Achievement Gap Project.
Department of Education............... Elementary & Secondary Youth Development, Albuquerque, NM for 850,000 Melanie Stansbury
Education. student and family wraparound services.
Department of Education............... Elementary & Secondary YWCA Metropolitan Chicago, IL, for early 500,000 Krishnamoorthi
Education. childhood learning.
Department of Education............... Higher Education......... Adrian College, Adrian, MI for 300,000 Walberg
establishment of a shared majors
partnership program.
Department of Education............... Higher Education......... African American History and Culture 250,000 Lowenthal
Foundation, Long Beach, CA for college
prepartion activities, including
scholarships.
Department of Education............... Higher Education......... Alamo Colleges District, San Antonio, TX 95,000 Castro (TX)
for lab equipment.
Department of Education............... Higher Education......... Alvernia University, Reading, PA for 2,000,000 Meuser
programming and classroom and
technology upgrades.
Department of Education............... Higher Education......... Arkansas Tech University, Russellville, 675,000 Womack
AR for nursing program simulation labs,
including the purchase of information
technology.
Department of Education............... Higher Education......... Austin Community College District. 700,000 Doggett
Austin, TX for child care supports for
student parents, establishing an online
Child Development Associate program,
and curriculum development.
Department of Education............... Higher Education......... Baylor University, Waco, TX for 1,000,000 Sessions
cybersecurity initiative and the
purchase of information technology.
Department of Education............... Higher Education......... Be A Leader Foundation, Phoenix, AZ for 175,000 Gallego
a college access and success program.
Department of Education............... Higher Education......... Bellarmine University, Louisville, KY 1,000,000 Yarmuth
for simulation technology, equipment,
and instruction, including educational
opportunities for K-12 students.
Department of Education............... Higher Education......... Benjamin Franklin Institute of 300,000 Pressley
Technology (BFIT), Boston, MA for a
certificate program, including
equipment.
Department of Education............... Higher Education......... Berkshire Community College, Pittsfield, 350,000 Neal
MA for technology and equipment.
Department of Education............... Higher Education......... Bristol Community College, Fall River, 2,000,000 Keating; Auchincloss
MA for curriculum development and
equipment.
Department of Education............... Higher Education......... Brookdale Community College, Lincroft, 450,000 Smith (NJ)
NJ for establishment of a center for
excellence in cybersecurity education,
including the purchase of equipment and
information technology.
Department of Education............... Higher Education......... California State University Channel 250,000 Brownley
Islands, Camarillo, CA for curriculum
development.
Department of Education............... Higher Education......... California State University, Sacramento, 575,000 Matsui
Sacremento, CA for lab equipment.
Department of Education............... Higher Education......... California State University, Sacramento, 250,000 Matsui
Sacremento, CA for equipment and
classroom material.
Department of Education............... Higher Education......... Cape Cod Community College, West 1,950,000 Keating
Barnstable, MA for an aviation program,
including equipment.
Department of Education............... Higher Education......... Center for Employment Training, San 325,000 Lofgren
Jose, CA for equipment.
Department of Education............... Higher Education......... Chapman University, Orange, CA for the 1,000,000 Correa
Earth Systems Science and Data
Solutions Lab (EssDs), including
equipment, scholarships, and
fellowships.
Department of Education............... Higher Education......... Christian Brothers University, Memphis, 400,000 Cohen
TN for workforce development and
educational opportunities, including
stipends and equipment.
Department of Education............... Higher Education......... City College of New York, City 1,500,000 Espaillat
University of New York, New York, NY
for workforce development program,
including equipment and stipends.
Department of Education............... Higher Education......... City of Paramount, CA for student 550,000 Roybal-Allard
scholarships and learning center
technology and equipment upgrades.
Department of Education............... Higher Education......... College of Southern Maryland, La Plata, 550,000 Hoyer
MD for equipment.
Department of Education............... Higher Education......... Colorado State University, Fort Collins, 1,000,000 Neguse
CO for a college access and success
initiative.
Department of Education............... Higher Education......... Community College of Rhode Island, 1,060,000 Langevin
Warwick, RI for a constituent relations
management tool.
Department of Education............... Higher Education......... Durham Technical Community College, 1,200,000 Price (NC)
Durham, NC for a workforce development
initiative.
Department of Education............... Higher Education......... East Los Angeles College, Monterey Park, 200,000 Chu
CA to establish a collaborative
partnership promoting college access
and success.
Department of Education............... Higher Education......... East-West University, Chicago, IL for 240,000 Davis, Danny K.
technology upgrades.
Department of Education............... Higher Education......... Eastern Kentucky University, Richmond, 505,000 Barr
KY for a center focused on science,
technology, engineering, and
mathematics, including the purchase of
information technology.
Department of Education............... Higher Education......... El Camino College, Torrance, CA for 350,000 Waters
student supports, including stipends
and scholarships.
Department of Education............... Higher Education......... Elmira College, Elmira, NY for 1,850,000 Reed
information technology upgrades and
equipment.
Department of Education............... Higher Education......... Framingham State University, Framingham, 600,000 Clark (MA)
MA for an early college program,
including partnerships with middle
schools and high schools.
Department of Education............... Higher Education......... Georgia Gwinnett College, Lawrenceville, 1,450,000 Bourdeaux
GA for student support services,
including scholarships and equipment.
Department of Education............... Higher Education......... Glen Oaks Community College, 900,000 Upton
Centreville, MI for information
technology and equipment for distance
learning.
Department of Education............... Higher Education......... Grambling State University, Grambling, 2,000,000 Letlow
LA for a teacher preparation program
and equipment.
Department of Education............... Higher Education......... Grand Valley State University, 1,000,000 Meijer
Allendale, MI for curriculum,
information technology, and equipment
for applied research program.
Department of Education............... Higher Education......... Harris-Stowe State University, St. 1,000,000 Bush
Louis, MO for an entrepreneurship
program and center.
Department of Education............... Higher Education......... Hartwick College, Oneonta, NY for the 300,000 Delgado
Grain Innovation Center, including
equipment.
Department of Education............... Higher Education......... Housatonic Community College, 1,000,000 Himes
Bridegeport, CT for an advanced
manufacturing training program,
including scholarships and equipment.
Department of Education............... Higher Education......... Houston Community College, Houston, TX 2,000,000 Jackson Lee
for program development.
Department of Education............... Higher Education......... Hudson County Community College, Union 975,000 Sires
City, NJ for technology and equipment.
Department of Education............... Higher Education......... Illinois College, Jacksonville, IL for 330,000 LaHood
creation of an online Master of Science
in Nursing program and equipment.
Department of Education............... Higher Education......... Indian Hills Community College, Ottumwa, 2,000,000 Miller-Meeks
IA for college and career transition
counselors initiative.
Department of Education............... Higher Education......... Ivy Tech Community College - Lake County 1,200,000 Mrvan
Campus, East Chicago, IN for an
academic and student support initiative.
Department of Education............... Higher Education......... Ivy Tech Community College, 300,000 Andre Carson
Indianapolis, IN for a mobile unit to
offer training and other services.
Department of Education............... Higher Education......... JobPath, Inc., Tucson, AZ to assist 500,000 Raul M. Grijalva
displaced workers in enrolling in and
completing degree and certificate
programs.
Department of Education............... Higher Education......... Juniata College, Huntingdon, PA for a 995,000 Joyce (PA)
public health educational and research
program.
Department of Education............... Higher Education......... Kankakee Area Career Center, 175,000 Kelly (IL)
Bourbonnais, IL for a counselor,
technology, and equipment.
Department of Education............... Higher Education......... KVCR (Inland Future's Foundation), San 1,000,000 Aguilar
Bernardino, CA for public broadcasting
opportunities for college students,
including curriculum development.
Department of Education............... Higher Education......... Lackawanna College, Scranton, PA for 2,000,000 Cartwright
technical and vocational education
program development, including
equipment.
Department of Education............... Higher Education......... Lane Community College, Eugene, OR for 500,000 DeFazio
equipment.
Department of Education............... Higher Education......... Lehman College, City University of New 250,000 Espaillat
York, New York, NY for an economic
recovery and revitalization program for
students, including financial
assistance.
Department of Education............... Higher Education......... Lincoln University, Lincoln University, 175,000 Houlahan
PA for curriculum development,
including scholarships.
Department of Education............... Higher Education......... Los Angeles City College, Los Angeles, 975,000 Schiff
CA for basic needs project.
Department of Education............... Higher Education......... Los Angeles Community College District, 400,000 Tony Cardenas
Los Angeles, CA for workforce
development programs, including
equipment.
Department of Education............... Higher Education......... Los Angeles Southwest College, Los 1,500,000 Waters
Angeles, CA for student support
services.
Department of Education............... Higher Education......... Louisiana State University at 120,000 Letlow
Alexandria, Alexandria, LA to develop a
program for young people with
developmental disabilities and the
purchase of information technology.
Department of Education............... Higher Education......... Louisiana Tech University, Ruston, LA 2,000,000 Letlow
for a cyber education and training
program.
Department of Education............... Higher Education......... Marquette University, Milwaukee, WI for 750,000 Moore (WI)
a college access and success initiative.
Department of Education............... Higher Education......... Massachusetts Maritime Academy, Buzzards 1,000,000 Keating
Bay, MA for equipment and program
development.
Department of Education............... Higher Education......... McHenry County College, Crystal Lake, IL 825,000 Underwood
for dual enrollment activities.
Department of Education............... Higher Education......... Mid-America Christian University, 850,000 Cole
Oklahoma City, OK for a mental health
counselor training and credentialing
program and the purchase of equipment.
Department of Education............... Higher Education......... Minnesota State Northern Agricultural 2,000,000 Stauber
Center of Excellence, Staples, MN for
meat cutting and butchery program,
including the purchase of equipment.
Department of Education............... Higher Education......... Mitchell College, New London, CT for 550,000 Courtney
curriculum development, including
equipment.
Department of Education............... Higher Education......... Moorpark College, Ventura County 225,000 Brownley
Community College District, Moorpark,
CA for workbased learning
opportunities, including student
stipends.
Department of Education............... Higher Education......... Morehouse College, Atlanta, GA for 900,000 Williams (GA)
student support services, including
scholarships, curriculum development,
and summer bridge programs.
Department of Education............... Higher Education......... Mt. San Antonio College, Walnut, CA for 500,000 Kim (CA)
vocational health training programs.
Department of Education............... Higher Education......... New York University, New York, NY for a 300,000 Nadler
prison education program, including
stipends and scholarships.
Department of Education............... Higher Education......... Nova Southeastern University, Ft. 1,950,000 Wasserman Schultz
Lauderdale, FL for technology and
equipment.
Department of Education............... Higher Education......... Oklahoma State University, Oklahoma 850,000 Bice (OK)
City, OK for a workforce development
program.
Department of Education............... Higher Education......... Pima County Community College, Tucson, 1,000,000 Raul M. Grijalva;
AZ for lab equipment. Kirkpatrick
Department of Education............... Higher Education......... Portland Community College, Portland, OR 800,000 Blumenauer
for curriculum development, including
equipment and technology.
Department of Education............... Higher Education......... Quinsigamond Community College, 975,000 McGovern
Worcester, MA for technology.
Department of Education............... Higher Education......... Red Rocks Community College, Lakewood, 300,000 Perlmutter
CO for a credential attainment
initiative related to STEM fields.
Department of Education............... Higher Education......... Rhode Island College, Providence, RI for 500,000 Langevin
developing certificate programs.
Department of Education............... Higher Education......... Riverside Community College District, 1,500,000 Takano
Riverside, CA for the Inland Empire
Technical Trade Center.
Department of Education............... Higher Education......... Rowan University, Glassboro, NJ for the 500,000 Norcross
Wind Energy Workforce Training Program,
including equipment and technology.
Department of Education............... Higher Education......... Salt Lake Community College, Salt Lake 500,000 Owens
City, UT for a campus internship
program.
Department of Education............... Higher Education......... San Carlos Apache College, San Carlos, 875,000 O'Halleran
AZ for library and computer center
modernization project.
Department of Education............... Higher Education......... San Diego Community College District, 975,000 Peters
San Diego, CA for IT system upgrades
and modernization project.
Department of Education............... Higher Education......... San Jacinto College, Houston, TX for 585,000 Nehls
aerospace training programs and the
purchase of equipment.
Department of Education............... Higher Education......... Santa Clarita Community College District 1,000,000 Garcia (CA)
(College of the Canyons), Santa
Clarita, CA for equipment for the
advanced technology center.
Department of Education............... Higher Education......... Seminole State College, Sanford, FL for 475,000 Murphy (FL)
simulation laboratory equipment.
Department of Education............... Higher Education......... Southern California College Access 650,000 Gomez
Network, Los Angeles, CA for college
and career advising support services to
residents in public housing.
Department of Education............... Higher Education......... St. Catherine University, St. Paul, MN 800,000 McCollum
for technology and equipment.
Department of Education............... Higher Education......... St. Mary's College of Maryland, St. 900,000 Hoyer
Mary's City, MD for a marine sciences
program, including purchase of a
research vessel and other associated
equipment.
Department of Education............... Higher Education......... Stevens Institute of Technology, 750,000 Sires
Hoboken, NJ for college preparation and
success activities, including
scholarships.
Department of Education............... Higher Education......... Sul Ross State University, Alpine, TX 1,000,000 Gonzales, Tony
for an archaeology, anthropology, and
cultural research initiative and the
purchase of equipment.
Department of Education............... Higher Education......... TechUnited:NJ BetterFutureLabs, Hoboken, 1,000,000 Watson Coleman
NJ for a technology program, including
curriculum development.
Department of Education............... Higher Education......... Texas A&M University-Kingsville, 500,000 Vela
Kingsville, TX for teacher preparation
and bridge programs.
Department of Education............... Higher Education......... The Ohio State University, Columbus, OH 475,000 Beatty
for the Race, Inclusion, and Social
Equity (RAISE) Institute.
Department of Education............... Higher Education......... The University of Massachusetts Amherst, 1,000,000 McGovern
Amherst, MA for a robotics program,
including scholarships.
Department of Education............... Higher Education......... Tougaloo College, Tougaloo, MS for the 1,000,000 Thompson (MS)
Reuben V. Anderson Institute for Social
Justice.
Department of Education............... Higher Education......... United Community Center, Milwaukee, WI 275,000 Moore (WI)
for college access and success
initiative.
Department of Education............... Higher Education......... University of Colorado Boulder, Boulder, 275,000 Neguse
CO for college access and success
initiative.
Department of Education............... Higher Education......... University of Idaho Rinker Rock Creek 1,325,000 Simpson
Ranch, Moscow, ID for education,
research training, and equipment for
rangeland management and animal science.
Department of Education............... Higher Education......... University of Louisville, Louisville, KY 750,000 Yarmuth
for robotics and manufacturing
equipment and software..
Department of Education............... Higher Education......... University of Massachusetts Lowell, 500,000 Trahan
Lowell. MA for student support services
for first generation students,
including scholarships.
Department of Education............... Higher Education......... University of North Carolina System 225,000 Adams
Office, Chapel Hill, NC for college
preparation program for high school
students and their parents.
Department of Education............... Higher Education......... University of Texas at Dallas, 400,000 Allred
Richardson, TX for a study related to
the impact of COVID-19 on postsecondary
students.
Department of Education............... Higher Education......... University of Utah, Salt Lake City, UT 750,000 Owens
for social work fellowship program.
Department of Education............... Higher Education......... University of Utah, Salt Lake City, UT 1,000,000 Moore (UT)
to pilot a college access and degree
completion initiative for young adults
exiting the foster care system and the
purchase of equipment.
Department of Education............... Higher Education......... University of Wisconsin-Milwaukee Center 350,000 Moore (WI)
for Economic Development, Milwaukee, WI
for research and curriculum development.
Department of Education............... Higher Education......... Utah State University, Logan, UT for 585,000 Moore (UT)
academic, research, and career
development program.
Department of Education............... Higher Education......... Vermont State Colleges-Northern Vermont 250,000 Welch
University--Lyndon, Lyndonville, VT for
student support services.
Department of Education............... Higher Education......... Wake Technical Community College, 600,000 Ross
Raleigh, NC for college preparation and
success initiative.
Department of Education............... Higher Education......... Walsh University, North Canton, OH for a 500,000 Gonzalez (OH)
workforce program and the purchase of
equipment and information technology.
Department of Education............... Higher Education......... Warren County Community College, 750,000 Malinowski
Washington, NJ to develop a new
education and training program.
Department of Education............... Higher Education......... Western Michigan University, Kalamazoo, 1,500,000 Upton
MI for a pipeline and workforce program
focused on science, technology,
engineering, and mathematics, including
the purchase of information technology.
Department of Education............... Higher Education......... Worcester State University, Worchester, 1,000,000 McGovern
MA for dual enrollment activities.
Department of Education............... Higher Education......... York College, CUNY, Jamaica, NY for 2,000,000 Meeks
health disparities initiative.
Department of Education............... Higher Education......... York College, CUNY, Jamaica, NY for 525,000 Meeks
workforce development programs.
Department of Health & Human Services. Health Resources and 26Health, Orlando, FL for purchase of 250,000 Murphy (FL)
Services Administration-- equipment.
Program Management.
Department of Health & Human Services. Health Resources and Advocate Health and Hospitals 150,000 Newman
Services Administration-- Corporation dba Advocate Christ Medical
Program Management. Center, Oak Lawn, IL for facilities and
equipment.
Department of Health & Human Services. Health Resources and Advocate Illinois Masonic Medical 300,000 Quigley
Services Administration-- Center, Chicago, IL for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Affinia Healthcare, Saint Louis, MO for 2,000,000 Bush
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Aging in PACE Washington, Seattle, WA 700,000 Smith (WA)
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and AIDS Care Group, Chester, PA for 1,000,000 Scanlon
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Aleutians East Borough, Sand Point, AK 2,000,000 Young
Services Administration-- for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Alzheimer's Foundation of America, 100,000 Garbarino
Services Administration-- Amityville, NY for education and
Program Management. training services.
Department of Health & Human Services. Health Resources and Andy's Angels, Jackson, MI for 300,000 Walberg
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and Arc of the Ozarks, Springfield, MO for 800,000 Long
Services Administration-- equipment and autism diagnostic and
Program Management. treatment services.
Department of Health & Human Services. Health Resources and Asian American Drug Abuse Prevention, 250,000 Bass
Services Administration-- Los Angeles, CA for a health initiative.
Program Management.
Department of Health & Human Services. Health Resources and Asian American Health Coalition of 1,000,000 Garcia (TX)
Services Administration-- Greater Houston, d/b/a HOPE Clinic,
Program Management. Houston, TX for a health initiative,
including facilities and equipment.
Department of Health & Human Services. Health Resources and Asian American Health Coalition of 2,000,000 Green, Al (TX)
Services Administration-- Greater Houston, d/b/a HOPE Clinic,
Program Management. Houston, TX for facilities and
equipment.
Department of Health & Human Services. Health Resources and Atlantic Health System, Morristown, NJ 750,000 Gottheimer
Services Administration-- for facilities and equipment at
Program Management. Atlantic Health System - Newton Medical
Center.
Department of Health & Human Services. Health Resources and Aurora Community Mental Health Center, 1,000,000 Crow
Services Administration-- Aurora, CO for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Autism New Jersey, Robbinsville, NJ for 200,000 Smith (NJ)
Services Administration-- facilities and equipment and purchase
Program Management. of information technology.
Department of Health & Human Services. Health Resources and Avenidas, Palo Alto, CA for facilities 150,000 Eshoo
Services Administration-- and equipment for the Avenidas Rose
Program Management. Kleiner Center.
Department of Health & Human Services. Health Resources and Ballad Health, Johnson City, TN for 450,000 Griffith
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and BANJ Health Center Inc., Compton, CA for 50,000 Nanette Diaz Barragan
Services Administration-- a health initiative.
Program Management.
Department of Health & Human Services. Health Resources and Baptist Health Hardin, Elizabethtown, KY 300,000 Guthrie
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Battle Ground Healthcare, Battle Ground, 320,000 Herrera Beutler
Services Administration-- WA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Bay Area Community Health, Fremont, CA 1,000,000 Lofgren
Services Administration-- for an electronic health records
Program Management. initiative.
Department of Health & Human Services. Health Resources and Baylor College of Medicine, Houston, TX 1,100,000 Garcia (TX)
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Beach Cities Health District, Redondo 1,000,000 Lieu
Services Administration-- Beach, CA for facilities and equipment
Program Management. for the Youth Wellness Center.
Department of Health & Human Services. Health Resources and Benton County, Kennewick, WA for 2,000,000 Newhouse
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and Bethel School District #403, Spanaway, 2,000,000 Schrier
Services Administration-- WA for facilities and equipment for the
Program Management. School-Based Health Clinic at Graham-
Kapowsin High School.
Department of Health & Human Services. Health Resources and Bexar County Hospital District d/b/a 300,000 Castro (TX)
Services Administration-- University Health, San Antonio, TX for
Program Management. a health initiative.
Department of Health & Human Services. Health Resources and Blood Bank of Hawaii, Honolulu, HI for 2,000,000 Case
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Bluefield State College, Bluefield, WV 300,000 Miller (WV)
Services Administration-- for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Board of Trustees of the University of 2,000,000 Kinzinger
Services Administration-- Illinois, Urbana, IL for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Bon Secours Mercy Health Inc., 1,000,000 Ryan
Services Administration-- Cincinnati, OH for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Bowling Green-Warren County Community 250,000 Guthrie
Services Administration-- Hospital Corporation dba The Medical
Program Management. Center at Caverna, Horse Cave, KY for
facilities and equipment.
Department of Health & Human Services. Health Resources and Brooklyn Communities Collaborative, 875,000 Jeffries; Clarke
Services Administration-- Inc., Brooklyn, NY for a telehealth and
Program Management. electronic medical records initiative.
Department of Health & Human Services. Health Resources and Brooklyn Hospital Center, Brooklyn, NY 2,000,000 Jeffries
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Broward Community and Family Health 225,000 Wilson (FL)
Services Administration-- Centers, Inc., Hollywood, FL for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and Brownsville Community Development 1,000,000 Clarke (NY)
Services Administration-- Corporation dba BMS Family Health and
Program Management. Wellness Centers, Brooklyn, NY for
facilities and equipment.
Department of Health & Human Services. Health Resources and Bucks County Department of Mental 500,000 Fitzpatrick
Services Administration-- Health: Developmental Programs,
Program Management. Doylestown, PA for facilities.
Department of Health & Human Services. Health Resources and Burre Dental Center, Arcata, CA for 1,000,000 Huffman
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and C.W. Williams Community Health Center, 1,150,000 Adams
Services Administration-- Charlotte, NC for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and California State University, Dominguez 700,000 Nanette Diaz Barragan
Services Administration-- Hills, Carson, CA for facilities and
Program Management. equipment and an electronic medical
records initiative.
Department of Health & Human Services. Health Resources and Camino Community Development Corp., 200,000 Adams
Services Administration-- Charlotte, NC for facilities and
Program Management. equipment and an electronic health
records initiative.
Department of Health & Human Services. Health Resources and Cape Cod Healthcare, Hyannis, MA for an 1,500,000 Keating
Services Administration-- electronic health records initiative.
Program Management.
Department of Health & Human Services. Health Resources and Capital Health System, Inc., Trenton, NJ 550,000 Watson Coleman
Services Administration-- for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Capstone Rural Health Center, Parrish, 725,000 Aderholt
Services Administration-- AL for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Care Plus Bergen Inc. DBA Bergen New 2,000,000 Gottheimer
Services Administration-- Bridge Medical Center, Paramus, NJ for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and CareSTL Health, Saint Louis, MO for 1,000,000 Bush
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Caridad Center, Inc., Boynton Beach, FL 1,150,000 Frankel, Lois
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Cedars-Sinai, Los Angeles, CA for 1,000,000 Lieu
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Center for African American Health, 1,000,000 DeGette
Services Administration-- Denver, CO for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Central Michigan University College of 370,000 Moolenaar
Services Administration-- Medicine, Mount Pleasant, MI for
Program Management. telepsychiatry services, equipment, and
associated information technology.
Department of Health & Human Services. Health Resources and Centre Volunteers in Medicine, State 1,065,000 Thompson (PA)
Services Administration-- College, PA for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Centro De Salud Familiar La Fe, Inc., El 925,000 Escobar
Services Administration-- Paso, TX for faciilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Centro Las Americas, Inc., Worcester, MA 975,000 McGovern
Services Administration-- for a telehealth and electronic health
Program Management. records initiative, including the
purchase of equipment.
Department of Health & Human Services. Health Resources and Chestnut Health Systems, Bloomington, IL 430,000 Davis, Rodney
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Child Focus, Inc., Cincinnati, OH for 1,000,000 Wenstrup
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Children's Health System of Texas, 850,000 Allred; Veasey
Services Administration-- Dallas, TX for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Children's Hospital Colorado, Anschutz 500,000 Crow
Services Administration-- Medical Campus, Aurora, CO for a health
Program Management. training initiative.
Department of Health & Human Services. Health Resources and Children's Hospital Los Angeles, Los 550,000 Garcia (CA)
Services Administration-- Angeles, CA for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Children's Hospital Los Angeles, Los 1,600,000 Schiff
Services Administration-- Angeles, CA for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Children's Hospital of Wisconsin, Inc., 400,000 Fitzgerald
Services Administration-- Wauwatosa, WI for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Children's National Hospital, 2,000,000 Norton
Services Administration-- Washington, DC for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Chiricahua Community Health Centers, 625,000 Kirkpatrick
Services Administration-- Inc., Douglas, AZ for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Christian Community Health Center, 20,000 Rush
Services Administration-- Chicago, IL for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Church Health Center of Memphis, 350,000 Cohen
Services Administration-- Memphis, TN for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and City of Auburn, WA for facilities and 500,000 Schrier
Services Administration-- equipment for the Auburn Consolidated
Program Management. Resource Center.
Department of Health & Human Services. Health Resources and City of Baltimore, MD for facilities and 2,325,000 Ruppersberger; Sarbanes
Services Administration-- equipment and a telehealth initiative.
Program Management.
Department of Health & Human Services. Health Resources and City of Brooklyn Center, MN for a health 100,000 Omar
Services Administration-- initiative.
Program Management.
Department of Health & Human Services. Health Resources and City of Hope Duarte Medical Center, 450,000 Napolitano
Services Administration-- Duarte, CA for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and City of Hope National Medical Center, 700,000 Calvert
Services Administration-- Duarte, CA for equipment.
Program Management.
Department of Health & Human Services. Health Resources and City of Hope National Medical Center, 1,200,000 Garcia (CA)
Services Administration-- Duarte, CA for equipment.
Program Management.
Department of Health & Human Services. Health Resources and City of Houston Fire Department, 450,000 Fletcher; Green
Services Administration-- Houston, TX for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and City of Houston Health Department, 900,000 Green, Al (TX); Fletcher
Services Administration-- Houston, TX for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and City of Long Branch, NJ for facilities 2,000,000 Pallone
Services Administration-- and equipment for the City of Long
Program Management. Branch Health Department.
Department of Health & Human Services. Health Resources and City of Morgantown, WV for facilities 100,000 McKinley
Services Administration-- and equipment.
Program Management.
Department of Health & Human Services. Health Resources and City of Mount Sterling, KY for 1,000,000 Barr
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and City of Rochester Department of 225,000 Morelle
Services Administration-- Recreation and Human Services,
Program Management. Rochester, NY for facilities and
equipment.
Department of Health & Human Services. Health Resources and City of West Wendover, NV for facilities 320,000 Amodei
Services Administration-- and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Clinica Amistad, Tucson, AZ for a 185,000 Raul M. Grijalva
Services Administration-- telehealth initiative and purchase of
Program Management. equipment.
Department of Health & Human Services. Health Resources and Clinicas de Salud del Pueblo, El Centro, 1,000,000 Ruiz
Services Administration-- CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Colorado Coalition for the Homeless, 2,000,000 DeGette
Services Administration-- Denver, CO for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Columbus Neighborhood Health Center, 500,000 Beatty
Services Administration-- Inc., dba PrimaryOne Health (P1H),
Program Management. Columbus, OH for facilities and
equipment.
Department of Health & Human Services. Health Resources and Commonwealth Healthcare Corporation, 1,200,000 Sablan
Services Administration-- Sapian, MP for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and CommuniCare Health Centers, Davis, CA 400,000 Garamendi
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Community College District 502, Glen 500,000 Casten
Services Administration-- Elyn, IL for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Community Health Access Network, 700,000 Pappas
Services Administration-- Newmarket, NH for an electronic medical
Program Management. records initiative.
Department of Health & Human Services. Health Resources and Community Health Centers of Pinellas, 2,000,000 Bilirakis
Services Administration-- Inc., Clearwater, FL for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Compass Health, Everett, WA for 2,000,000 Larsen (WA)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and ComWell, Red Bud, IL for rural mental 250,000 Bost
Services Administration-- health and psychiatric care.
Program Management.
Department of Health & Human Services. Health Resources and Contra Costa Regional Medical Center, 900,000 Thompson (CA);
Services Administration-- Martinez, CA for a health training and DeSaulnier
Program Management. electronic health records initiative.
Department of Health & Human Services. Health Resources and Cooper University Health Care, Camden, 500,000 Norcross
Services Administration-- NJ for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Cornerstone Care, Inc., Greensboro, PA 1,500,000 Doyle, Michael F.
Services Administration-- for facilities and equipment for a
Program Management. facility in Clairton, PA.
Department of Health & Human Services. Health Resources and Cornerstone Services, Inc., Joliet, IL 1,050,000 Foster
Services Administration-- for facilites and equipment.
Program Management.
Department of Health & Human Services. Health Resources and County of Alameda, Oakland, CA for 1,250,000 Lee (CA)
Services Administration-- facilities and equipment for the West
Program Management. Oakland Health Council.
Department of Health & Human Services. Health Resources and County of Benton, Corvalis, OR for 1,000,000 DeFazio
Services Administration-- facilities and equipment for the Benton
Program Management. County Crisis Respite Center.
Department of Health & Human Services. Health Resources and County of Clear Creek, Georgetown, CO 1,000,000 Neguse
Services Administration-- for facilities and equipment for the
Program Management. Clear Creek County Collaborative Care
Center.
Department of Health & Human Services. Health Resources and County of Contra Costa Health Services 1,000,000 DeSaulnier
Services Administration-- Department, Behavioral Health Division,
Program Management. Martinez, CA for facilities and
equipment.
Department of Health & Human Services. Health Resources and County of Fairfax, Fairfax, VA for 2,000,000 Connolly
Services Administration-- facilities and equipment for the
Program Management. Merrifield Crisis Response Center.
Department of Health & Human Services. Health Resources and County of Fairfax, VA for a health 375,000 Wexton
Services Administration-- information technology initiative,
Program Management. including purchase of equipment.
Department of Health & Human Services. Health Resources and County of Fairfax, VA for a health IT 800,000 Beyer
Services Administration-- initiative.
Program Management.
Department of Health & Human Services. Health Resources and County of Franklin, Columbus, OH for 500,000 Beatty
Services Administration-- facilities and equipment for the
Program Management. Franklin County Mental Health and
Addiction Crisis Center.
Department of Health & Human Services. Health Resources and County of Henrico, Henrico, VA for 1,000,000 Spanberger
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and County of Lane, Eugene, OR for 1,500,000 DeFazio
Services Administration-- facilities and equipment for a rural
Program Management. community health clinic in Cottage
Grove, OR.
Department of Health & Human Services. Health Resources and County of Orange, Orlando, FL for a 300,000 Murphy (FL)
Services Administration-- health workforce initiative.
Program Management.
Department of Health & Human Services. Health Resources and County of Orange, Santa Ana, CA for 2,000,000 Kim (CA)
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and County of Prince George's Department of 4,000,000 Hoyer; Brown
Services Administration-- Health, Largo, MD, for a telehealth
Program Management. initiative, including purchase of
equipment.
Department of Health & Human Services. Health Resources and County of Prince William, Prince 800,000 Connolly
Services Administration-- William, VA for a health initiative.
Program Management.
Department of Health & Human Services. Health Resources and County of Santa Barbara, Santa Barbara, 900,000 Carbajal
Services Administration-- CA for facilities and equipment for the
Program Management. Lompoc Health Clinic.
Department of Health & Human Services. Health Resources and County of Santa Clara, San Jose, CA for 1,000,000 Khanna
Services Administration-- a health workforce initiative.
Program Management.
Department of Health & Human Services. Health Resources and County of Wayne, Honesdale, PA for 2,000,000 Cartwright
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Dallas County Hospital District d/b/a 275,000 Johnson (TX)
Services Administration-- Parkland Health & Hospital System,
Program Management. Dallas, TX for facilities and equipment.
Department of Health & Human Services. Health Resources and Day Kimball Hospital, Putnam, CT for 550,000 Courtney
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Delaware Division of Libraries, Dover, 275,000 Blunt Rochester
Services Administration-- DE for a telehealth initiative,
Program Management. including the purchase of equipment.
Department of Health & Human Services. Health Resources and Delaware-Morrow Mental Health & Recovery 750,000 Balderson
Services Administration-- Services Board, Delaware, OH for
Program Management. facilities.
Department of Health & Human Services. Health Resources and Denver Health and Hospital Authority, 1,200,000 DeGette
Services Administration-- Denver, CO for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Dientes Community Dental Care, Santa 1,050,000 Panetta
Services Administration-- Cruz, CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Dimock Center, Inc. d/b/a The Dimock 1,000,000 Pressley
Services Administration-- Center, Roxbury, MA for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Doylestown Health Foundation, 100,000 Fitzpatrick
Services Administration-- Doylestown, PA for equipment and
Program Management. associated information technology.
Department of Health & Human Services. Health Resources and East Los Angeles College, Monterey Park, 925,000 Nanette Diaz Barragan
Services Administration-- CA for a health workforce initiative,
Program Management. including facilities and equipment.
Department of Health & Human Services. Health Resources and Easterseals Midwest, St. Louis, MO for 200,000 Long
Services Administration-- equipment, information technology, and
Program Management. support services.
Department of Health & Human Services. Health Resources and Easterseals of Southwest Florida, 2,000,000 Buchanan
Services Administration-- Sarasota, FL for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Edward M. Kennedy Community Health 1,000,000 Clark (MA)
Services Administration-- Center, Inc., Worcester, MA for an
Program Management. interpreter services program.
Department of Health & Human Services. Health Resources and El Centro de Corazon, Houston, TX for 225,000 Garcia (TX)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and El Paso County Hospital District/ 1,200,000 Escobar
Services Administration-- University Medical Center of El Paso,
Program Management. El Paso, TX for purchase of equipment.
Department of Health & Human Services. Health Resources and El Proyecto del Barrio, Inc., Winnetka, 1,000,000 Sherman
Services Administration-- CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and El Rio Santa Cruz Neighborhood Health 1,450,000 Kirkpatrick
Services Administration-- Care, Inc., Tucson, AZ for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and Equitas Health, Columbus, OH for 150,000 Beatty
Services Administration-- purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Erie County Health Department, Sandusky, 2,000,000 Kaptur
Services Administration-- OH for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Erie Neighborhood House, Chicago, IL for 2,000,000 Jesus G. ``Chuy'' Garcia
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Erlanger Health System, Chattanooga, TN 2,000,000 Fleischmann
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and EveryMind, Rockville, MD for telehealth. 325,000 Trone
Services Administration--
Program Management.
Department of Health & Human Services. Health Resources and Excela Health, Greensburg, PA for 125,000 Joyce (PA)
Services Administration-- equipment.
Program Management.
Department of Health & Human Services. Health Resources and Excela Health, Greensburg, PA for 650,000 Reschenthaler
Services Administration-- equipment.
Program Management.
Department of Health & Human Services. Health Resources and Families Flourish Northeast, Lebanon, NH 500,000 Kuster
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Family Services, Inc., Poughkeepsie, NY 1,200,000 Maloney, Sean
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Jewish Family and Children's Service of 325,000 Frankel, Lois
Services Administration-- Palm Beach County, West Palm Beach, FL
Program Management. for an electronic health records
initiative.
Department of Health & Human Services. Health Resources and Flanner House of Indianapolis, Inc., 250,000 Andre Carson
Services Administration-- Indianapolis, IN for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Floating Hospital, Inc., Long Island 925,000 Maloney, Carolyn B.
Services Administration-- City, NY for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Florida International University, Miami, 2,000,000 Wasserman Schultz
Services Administration-- FL for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Flushing Hospital and Medical Center, 750,000 Meng
Services Administration-- Flushing, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Free Clinic of Meridian Inc., Meridian, 315,000 Guest
Services Administration-- MS for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Fresno City College, Fresno, CA for a 475,000 Costa
Services Administration-- health workforce initiative.
Program Management.
Department of Health & Human Services. Health Resources and Friend Family Health Center, Chicago, IL 250,000 Rush
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Gardner Family Health Network, Inc., San 900,000 Lofgren
Services Administration-- Jose, CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Gateway Community Health Center, Inc., 2,000,000 Cuellar
Services Administration-- Laredo, TX for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Gavin Foundation, Inc., South Boston, MA 1,000,000 Lynch
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and George Mason University, Fairfax, VA for 1,150,000 Connolly
Services Administration-- a health workforce initiative.
Program Management.
Department of Health & Human Services. Health Resources and Glenbrook High School District 225, 250,000 Schakowsky
Services Administration-- Glenview, IL for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and God's Love We Deliver, Inc., New York, 775,000 Nadler
Services Administration-- NY for a health initiative.
Program Management.
Department of Health & Human Services. Health Resources and GoochlandCares Inc., Goochland, VA for 15,000 Spanberger
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Grandview Foundation, Dayton, OH for 1,250,000 Turner
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and Great Lakes Recovery Centers, Ishpeming, 680,000 Bergman
Services Administration-- MI for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Greater Bergen Community Action, Inc., 1,500,000 Pascrell
Services Administration-- Garfield, NJ for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Greater Lawrence Family Health Center, 2,000,000 Trahan
Services Administration-- Methuen, MA for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Greater New Bedford Community Health 2,000,000 Keating
Services Administration-- Center, New Bedford, MA for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and Green County Human Services, Aging & 200,000 Pocan
Services Administration-- Disability Resource Center, Monroe, WI
Program Management. for a rural health initiative,
including the purchase of equipment.
Department of Health & Human Services. Health Resources and H. Lee Moffitt Cancer Center and 2,000,000 Castor (FL)
Services Administration-- Research Institute, Inc., Tampa, FL for
Program Management. purchase of equipment.
Department of Health & Human Services. Health Resources and Habilitative Systems, Inc., Chicago, IL 500,000 Davis, Danny K.
Services Administration-- for facilities and equipment and for an
Program Management. electronic health records initiative.
Department of Health & Human Services. Health Resources and Hackensack Meridian Health, Edison, NJ 775,000 Gottheimer
Services Administration-- for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Hackensack Meridian School of Medicine, 775,000 Pascrell
Services Administration-- Nutley, NJ for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Hana Health, Hana, HI for facilities and 1,000,000 Kahele
Services Administration-- equipment.
Program Management.
Department of Health & Human Services. Health Resources and Harbor Community Health Centers, San 1,000,000 Nanette Diaz Barragan
Services Administration-- Pedro, CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Harbor Hospital, Inc., Baltimore, MD for 875,000 Ruppersberger
Services Administration-- a telehealth initiative, including the
Program Management. purchase of equipment.
Department of Health & Human Services. Health Resources and Harry E. Davis Partnership for 650,000 Pingree
Services Administration-- Children's Oral Health, Yarmouth, ME
Program Management. for a telehealth initiative.
Department of Health & Human Services. Health Resources and Health Care Coalition of Rural Missouri, 2,000,000 Cleaver
Services Administration-- Lexington, MO for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and HealthPoint, Renton, WA for facilities 350,000 Smith (WA)
Services Administration-- and equipment, including telehealth
Program Management. equipment.
Department of Health & Human Services. Health Resources and Hennepin Healthcare System, Inc., 2,000,000 Omar
Services Administration-- Minneapolis, MN for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Henry Ford Wyandotte Hospital, Detroit, 900,000 Dingell
Services Administration-- MI for facilities and equipment,
Program Management. including telehealth equipment.
Department of Health & Human Services. Health Resources and Henry Ford West Bloomfield Hospital, 1,150,000 Lawrence
Services Administration-- West Bloomfield, MI for purchase of
Program Management. equipment.
Department of Health & Human Services. Health Resources and Henry Mayo Newhall Hospital, Valencia, 610,000 Garcia (CA)
Services Administration-- CA for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Hepatitis B Foundation, Doylestown, PA 475,000 Fitzpatrick
Services Administration-- for public health programming.
Program Management.
Department of Health & Human Services. Health Resources and Hill Country Mental Health and 2,000,000 Gonzales, Tony
Services Administration-- Developmental Disabilities Centers,
Program Management. Kerrville, TX for facilities and
equipment.
Department of Health & Human Services. Health Resources and Hill Hospital, York, AL for facilities 575,000 Sewell
Services Administration-- and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Hurley Medical Center, Flint, MI for 1,450,000 Kildee
Services Administration-- purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Illinois College of Optometry, Chicago, 300,000 Rush
Services Administration-- IL for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Independence Health & Therapy, 60,000 Underwood
Services Administration-- Woodstock, IL for an electronic medical
Program Management. records initiative.
Department of Health & Human Services. Health Resources and Ironbound Community Health Center, 550,000 Sires
Services Administration-- Newark, NJ for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and It Takes Philly, Inc. d/b/a/ Black 2,000,000 Boyle, Brendan F.
Services Administration-- Doctors COVID19 Consortium, Jenkintown,
Program Management. PA for facilities and equipment.
Department of Health & Human Services. Health Resources and Jackson County School District, 85,000 Dunn
Services Administration-- Marianna, FL for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Jamaica Hospital Medical Center, 1,500,000 Meeks
Services Administration-- Richmond Hill, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Jessie Trice Community Health Systems 400,000 Wilson (FL)
Services Administration-- Inc., Miami, FL for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Joseph P. Addabbo Family Health Center, 1,500,000 Meeks
Services Administration-- Inc., Arverne, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and JWCH Institute, Inc., Bell Gardens, CA 300,000 Roybal-Allard
Services Administration-- for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Kids First Health Care, Commerce City, 800,000 Perlmutter
Services Administration-- CO for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and KoKua Kalihi Valley Comprehensive Family 1,050,000 Case
Services Administration-- Services, Honolulu, HI for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and La Clinica Tepeyac, Inc., Denver, CO for 2,000,000 DeGette
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Lake County Health Department & 1,000,000 Schneider
Services Administration-- Community Health Center, Waukegan, IL
Program Management. for facilities and equipment.
Department of Health & Human Services. Health Resources and Lakewood Community Services Corporation, 400,000 Smith (NJ)
Services Administration-- Lakewood, NJ for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Lebanon Valley College, Annville, PA for 1,000,000 Meuser
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and Legacy Community Health, Houston, TX for 20,000 Green, Al (TX)
Services Administration-- a health initiative.
Program Management.
Department of Health & Human Services. Health Resources and LGBT Life Center, Norfolk, VA for 1,800,000 Scott (VA)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Linda Crnic Institute for Down Syndrome, 950,000 Crow
Services Administration-- Aurora, CO for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Lions Eye Institute for Transplant and 2,000,000 Crist
Services Administration-- Research Foundation Inc., Tampa, FL for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and Loma Linda University Health, Loma 1,000,000 Ruiz
Services Administration-- Linda, CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Loma Linda University Medical Center-- 600,000 Calvert
Services Administration-- Murrieta, Murrieta, CA for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Long Island FQHC, Inc., Westbury, NY for 2,000,000 Meeks
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Long Island FQHC, Inc., Westbury, NY for 1,000,000 Rice (NY)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Loretto Health and Rehabilitation 260,000 Katko
Services Administration-- Center, Syracuse, NY for the purchase
Program Management. of equipment and software for a medical
records system.
Department of Health & Human Services. Health Resources and Los Angeles LGBT Center, Los Angeles, CA 775,000 Schiff
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Louisiana State University Health New 2,000,000 Troy A. Carter
Services Administration-- Orleans, New Orleans, LA for the
Program Management. purchase of equipment.
Department of Health & Human Services. Health Resources and Main St. Missions, Doylestown, PA for 200,000 Fitzpatrick
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and Manet Community Health Center, Quincy, 500,000 Auchincloss
Services Administration-- MA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Martin Luther King, Jr. Family Clinic, 100,000 Johnson (TX)
Services Administration-- Dallas, TX for a health workforce
Program Management. training initiative, including
equipment and technology.
Department of Health & Human Services. Health Resources and Mary Bird Perkins Cancer Center, Baton 775,000 Graves (LA)
Services Administration-- Rouge, LA for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Maverick County Hospital District, Eagle 500,000 Gonzales, Tony
Services Administration-- Pass, TX for information technology and
Program Management. telehealth services.
Department of Health & Human Services. Health Resources and McLaren Northern Michigan, Petoskey, MI 500,000 Bergman
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and McLaren Oakland Hospital, Pontiac, MI 400,000 Lawrence
Services Administration-- for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Medstar Southern Maryland Hospital 925,000 Hoyer
Services Administration-- Center, Clinton, MD for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and MedStar Washington Hospital Center, 800,000 Norton
Services Administration-- Washington, DC for facilities and
Program Management. equipment and an electronic medical
records initiative.
Department of Health & Human Services. Health Resources and Meharry Medical College, Nashville, TN 1,000,000 Cooper
Services Administration-- for curriculum and degree program
Program Management. development.
Department of Health & Human Services. Health Resources and Memorial Hospital at Gulfport 2,000,000 Palazzo
Services Administration-- Foundation, Inc., Gulfport, MS for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and MemorialCare Health System, Long Beach, 575,000 Lowenthal
Services Administration-- CA for facilities and equipment and an
Program Management. electronic health records initiative.
Department of Health & Human Services. Health Resources and Mental Health Care, Inc., Tampa, FL for 2,000,000 Castor (FL)
Services Administration-- facilities and equipment for the
Program Management. Mariposa Women's Neuropsychiatric
Hospital.
Department of Health & Human Services. Health Resources and Methodist Health Services Corporation, 2,000,000 LaHood
Services Administration-- Peoria, IL for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Metropolitan Family Health Network, 800,000 Payne
Services Administration-- Inc., Jersey City, NJ for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and Miami SCI Wellness Inc., Miami, FL for 440,000 Gimenez
Services Administration-- equipment.
Program Management.
Department of Health & Human Services. Health Resources and Millikin University, Decatur, IL for 2,000,000 Davis, Rodney
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Minnesota State College Southeast, Red 825,000 Craig
Services Administration-- Wing, MN for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Mississippi State University, 1,000,000 Guest
Services Administration-- Mississippi State, MS for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and Missouri Valley College, Marshall, MO 2,000,000 Cleaver
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Monongahela Valley Hospital Foundation, 455,000 Reschenthaler
Services Administration-- Monongahela, PA for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Montefiore Medical Center, Bronx, NY for 3,350,000 Espaillat; Torres
Services Administration-- facilities and equipment, including
Program Management. telehealth equipment.
Department of Health & Human Services. Health Resources and Montefiore St. Luke's Cornwall, 2,000,000 Maloney, Sean
Services Administration-- Cornwall, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Mount St. Mary's Hospital of Niagara 2,000,000 Jacobs (NY)
Services Administration-- Falls, Lewiston, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Muslim Community Center, Inc., Silver 250,000 Sarbanes; Raskin
Services Administration-- Spring, MD for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and National Alliance on Mental Illness, 2,000,000 Kaptur
Services Administration-- Ohio Chapter, Toledo, OH, for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and Nemours Foundation, Jacksonville, FL for 105,000 Rutherford
Services Administration-- equipment and information technology.
Program Management.
Department of Health & Human Services. Health Resources and Nevada State College, Henderson, NV for 35,000 Lee (NV)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and New Alternatives for Children, Inc., New 500,000 Maloney, Carolyn B.
Services Administration-- York, NY for purchase of equipment,
Program Management. including telehealth equipment.
Department of Health & Human Services. Health Resources and New York City Health + Hospitals/ 800,000 Meng
Services Administration-- Elmhurst, Queens, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and New York City Health + Hospitals/ 3,000,000 Meng; Ocasio-Cortez
Services Administration-- Elmhurst, Queens, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and New York City Health + Hospitals/Queens 1,000,000 Meng
Services Administration-- Hospital, Jamaica, NY for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and New York Community Hospital of Brooklyn, 975,000 Clarke (NY)
Services Administration-- Inc., Brooklyn, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Newark Community Health Centers, Inc., 760,000 Payne
Services Administration-- Newark, NJ for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Newark-Wayne Community Hospital, Newark, 180,000 Katko
Services Administration-- NY for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Night Ministry, Chicago, IL for 275,000 Quigley
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Norman Regional Hospital Authority, 650,000 Cole
Services Administration-- Norman, OK for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and North Country Community College, Saranac 1,000,000 Stefanik
Services Administration-- Lake, NY for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and North Oakland County Fire Authority, 500,000 Slotkin
Services Administration-- Holly, MI for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and North Shore Community College, Danvers, 900,000 Moulton
Services Administration-- MA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and North Shore Community Health, Salem, MA 1,000,000 Moulton
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Northern Dutchess Hospital / Nuvance 300,000 Delgado
Services Administration-- Health, Rhinebeck, NY for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and Northern Nye County Hospital District, 2,000,000 Horsford
Services Administration-- Tonopah, NV for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Northwell Health, New Hyde Park, NY for 2,000,000 Suozzi
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Nursing Care Quality Assurance 1,000,000 Newhouse
Services Administration-- Commission, Tumwater, WA for a health
Program Management. workforce training program.
Department of Health & Human Services. Health Resources and NYC Health + Hospitals/Coney Island, 2,000,000 Malliotakis
Services Administration-- Brooklyn, NY for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Oakland LGBTQ Community Center, Oakland, 350,000 Lee (CA)
Services Administration-- CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Oklahoma Medical Research Foundation, 835,000 Cole; Bice
Services Administration-- Oklahoma City, OK for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Oklahoma State University Center for 2,000,000 Lucas
Services Administration-- Health Sciences, Tulsa, OK for
Program Management. facilities.
Department of Health & Human Services. Health Resources and Olivet Nazarene University, Borubonnais, 90,000 Kelly (IL)
Services Administration-- IL for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and One Brooklyn Health System, Inc., 425,000 Clarke (NY)
Services Administration-- Brooklyn, NY for an electronic health
Program Management. records initiative.
Department of Health & Human Services. Health Resources and One Brooklyn Health System, Inc., 1,000,000 Jeffries
Services Administration-- Brooklyn, NY for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Oregon Health & Science University 800,000 Blumenauer
Services Administration-- Northwest Native American Center of
Program Management. Excellence, Portland, OR for a health
workforce initiative.
Department of Health & Human Services. Health Resources and OSF St. Joseph Medical Center, 700,000 LaHood
Services Administration-- Bloomington, IL for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Outer Cape Health Services, Harwich 250,000 Keating
Services Administration-- Port, MA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Pace Center For Girls Inc., 500,000 Wasserman Schultz
Services Administration-- Jacksonville, FL for a telehealth
Program Management. initiative, including the purchase of
equipment.
Department of Health & Human Services. Health Resources and Pace Center for Girls, Inc., 2,000,000 Buchanan
Services Administration-- Jacksonville, FL for facilities.
Program Management.
Department of Health & Human Services. Health Resources and Palm Beach State College, Lake Worth, FL 700,000 Frankel, Lois
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Palo Verde Hospital District, Blythe, 350,000 Ruiz
Services Administration-- CA, for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Pascua Yaqui Tribe, Tucson, AZ for 900,000 Raul M. Grijalva
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Patrick County Economic Development 600,000 Griffith
Services Administration-- Authority, Stuart, VA for equipment.
Program Management.
Department of Health & Human Services. Health Resources and Penn State Health St. Joseph Medical 500,000 Houlahan
Services Administration-- Center, Reading, PA, for a rural health
Program Management. initiative, including the purchase of
equipment.
Department of Health & Human Services. Health Resources and Pennsylvania Organization for Women in 1,500,000 Doyle, Michael F.
Services Administration-- Recovery, Pittsburgh, PA for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and People Coordinated Services of Southern 600,000 Bass
Services Administration-- California, Inc., Los Angeles, CA for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and Petaluma Health Center, Inc., Petaluma, 1,000,000 Thompson (CA)
Services Administration-- CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Petaluma Health Center, Petaluma, CA for 1,600,000 Huffman
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Phoebe Putney Health System, Inc., 1,000,000 Bishop (GA)
Services Administration-- Albany, GA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Piatt County Nursing Home, Monticello, 215,000 Davis, Rodney
Services Administration-- IL for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Pierce Center for Arts & Technology, 450,000 Strickland
Services Administration-- Tacoma, WA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Pikeville Medical Center, Inc., 675,000 Rogers (KY)
Services Administration-- Pikeville, KY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Planned Parenthood Mar Monte, San Jose, 1,000,000 Lofgren
Services Administration-- CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Planned Parenthood Mar Monte, San Jose, 1,000,000 Lofgren
Services Administration-- CA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Pomona Community Health Center dba 775,000 Torres (CA)
Services Administration-- ParkTree Community Health Center,
Program Management. Pomona, CA for facilities and equipment.
Department of Health & Human Services. Health Resources and Potomac Valley Hospital, Keyser, WV for 750,000 McKinley
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Preston Memorial Hospital, Kingwood, WV 580,000 McKinley
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Primary Health Care, Inc., Des Moines, 100,000 Axne
Services Administration-- IA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Primary Health Care, Inc., Des Moines, 200,000 Hinson
Services Administration-- IA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Providence Milwaukie Hospital , 800,000 Schrader
Services Administration-- Milwaukie, OR for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Puerto Rican Organization to Motivate, 825,000 Torres (NY)
Services Administration-- Enlighten, and Serve Addicts, Inc.,
Program Management. Bronx, NY for facilities and equipment.
Department of Health & Human Services. Health Resources and Queens College, The City of New York, 1,850,000 Meng
Services Administration-- Flushing, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Refuah Health Center, Inc., Spring 2,000,000 Jones
Services Administration-- Valley, NY for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Regents of the University of California, 600,000 Lieu
Services Administration-- Los Angeles, CA for the purchase of
Program Management. equipment, including telehealth
equipment.
Department of Health & Human Services. Health Resources and Regents of the University of Washington, 550,000 Jayapal
Services Administration-- Seattle, WA for purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Regional One Health, Memphis, TN for 1,000,000 Cohen
Services Administration-- purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Research Institute at Nationwide 500,000 Beatty
Services Administration-- Children's Hospital, Columbus, OH for
Program Management. purchase of equipment.
Department of Health & Human Services. Health Resources and Richmond Medical Center of Staten Island 1,815,000 Malliotakis
Services Administration-- , Staten Island, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and RIDOH Division of State Laboratories and 900,000 Langevin
Services Administration-- Medical Examiners, Providence, RI for
Program Management. purchase of equipment.
Department of Health & Human Services. Health Resources and Rochester General Hospital, Rochester, 1,000,000 Morelle
Services Administration-- NY for a health workforce initiative.
Program Management.
Department of Health & Human Services. Health Resources and Rockland County Pride Center, Nyack, NY, 1,500,000 Jones
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Roosevelt Special Hospital, Portales, NM 600,000 Leger Fernandez
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Rosalynn Carter Institute for 1,100,000 Bishop (GA)
Services Administration-- Caregivers, Americus, GA for purchase
Program Management. of equipment.
Department of Health & Human Services. Health Resources and Roswell Park Comprehensive Cancer 1,500,000 Higgins (NY)
Services Administration-- Center, Buffalo, NY for purchase of
Program Management. equipment.
Department of Health & Human Services. Health Resources and Rowan University/Rutgers-Camden Board of 500,000 Norcross
Services Administration-- Governors, Camden, NJ for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and SAC Health System, San Bernadino, CA for 375,000 Aguilar
Services Administration-- purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and Saint Francis University School of 500,000 Thompson (PA)
Services Administration-- Health Sciences and Education, Loretto,
Program Management. PA for facilities.
Department of Health & Human Services. Health Resources and Saint Joseph's Health, Paterson, NJ for 1,000,000 Pascrell
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Saint Louis University, Saint Louis, MO 500,000 Bush
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and San Antonio College, San Antonio, TX for 1,050,000 Doggett
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and San Francisco Community Clinic 1,000,000 Pelosi
Services Administration-- Consortium, San Francisco, CA for
Program Management. facilities and equipment, including an
electronic medical records initiative.
Department of Health & Human Services. Health Resources and San Juan College, Farmington, NM for 1,100,000 Leger Fernandez
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and San Juan County, Monticello, UT for 520,000 Curtis
Services Administration-- cancer screening.
Program Management.
Department of Health & Human Services. Health Resources and Savio House, Denver, CO for facilities 300,000 Perlmutter
Services Administration-- and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Schenectady Family Health Services, 750,000 Tonko
Services Administration-- Inc., D/B/A Hometown Health Centers,
Program Management. Schenectady, NY for facilities and
equipment.
Department of Health & Human Services. Health Resources and Sharon Hospital, Sharon, CT for 400,000 Hayes
Services Administration-- facilities and equipment, including
Program Management. telehealth equipment.
Department of Health & Human Services. Health Resources and Shasta Community Health Center, Redding, 750,000 LaMalfa
Services Administration-- CA for facilities, equipment, and
Program Management. information technology.
Department of Health & Human Services. Health Resources and Sixteenth Street Community Health 1,250,000 Moore (WI)
Services Administration-- Center, Milwaukee, WI for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and Snohomish Health District, Everett, WA 250,000 DelBene
Services Administration-- for a telehealth and electronic health
Program Management. records initiative, including purchase
of equipment.
Department of Health & Human Services. Health Resources and Spectrum Health Lakeland, St. Joseph, MI 505,000 Upton
Services Administration-- for facilities and equipment, including
Program Management. information technology.
Department of Health & Human Services. Health Resources and Spokane County, Spokane, WA for 1,125,000 Rodgers (WA)
Services Administration-- equipment.
Program Management.
Department of Health & Human Services. Health Resources and St. Barnabas Hospital, Bronx, NY for 1,350,000 Torres (NY)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and St. John's Episcopal Hospital, Far 2,000,000 Meeks
Services Administration-- Rockaway, NY for facilities and
Program Management. equipment for the Behavioral Health
Equity Renovation Project.
Department of Health & Human Services. Health Resources and St. John's Episcopal Hospital, Far 2,000,000 Meeks
Services Administration-- Rockaway, NY for facilities and
Program Management. equipment for the Women and Newborns
Health Equity Renovation Project.
Department of Health & Human Services. Health Resources and St. John's University, Jamaica, NY for 1,250,000 Meeks
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and St. Louis Center for Exceptional 500,000 Walberg
Services Administration-- Children and Adults, Chelsea, MI for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and St. Luke's Hospital, New Bedford, MA for 975,000 Keating
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and St. Luke's Quakertown Hospital, 400,000 Fitzpatrick
Services Administration-- Quakertown, PA for facilities.
Program Management.
Department of Health & Human Services. Health Resources and St. Mary's University of San Antonio, 875,000 Castro (TX)
Services Administration-- San Antonio, TX for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and St. Tammany Parish Hospital Service 1,000,000 Scalise
Services Administration-- District No. 1, d/b/a St. Tammany
Program Management. Health System, Covington, LA for
equipment.
Department of Health & Human Services. Health Resources and Stanislaus County Behavioral Health and 2,000,000 Harder (CA)
Services Administration-- Recovery Services, Modesto, CA for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and Staten Island University Hospital, 2,000,000 Malliotakis
Services Administration-- Staten Island, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Stepping Stones Inc., Joliet, IL for 2,000,000 Foster
Services Administration-- facilities and equipment.
Program Management.
Department of Education............... Higher Education......... Stillman College, Tuscaloosa, AL to 800,000 Sewell
support biomedical research activities,
including equipment.
Department of Health & Human Services. Health Resources and STOP Inc., Virginia Beach, VA for a 250,000 Scott (VA)
Services Administration-- telehealth initiative, including
Program Management. purchase of equipment.
Department of Health & Human Services. Health Resources and Summa Health, Akron, OH for facilities 1,000,000 Ryan
Services Administration-- and equipment.
Program Management.
Department of Health & Human Services. Health Resources and SUNY Downstate Health Sciences 1,925,000 Clarke (NY)
Services Administration-- University, Brooklyn, NY for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and Terros, Inc.--DBA Terros Health, 600,000 Stanton
Services Administration-- Phoenix, AZ for facilities and
Program Management. equipment for Terros Health - Stapley
Health Center.
Department of Health & Human Services. Health Resources and Terros, Inc. DBA Terros Health, Phoenix, 900,000 Gallego
Services Administration-- AZ for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Texas Southern University, Houston, TX 2,000,000 Jackson Lee
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Thresholds, Chicago, IL for facilities 1,000,000 Newman
Services Administration-- and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Tidalhealth Nanticoke, Seaford, DE for 350,000 Blunt Rochester
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Tillamook Bay Community College 425,000 Schrader
Services Administration-- Foundation, Tillamook, OR for a health
Program Management. workforce training initiative,
including purchase of equipment.
Department of Health & Human Services. Health Resources and Touro University California, Vallejo, CA 1,000,000 Thompson (CA)
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Town of East Millinocket, ME for 300,000 Golden
Services Administration-- purchase of equipment for the East
Program Management. Millinocket Rural Ambulance Service.
Department of Health & Human Services. Health Resources and Town of Randolph, MA for facilities and 1,000,000 Pressley
Services Administration-- equipment at Randolph High School.
Program Management.
Department of Health & Human Services. Health Resources and Truman Medical Center Inc., Kansas City, 2,000,000 Cleaver
Services Administration-- MO for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Tulane University, New Orleans, LA for 1,000,000 Troy A. Carter
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and United Way of Tarrant County, TX for a 25,000 Veasey
Services Administration-- health initiative.
Program Management.
Department of Health & Human Services. Health Resources and United Way of the Crossroads, Victoria, 40,000 Vela
Services Administration-- TX for a rural health initiative.
Program Management.
Department of Health & Human Services. Health Resources and Unity Care Northwest, Bellingham, WA for 2,000,000 Larsen (WA)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Universal Community Health Center, Los 300,000 Roybal-Allard
Services Administration-- Angeles, CA for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and University at Albany, Albany, NY for 1,000,000 Tonko
Services Administration-- purchase of equipment.
Program Management.
Department of Health & Human Services. Health Resources and University Health System, Inc., 2,000,000 Burchett
Services Administration-- Knoxville, TN for facilities.
Program Management.
Department of Health & Human Services. Health Resources and University Health System, Inc., 2,000,000 Rose
Services Administration-- Knoxville, TN for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and University Hospitals Cleveland Medical 1,000,000 Ryan
Services Administration-- Center, Shaker Heights, OH for
Program Management. facilities and equipment for the
University Hospitals Portage Medical
Center.
Department of Health & Human Services. Health Resources and University of Alaska, Fairbanks, AK for 2,000,000 Young
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and University of California San Diego, La 950,000 Peters
Services Administration-- Jolla, CA for a telehealth initiative,
Program Management. including purchase of equipment.
Department of Health & Human Services. Health Resources and University of California (San Francisco) 475,000 Costa
Services Administration-- Fresno Regional Campus, Fresno, CA for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and University of California, Davis Health, 1,700,000 Matsui
Services Administration-- Sacramento, CA for an electronic health
Program Management. record and telehealth initiative.
Department of Health & Human Services. Health Resources and University of California-Davis, Davis, 1,000,000 Garamendi
Services Administration-- CA for a health workforce initiative.
Program Management.
Department of Health & Human Services. Health Resources and University of Cincinnati Medical Center, 4,000,000 Chabot; Wenstrup
Services Administration-- Cincinnati, OH for facilities.
Program Management.
Department of Health & Human Services. Health Resources and University of Colorado Anschutz Medical 1,000,000 Crow
Services Administration-- Campus, Aurora, CO for a health
Program Management. workforce initiative.
Department of Health & Human Services. Health Resources and University of Florida Health 705,000 Rutherford
Services Administration-- Jacksonville, Jacksonville, FL for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and University of Hawaii System, Honolulu, 1,000,000 Case
Services Administration-- HI for a rural health initiative.
Program Management.
Department of Health & Human Services. Health Resources and University of Illinois - Chicago, 500,000 Jesus G. ``Chuy'' Garcia
Services Administration-- College of Dentistry and Oral Health,
Program Management. Chicago, IL for facilities and
equipment.
Department of Health & Human Services. Health Resources and University of Kansas Medical Center, 1,000,000 Davids (KS)
Services Administration-- Kansas City, KS for purchase of
Program Management. equipment for the Kansas University
Cancer Center.
Department of Health & Human Services. Health Resources and University of Massachusetts Boston, 1,350,000 Lynch
Services Administration-- Boston, MA for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and University of New Mexico, Albuquerque, 1,500,000 Melanie Stansbury
Services Administration-- NM for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and University of Pittsburgh Medical Center 100,000 Thompson (PA)
Services Administration-- Northwest, Seneca, PA for facilities
Program Management. and equipment.
Department of Health & Human Services. Health Resources and University of Saint Francis - Crown 225,000 Mrvan
Services Administration-- Point Campus, Fort Wayne, IN for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and University of Texas at Dallas, TX for 850,000 Johnson (TX)
Services Administration-- facilities and equipment and a
Program Management. telehealth initiative.
Department of Health & Human Services. Health Resources and University of Texas Southwestern Medical 1,000,000 Allred
Services Administration-- Center, Dallas, TX for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and University of Texas Southwestern Medical 800,000 Johnson (TX)
Services Administration-- Center, Dallas, TX for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and University of Toledo Medical Center, 500,000 Kaptur
Services Administration-- Toledo, OH for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Urban Health Plan, Bronx, NY for 500,000 Torres (NY)
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Urban Health Plan, Inc., Corona, NY for 100,000 Ocasio-Cortez
Services Administration-- facilities and equipment, including
Program Management. telehealth equipment.
Department of Health & Human Services. Health Resources and Veterans Transition House, New Bedford, 375,000 Keating
Services Administration-- MA for a telehealth and electronic
Program Management. medical records initiative, including
the purchase of equipment.
Department of Health & Human Services. Health Resources and Via Care Community Health Center, Los 150,000 Chu
Services Administration-- Angeles, CA for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Village of Dwight, Dwight, IL for 250,000 Kinzinger
Services Administration-- equipment.
Program Management.
Department of Health & Human Services. Health Resources and Vinland National Center, Loretto, MN for 500,000 Emmer
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and Virginia Garcia Memorial Health Center, 2,000,000 Bonamici
Services Administration-- Hillsboro, OR for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Visiting Nurse Association of Central 700,000 Smith (NJ)
Services Administration-- Jersey Freehold Family Health Center,
Program Management. Freehold, NJ for facilities and
equipment.
Department of Health & Human Services. Health Resources and Visiting Nurse Association of Central 400,000 Smith (NJ)
Services Administration-- Jersey Red Bank Primary Care Center,
Program Management. Red Bank, NJ for facilities and
equipment.
Department of Health & Human Services. Health Resources and Washington Hospital Foundation, 1,210,000 Reschenthaler
Services Administration-- Washington, PA for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and WEAVE INC., Sacramento, CA for 275,000 Bera
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and Wenatchee Valley College, Omak, WA for 2,000,000 Newhouse
Services Administration-- facilities.
Program Management.
Department of Health & Human Services. Health Resources and West Central Alabama Area Health 300,000 Sewell
Services Administration-- Education Center, Demopolis, AL for a
Program Management. community health worker initiative and
purchase of equipment.
Department of Health & Human Services. Health Resources and Westchester Public/Private Membership 375,000 Bowman
Services Administration-- Fund for Aging Services, Mount Vernon,
Program Management. NY for telehealth, including telehealth
equipment.
Department of Health & Human Services. Health Resources and Wheeling Health Right, Wheeling, WV for 350,000 McKinley
Services Administration-- facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and White Memorial Medical Center, Los 1,200,000 Gomez
Services Administration-- Angeles, CA for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and Will-Grundy Medical Clinic Inc., Joliet, 300,000 Foster
Services Administration-- IL for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and William F. Ryan Community Health Center, 2,000,000 Nadler
Services Administration-- Inc., New York, NY for facilities and
Program Management. equipment.
Department of Health & Human Services. Health Resources and WINGS Program Inc., Rolling Meadows, IL 250,000 Krishnamoorthi
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Winters Health Foundation, Winters, CA 500,000 Garamendi
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Wood River Health Services, Hope Valley, 1,000,000 Langevin
Services Administration-- RI for facilities and equipment.
Program Management.
Department of Health & Human Services. Health Resources and Young Men's Christian Association of 2,000,000 Adams
Services Administration-- Greater Charlotte, Charlotte, NC for
Program Management. facilities and equipment.
Department of Health & Human Services. Health Resources and Youthbuild Louisville , Louisville, KY 600,000 Yarmuth
Services Administration-- for facilities and equipment.
Program Management.
Department of Health & Human Services. Substance Abuse and Access Community Health Network, 140,000 Krishnamoorthi
Mental Health Services Chicago, IL for behavioral health and
Administration--Health supportive services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Adult & Teen Challenge USA, Ozark, MO 475,000 Long
Mental Health Services for recovery support services,
Administration--Health equipment, and technology.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and AdventHealth, Sanford, FL for substance 400,000 Murphy (FL)
Mental Health Services use treatment and support services.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and All Star Children's Foundation, 1,500,000 Buchanan
Mental Health Services Sarasota, FL for child welfare and
Administration--Health trauma services program and associated
Surveillance and Program support services.
Support.
Department of Health & Human Services. Substance Abuse and Arlington County Government, Arlington, 390,000 Beyer
Mental Health Services VA for a mobile mental health crisis
Administration--Health reponse team.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Ashley, Inc., Havre de Grace, MD for a 525,000 Ruppersberger
Mental Health Services substance use treatment program
Administration--Health partnership to identify, implement, and
Surveillance and Program broadly disseminate new forms of SUD
Support. treatment targeted to underserved
populations.
Department of Health & Human Services. Substance Abuse and Assisted Recovery Centers of America, 1,300,000 Bush
Mental Health Services St. Louis, MO for mental health and
Administration--Health substance use treatment and other
Surveillance and Program wraparound services.
Support.
Department of Health & Human Services. Substance Abuse and Baltimore City Health Department, 475,000 Mfume
Mental Health Services Baltimore, MD for a mobile unit
Administration--Health providing clinical SUD treatment and
Surveillance and Program other services.
Support.
Department of Health & Human Services. Substance Abuse and Behavioral Health Network of Vermont 1,150,000 Welch
Mental Health Services Inc., Montpelier, VT for Wheels and
Administration--Health Waves opiate use disorder treatment
Surveillance and Program program.
Support.
Department of Health & Human Services. Substance Abuse and BJC Healthcare, St. Louis, MO for 800,000 Bush
Mental Health Services behavioral health services for people
Administration--Health experiencing homelessness.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Capital Clubhouse Inc., Washington, DC 210,000 Norton
Mental Health Services for mental health and other support
Administration--Health services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Cascade AIDS Project, Portland, OR for 850,000 Blumenauer
Mental Health Services behavioral health services, including
Administration--Health medication assisted treatment.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Champions In Service, Pacoima, CA for 200,000 Tony Cardenas
Mental Health Services mental health and substance use
Administration--Health disorder treatment and services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Change the Outcome, Chanhassen, MN for 375,000 Phillips
Mental Health Services substance use prevention and treatment
Administration--Health services for youth and young adults.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Children's Fund, Inc., San Bernardino, 100,000 Aguilar
Mental Health Services CA for trauma-informed mental health
Administration--Health care for children.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Children's Health System of Texas, 900,000 Johnson (TX); Allred;
Mental Health Services Dallas, TX for children's mental health Veasey
Administration--Health services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Children's Hospital of Orange County, 325,000 Correa
Mental Health Services Orange, CA for mental health treatment
Administration--Health services and programs for children and
Surveillance and Program families.
Support.
Department of Health & Human Services. Substance Abuse and Chinese-American Planning Council, New 500,000 Nydia M. Velazquez
Mental Health Services York, NY for mental health services,
Administration--Health including outreach, education and other
Surveillance and Program support services.
Support.
Department of Health & Human Services. Substance Abuse and City of Augusta, ME for Project 265,000 Pingree
Mental Health Services Recovery, to increase access to
Administration--Health substance use treatment and recovery
Surveillance and Program services.
Support.
Department of Health & Human Services. Substance Abuse and City of Azusa, CA for mental health and 560,000 Napolitano
Mental Health Services support services through the Azusa Teen
Administration--Health and Family Center.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of Dublin, CA for a Mental Health 450,000 Swalwell
Mental Health Services Urgent Care Center to provide access to
Administration--Health mental health crisis care.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of Indianapolis, IN for mental 500,000 Andre Carson
Mental Health Services health and substance use treatment
Administration--Health services for people in need of
Surveillance and Program permanent supportive housing.
Support.
Department of Health & Human Services. Substance Abuse and City of Laredo, TX for a substance use 2,000,000 Cuellar
Mental Health Services treatment center.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of Murrieta, CA for homeless 500,000 Calvert
Mental Health Services services.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of Oakland, CA for the Oakland 1,230,000 Lee (CA)
Mental Health Services Mental Health Resilience project.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of Palo Alto, CA for a mental 2,000,000 Eshoo
Mental Health Services health crisis response team.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of Round Rock, TX for behavioral 1,000,000 Carter (TX)
Mental Health Services health services mobile outreach and
Administration--Health associated information technology.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of Seattle, WA for behavioral 775,000 Smith (WA)
Mental Health Services health crisis response through the
Administration--Health Health One program.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and City of St. Louis Mental Health Board of 600,000 Bush
Mental Health Services Trustees, St. Louis, MO for behavioral
Administration--Health health and trauma prevention services
Surveillance and Program for people impacted by gun violence.
Support.
Department of Health & Human Services. Substance Abuse and Clearfield Educational Foundation Inc., 1,020,000 Thompson (PA)
Mental Health Services Clearfield, PA for mental health and
Administration--Health substance abuse services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Columbia University Irving Medical 750,000 Espaillat
Mental Health Services Center, New York, NY for community-
Administration--Health based mental health services, including
Surveillance and Program training and service delivery.
Support.
Department of Health & Human Services. Substance Abuse and Adventist Health System West, Roseville, 985,000 Garamendi
Mental Health Services CA for mental health and substance use
Administration--Health disorder services, including wraparound
Surveillance and Program services.
Support.
Department of Health & Human Services. Substance Abuse and Community Action of Greater Indianapolis 75,000 Andre Carson
Mental Health Services Inc, Indianapolis, IN for behavioral
Administration--Health health treatment and services,
Surveillance and Program including supportive services.
Support.
Department of Health & Human Services. Substance Abuse and Contra Costa County Health Services 1,100,000 DeSaulnier
Mental Health Services Department--Behavioral Health Division,
Administration--Health Martinez, CA for mobile behavioral
Surveillance and Program health crisis response teams.
Support.
Department of Health & Human Services. Substance Abuse and County of Burlington, Mount Holly, NJ 300,000 Kim (NJ)
Mental Health Services for substance use disorder treatment
Administration--Health and recovery services through the Hope
Surveillance and Program One initiative.
Support.
Department of Health & Human Services. Substance Abuse and Covenant House Georgia, Atlanta, GA for 190,000 Williams (GA)
Mental Health Services mental health and supportive services
Administration--Health for families experiencing homelessness.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Delaware County Department of Human 650,000 Scanlon
Mental Health Services Services, Upper Darby, PA for mobile
Administration--Health crisis teams to respond to behavioral
Surveillance and Program health emergencies.
Support.
Department of Health & Human Services. Substance Abuse and Erie County Department of Health, 1,000,000 Higgins (NY)
Mental Health Services Buffalo, NY for peer support workers to
Administration--Health improve access to substance use
Surveillance and Program treatment and recovery services.
Support.
Department of Health & Human Services. Substance Abuse and Essex County Community Foundation, 700,000 Moulton
Mental Health Services Danvers, MA for mental health services
Administration--Health targeted to populations
Surveillance and Program disproportionately affected by COVID-19.
Support.
Department of Health & Human Services. Substance Abuse and Fifth Ward Community Redevelopment 1,000,000 Jackson Lee
Mental Health Services Corporation, Houston, TX for community
Administration--Health mental health treatment and support
Surveillance and Program services.
Support.
Department of Health & Human Services. Substance Abuse and First Behavioral Health Care Center, 310,000 Harder (CA)
Mental Health Services Turlock, CA to expand access to mental
Administration--Health health services, including a public
Surveillance and Program awareness campaign.
Support.
Department of Health & Human Services. Substance Abuse and Franciscan Health Olympia Fields, 625,000 Kelly (IL)
Mental Health Services Olympia Fields, IL for behavioral
Administration--Health health telemedicine.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Franklin County Opioid Task Force, 200,000 Neal
Mental Health Services Greenfield, MA to support individuals
Administration--Health in recovery from alcohol and other
Surveillance and Program substance use disorder to re-enter the
Support. workforce.
Department of Health & Human Services. Substance Abuse and Frederick County Government, Frederick, 850,000 Raskin; Trone
Mental Health Services MD for a behavioral health Crisis
Administration--Health Stabilization Center.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Friends of the Children, Portland, OR 750,000 Blumenauer
Mental Health Services for mentoring services for children.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Gads Hill Center, Chicago, IL for trauma- 350,000 Jesus G. ``Chuy'' Garcia
Mental Health Services informed mental and behavioral health
Administration--Health services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Garden State Equality, Asbury Park, NJ 175,000 Norcross
Mental Health Services to address the impacts of trauma on
Administration--Health mental health for LGBTQ and BIPOC youth.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Georgia Council on Substance Abuse, 30,000 McBath
Mental Health Services Atlanta, GA for recovery services,
Administration--Health including education, training and peer
Surveillance and Program recovery support services.
Support.
Department of Health & Human Services. Substance Abuse and Georgia State University, Atlanta, GA 200,000 Williams (GA)
Mental Health Services for mental health services and other
Administration--Health supports for children who have
Surveillance and Program experienced trauma.
Support.
Department of Health & Human Services. Substance Abuse and Great Lakes Dryhootch, Inc., Milwaukee, 155,000 Moore (WI)
Mental Health Services WI for the Dryhootch Quick Reaction
Administration--Health Force program to provide mental health
Surveillance and Program services for veterans.
Support.
Department of Health & Human Services. Substance Abuse and Greater Flint Health Coalition, Flint, 750,000 Kildee
Mental Health Services MI for a Community Information
Administration--Health Exchange, for mental health prevention
Surveillance and Program and treatment activities, including
Support. equipment and technology.
Department of Health & Human Services. Substance Abuse and Hartford Communities that Care, 630,000 Larson (CT)
Mental Health Services Hartford, CT for the Hartford Care
Administration--Health Response Team, a hospital linked
Surveillance and Program violence intervention program.
Support.
Department of Health & Human Services. Substance Abuse and Healthier Kids Foundation, San Jose, CA 400,000 Eshoo
Mental Health Services for a preventive mental health program
Administration--Health for students.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Hedwig House, Inc, Lansdale, PA for 270,000 Dean
Mental Health Services mental health services, including
Administration--Health treatment and other supportive services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Holy Redeemer Hospital, Huntingdon 250,000 Dean
Mental Health Services Valley, PA for a Neonatal Abstinence
Administration--Health Syndrome program, including equipment
Surveillance and Program and wraparound services.
Support.
Department of Health & Human Services. Substance Abuse and Hope of the Valley Rescue Mission, 2,000,000 Sherman
Mental Health Services Pacoima, CA for mental health and
Administration--Health substance use treatment and services
Surveillance and Program for people experiencing homelessness,
Support. and training for the mental health
workforce.
Department of Health & Human Services. Substance Abuse and Hope Services, San Jose, CA for mental 160,000 Speier
Mental Health Services health services for people with
Administration--Health developmental disabilities.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and John Morroni Legacy Foundation, 500,000 Crist
Mental Health Services Clearwater, FL for mental health
Administration--Health treatment and services for first
Surveillance and Program responders.
Support.
Department of Health & Human Services. Substance Abuse and Kane County State's Attorney's Office, 350,000 Underwood
Mental Health Services St. Charles, IL for a pre-arrest
Administration--Health diversion initiative based on the Law
Surveillance and Program Enforcement Assisted Diversion model.
Support.
Department of Health & Human Services. Substance Abuse and Latino Organization of the Southwest, 500,000 Newman
Mental Health Services Chicago, IL for a teen support program,
Administration--Health including equipment and technology.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Lesbian and Gay Community Services 350,000 Nadler
Mental Health Services Center, Inc., New York, NY for mental
Administration--Health health counseling and substance use
Surveillance and Program treatment services.
Support.
Department of Health & Human Services. Substance Abuse and Lexington-Fayette Urban County 620,000 Barr
Mental Health Services Government, Lexington, KY for the
Administration--Health purchase of equipment and recovery
Surveillance and Program support services.
Support.
Department of Health & Human Services. Substance Abuse and Lifeline Connections, Vancouver, WA for 50,000 Herrera Beutler
Mental Health Services a mentor program.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Long Island Crisis Center, Inc., 150,000 Rice (NY)
Mental Health Services Bellmore, NY for behavioral health
Administration--Health services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and LOVE Program, Rialto, CA to provide 380,000 Torres (CA)
Mental Health Services mental health and substance use
Administration--Health disorder treatment services and
Surveillance and Program diversion programs for juveniles in the
Support. criminal justice system.
Department of Health & Human Services. Substance Abuse and Maimonides Medical Center, Brooklyn, NY 700,000 Nadler
Mental Health Services for mental health and supportive
Administration--Health services for parents and infants.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Massachusetts Executive Office for 1,650,000 Trahan
Mental Health Services Health and Human Services, Boston, MA
Administration--Health to establish the Middlesex County
Surveillance and Program Restoration Center to provide
Support. behavioral health crisis and urgent
care services, and other supportive
services.
Department of Health & Human Services. Substance Abuse and Maui Economic Opportunity, Inc., 100,000 Kahele
Mental Health Services Wailuku, HI for alcohol and tobacco
Administration--Health prevention activities for youth.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and MedCura Health, Stone Mountain, GA for 300,000 Johnson (GA)
Mental Health Services mental health services for people
Administration--Health experiencing homelessness.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Mental Health Association of Essex and 300,000 Sherrill
Mental Health Services Morris, Inc., Parsippany, NJ for
Administration--Health suicide prevention services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Mental Health Partners, Lafayette, CO to 275,000 Neguse
Mental Health Services provide community mental health and
Administration--Health well-being services to mitigate the
Surveillance and Program long term impacts of trauma.
Support.
Department of Health & Human Services. Substance Abuse and Mile High United Way, Denver, CO for 100,000 DeGette
Mental Health Services behavioral health services for young
Administration--Health adults experiencing homelessness.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Milestone Recovery, Portland, ME for a 690,000 Pingree
Mental Health Services substance use disorder outpatient
Administration--Health treatment and support program.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Monroe County Office of Mental Health, 265,000 Morelle
Mental Health Services Rochester, NY for peer advocate
Administration--Health training.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Mount Vernon Neighborhood Health Center, 100,000 Bowman
Mental Health Services Mount Vernon, NY for behavioral health
Administration--Health services for homebound elderly and
Surveillance and Program disabled adults.
Support.
Department of Health & Human Services. Substance Abuse and New Hampshire Chapter of the National 380,000 Kuster
Mental Health Services Alliance on Mental Illness, Concord, NH
Administration--Health for the Connect Suicide Prevention
Surveillance and Program Program.
Support.
Department of Health & Human Services. Substance Abuse and NYC Health + Hospitals/Jacobi, Bronx, NY 400,000 Ocasio-Cortez; Bowman
Mental Health Services for the Stand Up to Violence program to
Administration--Health provide youth mental health and
Surveillance and Program substance use treatment services and
Support. other support services.
Department of Health & Human Services. Substance Abuse and Oakland County Health Network, Troy, MI 260,000 Stevens
Mental Health Services for mental health and law enforcement
Administration--Health co-response for behavioral health
Surveillance and Program crises, including Crisis Intervention
Support. Team and Mental Health First Aid
training.
Department of Health & Human Services. Substance Abuse and Office of the Mayor-President, City of 1,000,000 Troy A. Carter
Mental Health Services Baton Rouge, LA for a resource and
Administration--Health service center for recovery from trauma.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Oklahoma Children's Hospital, Oklahoma 1,000,000 Cole
Mental Health Services City, OK for facilities, equipment, and
Administration--Health children's behavioral health services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Orange County Government, Orlando, FL 300,000 Demings
Mental Health Services for behavioral health services for
Administration--Health students.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Oswego County Department of Social 250,000 Katko
Mental Health Services Services, Oswego, NY for transportation.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Para Los Ninos, Los Angeles, CA for 350,000 Schiff
Mental Health Services early childhood mental health services
Administration--Health and family supports, including
Surveillance and Program technology to provide telehealth
Support. services.
Department of Health & Human Services. Substance Abuse and Parents Anonymous, Claremont, CA for 1,000,000 Chu
Mental Health Services mental health services for Asian,
Administration--Health Latinx and Black/African American
Surveillance and Program families.
Support.
Department of Health & Human Services. Substance Abuse and Parkview Legacy Foundation, Riverside, 625,000 Takano
Mental Health Services CA for behavioral health focused
Administration--Health programs for students returning to
Surveillance and Program school after COVID-19.
Support.
Department of Health & Human Services. Substance Abuse and Path with Art, Seattle, WA for mental 210,000 Jayapal
Mental Health Services health and trauma recovery programming.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Penny Lane Centers, North Hills, CA to 400,000 Tony Cardenas
Mental Health Services provide mental health care and
Administration--Health supportive services to people
Surveillance and Program experiencing homelessness.
Support.
Department of Health & Human Services. Substance Abuse and Polk County Board of Commissioners, 850,000 Soto
Mental Health Services Bartow, FL for a behavioral health
Administration--Health outreach mobile crisis team.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and PRC, San Francisco, CA for behavioral 525,000 Pelosi
Mental Health Services health services for people experiencing
Administration--Health homelessness.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Rales Jewish Family Services, Boca 400,000 Deutch
Mental Health Services Raton, FL for telemental health
Administration--Health services to address mental illness and
Surveillance and Program substance use, including equipment and
Support. technology.
Department of Health & Human Services. Substance Abuse and Reliance Health, Inc., Norwich, CT for a 125,000 Courtney
Mental Health Services recovery support program.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Rick's Place, Wilbraham, MA for grief 100,000 Neal
Mental Health Services support services.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Rosecrance, Inc, Freeport, IL for a 300,000 Bustos
Mental Health Services behavioral health outpatient clinic.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and San Francisco AIDS Foundation, San 600,000 Pelosi
Mental Health Services Francisco, CA for mental health and
Administration--Health substance use treatment and services,
Surveillance and Program including case management services, for
Support. long term survivors of HIV/AIDS.
Department of Health & Human Services. Substance Abuse and Sankofa Safe Child Initiative, Chicago, 275,000 Davis, Danny K.
Mental Health Services IL for mental health services for teens
Administration--Health who have experienced trauma.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Santa Clara County Office of Education, 300,000 Khanna
Mental Health Services San Jose, CA for prevention and early
Administration--Health intervention services to address
Surveillance and Program student mental health and trauma.
Support.
Department of Health & Human Services. Substance Abuse and Selfhelp Community Services, New York, 15,000 Meng
Mental Health Services NY for mental health and emotional
Administration--Health wellness activities for seniors.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Sociedad de Educacion y Rehabilitacion 180,000 Jenniffer Gonzalez-Colon
Mental Health Services (SER) de Puerto Rico, Inc., San Juan,
Administration--Health PR for behavioral intervention services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Sonoma County, Santa Rosa, CA for the 1,600,000 Thompson (CA)
Mental Health Services Accessing Coordinated Care and
Administration--Health Empowering Self Sufficiency program to
Surveillance and Program provide mental health and substance use
Support. screening, treatment and other
services, including equipment and
technology.
Department of Health & Human Services. Substance Abuse and Stanislaus County Behavioral Health and 1,810,000 Harder (CA)
Mental Health Services Recovery Services, Modesto, CA for
Administration--Health mental health services through the
Surveillance and Program Promotores/Community Health Outreach
Support. Worker program and Community-Based
Mental Health Clinicians.
Department of Health & Human Services. Substance Abuse and Starr Commonwealth, Albion, MI for 850,000 Meijer
Mental Health Services facilities, equipment, and mental and
Administration--Health behavioral health services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Swords to Plowshares, San Francisco, CA 975,000 Pelosi
Mental Health Services for mental health and substance use
Administration--Health treatment services, case management and
Surveillance and Program other support services for veterans.
Support.
Department of Health & Human Services. Substance Abuse and Texas State University, San Marcos, TX 2,000,000 Doggett
Mental Health Services for a Community Mental Health
Administration--Health Surveillance Collaborative to
Surveillance and Program strengthen mental health
Support. infrastructure, including training,
equipment, and technology.
Department of Health & Human Services. Substance Abuse and The Community Rehabilitation Center, 500,000 Lawson (FL)
Mental Health Services Inc., Jacksonville, FL to increase
Administration--Health access to and improve quality of mental
Surveillance and Program health, health care, and substance use
Support. disorder treatment services.
Department of Health & Human Services. Substance Abuse and The Greater Scranton YMCA, Dunmore, PA 1,850,000 Cartwright
Mental Health Services for mental health and substance use
Administration--Health disorder treatment services, including
Surveillance and Program wraparound services.
Support.
Department of Health & Human Services. Substance Abuse and The Greater Washington Jewish Coalition 300,000 Raskin
Mental Health Services Against Domestic Abuse, Rockville, MD
Administration--Health to provide mental health and other
Surveillance and Program support services for domestic violence
Support. survivors and their families.
Department of Health & Human Services. Substance Abuse and The University Corporation dba Strength 1,000,000 Sherman
Mental Health Services United, Northridge, CA to address the
Administration--Health long-term mental health needs of
Surveillance and Program children following the COVID-19
Support. pandemic, including suicide prevention
activities, equipment and technology.
Department of Health & Human Services. Substance Abuse and TriCounty Community Network, Pottstown, 450,000 Dean
Mental Health Services PA for mental health screening and
Administration--Health treatment services, and other support
Surveillance and Program services.
Support.
Department of Health & Human Services. Substance Abuse and UCHealth Trauma Services, Aurora, CO for 450,000 Crow
Mental Health Services an at-risk intervention and mentoring
Administration--Health violence prevention program, including
Surveillance and Program mental health treatment and other
Support. services.
Department of Health & Human Services. Substance Abuse and United Way of Broward County, Ft. 650,000 Deutch
Mental Health Services Lauderdale, FL for a suicide prevention
Administration--Health program.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Unlawful Narcotics Investigations, 500,000 Rogers (KY)
Mental Health Services Treatment, and Education, Inc., London,
Administration--Health KY for substance abuse prevention and
Surveillance and Program the purchase of equipment and
Support. information technology.
Department of Health & Human Services. Substance Abuse and UPMC Western Behavioral Health at Twin 100,000 Joyce (PA)
Mental Health Services Lakes, Somerset, PA for recovery
Administration--Health support services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Valley Youth House, Bethlehem, PA for 400,000 Wild
Mental Health Services mental health services for at-risk
Administration--Health children and families.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Veterans Inc., Worcester, MA for 430,000 McGovern
Mental Health Services behavioral health services for veterans
Administration--Health and their families.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Village of Schaumburg, Schaumburg, IL 340,000 Krishnamoorthi
Mental Health Services for a mobile response unit for mental
Administration--Health health and substance misuse.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Vinland National Center, Loretto, MN for 140,000 Phillips
Mental Health Services mental health and substance use
Administration--Health treatment services, and other support
Surveillance and Program services, for people with brain
Support. injuries.
Department of Health & Human Services. Substance Abuse and Washington County Health Department, 475,000 Trone
Mental Health Services Hagerstown, MD for behavioral health
Administration--Health crisis treatment services.
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and Woods Services, Inc., Langhorne, PA for 500,000 Fitzpatrick
Mental Health Services mental health services.
Administration--Health
Surveillance and Program
Support.
Department of Health & Human Services. Substance Abuse and YWCA NH, Manchester, NH for mental 750,000 Pappas
Mental Health Services health care and support services for
Administration--Health children and families exposed to trauma.
Surveillance and Program
Support.
Department of Labor................... Employment and Training AIDS Service Center of Lower Manhattan, 1,000,000 Maloney, Carolyn B.
Administration--Training Inc. dba Alliance for Positive Change,
and Employment Services. New York, NY for a workforce
development initiative.
Department of Labor................... Employment and Training Anne Arundel County Government, 500,000 Brown
Administration--Training Annapolis, MD for Youthworks!.
and Employment Services.
Department of Labor................... Employment and Training Arizona Opportunities Industrialization 1,200,000 Gallego
Administration--Training Center, Phoenix, AZ for the provision
and Employment Services. of comprehensive training courses and
job placement in the hospitality
industry.
Department of Labor................... Employment and Training Avivo, Minneapolis, MN for workforce 1,000,000 Omar
Administration--Training training related to clean energy and
and Employment Services. green building, including equipment.
Department of Labor................... Employment and Training Benedict College, Columbia, SC for 2,000,000 Clyburn
Administration--Training workforce development activities,
and Employment Services. including technology, equipment, and
supportive services.
Department of Labor................... Employment and Training Beyond the Sanctuary, Inc., Rochester, 525,000 Morelle
Administration--Training NY for job readiness program, including
and Employment Services. equipment and supportive services.
Department of Labor................... Employment and Training Bristol County Chamber Foundation, Fall 500,000 Keating
Administration--Training River, MA for workforce development
and Employment Services. activities.
Department of Labor................... Employment and Training Broward College, Ft. Lauderdale, FL for 2,000,000 Wasserman Schultz
Administration--Training workforce development initiative,
and Employment Services. including mobile training units.
Department of Labor................... Employment and Training Buffalo Sewer Authority, Buffalo, NY for 575,000 Higgins (NY)
Administration--Training a workforce development initiative
and Employment Services. related to green infrastructure,
including equipment, stipends, and
supportive services.
Department of Labor................... Employment and Training California Mobility Center, Sacremento, 2,000,000 Matsui
Administration--Training CA for a workforce development
and Employment Services. initiative, including equipment.
Department of Labor................... Employment and Training City of Boston, MA for short-term 1,000,000 Pressley
Administration--Training training programs, including stipends.
and Employment Services.
Department of Labor................... Employment and Training City of East Providence, RI for a 350,000 Cicilline
Administration--Training training program.
and Employment Services.
Department of Labor................... Employment and Training City of Greensboro, NC for a workforce 1,600,000 Manning
Administration--Training development initiative, including
and Employment Services. technology and supportive services.
Department of Labor................... Employment and Training City of Houston, TX for a workforce 750,000 Green, Al (TX)
Administration--Training development initiative related to a
and Employment Services. solar initiative, including job-
placement, stipends, and supportive
services.
Department of Labor................... Employment and Training City of Perris, CA for a workforce 1,000,000 Takano
Administration--Training development initiative.
and Employment Services.
Department of Labor................... Employment and Training City of South San Francisco, CA, for 500,000 Speier
Administration--Training workforce development services,
and Employment Services. including career services and job
placement.
Department of Labor................... Employment and Training Coalition for Responsible Community 250,000 Roybal-Allard
Administration--Training Development, Los Angeles, CA for
and Employment Services. transitional employment and training
for formerly incarcerated adults,
including supportive services.
Department of Labor................... Employment and Training College of Eastern Idaho, Idaho Falls, 100,000 Simpson
Administration--Training ID for workforce training program and
and Employment Services. equipment.
Department of Labor................... Employment and Training College of Lake County, Grayslake, IL 900,000 Schneider
Administration--Training for a workforce development initiative
and Employment Services. related to manufacturing, including
equipment.
Department of Labor................... Employment and Training Colonial Farmhouse Restoration Society 200,000 Suozzi
Administration--Training of Bellerose, Inc., Floral Park, NY for
and Employment Services. a workforce training initiative,
including equipment.
Department of Labor................... Employment and Training Community Assistance Programs, Chicago, 100,000 Rush
Administration--Training IL for job training, job placement and
and Employment Services. supportive services.
Department of Labor................... Employment and Training Comunidades Organizando el Poder y la 1,000,000 Omar
Administration--Training Accion Latina Education Fund,
and Employment Services. Minneapolis, MN for workforce
development activities, including
equipment.
Department of Labor................... Employment and Training Cornerstone Revitalization Foundation, 1,500,000 Sewell
Administration--Training Inc., Birmingham, AL for workforce
and Employment Services. development activities. Including
opprtunities to obtain a GED,
postsecondary credentials, and stipends.
Department of Labor................... Employment and Training Council for Native Hawaiian Advancement, 1,200,000 Kahele
Administration--Training Kapolei, HI for workforce training
and Employment Services. programs.
Department of Labor................... Employment and Training Covenant House Florida, Ft. Lauderdale, 300,000 Deutch
Administration--Training FL for work-based learning and
and Employment Services. supportive services for homeless youth.
Department of Labor................... Employment and Training DC Central Kitchen, Washington, DC for 500,000 Norton
Administration--Training culinary job training, including
and Employment Services. stipends and equipment.
Department of Labor................... Employment and Training Dream It Do It Western New York Inc., 250,000 Reed
Administration--Training Jamestown, NY for job training and
and Employment Services. placement.
Department of Labor................... Employment and Training Eclectic Soul VOICES Corporation, 100,000 Andre Carson
Administration--Training Indianapolis, IN for a job training
and Employment Services. program, including supportive services
and stipends.
Department of Labor................... Employment and Training Emerald Isle Immigration Center, 60,000 Ocasio-Cortez
Administration--Training Woodside, NY for workforce development
and Employment Services. activities, including career and
supportive services.
Department of Labor................... Employment and Training Fairfax County Government, Fairfax, VA 1,000,000 Connolly
Administration--Training for a job training program for pregnant
and Employment Services. and parenting teens and non-parenting
young adults, including equipment.
Department of Labor................... Employment and Training Fairfax County Government, Fairfax, VA 400,000 Connolly
Administration--Training for an apprenticeship training program,
and Employment Services. including stipends.
Department of Labor................... Employment and Training Florida Endowment Foundation for 1,500,000 Steube
Administration--Training Florida's Graduates, Flagler Beach, FL
and Employment Services. for an at-risk youth jobs program.
Department of Labor................... Employment and Training Frederick County Government, Frederick, 250,000 Raskin
Administration--Training MD for a mobile career center.
and Employment Services.
Department of Labor................... Employment and Training Hire Heroes USA, Alpharetta, GA for job 625,000 Bourdeaux
Administration--Training placement and career services for
and Employment Services. veterans.
Department of Labor................... Employment and Training iFoster, Inc., Las Vegas, NV for a 150,000 Horsford
Administration--Training workforce development and readiness
and Employment Services. program.
Department of Labor................... Employment and Training Jewish Family Service of Colorado, 500,000 DeGette
Administration--Training Denver, CO for workforce development
and Employment Services. activities, including technology and
equipment.
Department of Labor................... Employment and Training Kent State University at Tuscarawas, New 250,000 Gibbs
Administration--Training Philadelphia, OH for advanced
and Employment Services. manufacturing equipment and training.
Department of Labor................... Employment and Training Kentucky Capital Development 440,000 Barr
Administration--Training Corporation, Frankfort, KY for
and Employment Services. cybersecurity/IT workforce development.
Department of Labor................... Employment and Training La Colaborativa/Chelsea Collaborative, 300,000 Pressley
Administration--Training Chelsea, MA for workforce development
and Employment Services. initiative.
Department of Labor................... Employment and Training Lansing Community College, Lansing, MI 400,000 Slotkin
Administration--Training for mobile skills laboratories,
and Employment Services. including equipment.
Department of Labor................... Employment and Training Living Classrooms Foundation, Baltimore, 750,000 Ruppersberger; Sarbanes
Administration--Training MD for workforce development
and Employment Services. activities, including technology.
Department of Labor................... Employment and Training Macomb County, Clinton Township, MI for 525,000 Levin (MI)
Administration--Training workforce development and certification
and Employment Services. courses, including technology and
supportive services.
Department of Labor................... Employment and Training Make the Road New York, Jackson Heights, 400,000 Meng
Administration--Training NY for workforce development, including
and Employment Services. adult education and equipment.
Department of Labor................... Employment and Training Mary's Mercy Center, Inc., San 300,000 Aguilar
Administration--Training Bernadino, CA for a training program
and Employment Services. and supportive services.
Department of Labor................... Employment and Training Mecklenburg County, Charlotte, NC for a 1,000,000 Adams
Administration--Training training program and supportive
and Employment Services. services.
Department of Labor................... Employment and Training Meristem, Inc., Fair Oaks, CA for a 450,000 Bera
Administration--Training training program for individuals with
and Employment Services. autism, including stipends.
Department of Labor................... Employment and Training Mi Casa Resource Center, Denver, CO for 20,000 DeGette
Administration--Training a workforce development program.
and Employment Services.
Department of Labor................... Employment and Training Milwaukee Metropolitan Sewerage 1,000,000 Moore (WI)
Administration--Training District, Milwaukee, WI for a workforce
and Employment Services. development initiative, including
equipment and stipends.
Department of Labor................... Employment and Training Montgomery County, Office of Broadband 1,000,000 Trone
Administration--Training Programs, Rockville, MD for a
and Employment Services. technology job training pilot program,
including equipment and supportive
services.
Department of Labor................... Employment and Training Multi-Craft Apprenticeship Preparation 200,000 Morelle
Administration--Training Program, Inc., Rochester, NY for
and Employment Services. workforce development initiative,
including stipends and equipment.
Department of Labor................... Employment and Training National Institute for Medical Assistant 450,000 Perlmutter
Administration--Training Advancement, Denver, CO for a training
and Employment Services. program, including technology and
equipment.
Department of Labor................... Employment and Training Neighborhood House Incorporated, 275,000 Jayapal
Administration--Training Seattle, WA for job placement and
and Employment Services. career services.
Department of Labor................... Employment and Training Neighbors and Neighbors Association, 500,000 Gimenez
Administration--Training Inc., Miami, FL for work readiness and
and Employment Services. vocational training.
Department of Labor................... Employment and Training New Century Careers, Pittsburgh, PA for 500,000 Doyle, Michael F.
Administration--Training pre-apprenticeship and apprenticeship
and Employment Services. programs in advanced manufacturing,
including job placement services..
Department of Labor................... Employment and Training New Jersey Chamber of Commerce 270,000 Van Drew
Administration--Training Foundation, Trenton, NJ for student
and Employment Services. training and equipment, including
information technology.
Department of Labor................... Employment and Training Newark Emergency Services for Families 325,000 Payne
Administration--Training (NESF), Newark, NJ for a workforce
and Employment Services. readiness program for hard-to-serve
target populations.
Department of Labor................... Employment and Training Northern Maine Community College, 1,000,000 Golden
Administration--Training Presque Isle, ME for a mechanized
and Employment Services. logging operations training program,
including equipment.
Department of Labor................... Employment and Training Opportunities Industrialization Center 575,000 Boyle, Brendan F.
Administration--Training (d/b/a Philadelphia OIC), Philadelphia,
and Employment Services. PA for a healthcare-related job
training program, including equipment.
Department of Labor................... Employment and Training Opportunity Village, Las Vegas, NV for 525,000 Titus
Administration--Training workforce development initiative for
and Employment Services. individuals with intellectual and
related disabilities.
Department of Labor................... Employment and Training Para Los Ninos, Los Angeles, CA for a 350,000 Gomez
Administration--Training youth workforce development initiative,
and Employment Services. including career and supportive
services.
Department of Labor................... Employment and Training Passaic County Community College, 1,950,000 Pascrell
Administration--Training Patterson, NJ for workforce training
and Employment Services. and career coaching, including
equipment.
Department of Labor................... Employment and Training Path of Life Ministries, Riverside, CA 250,000 Takano
Administration--Training for workforce development activities,
and Employment Services. including supportive services and
stipends.
Department of Labor................... Employment and Training Philadelphia Works, Inc., Philadelphia, 1,000,000 Scanlon
Administration--Training PA for workforce development
and Employment Services. activities, including transitional
employment.
Department of Labor................... Employment and Training PIDC Community Capital, Philadelphia, PA 525,000 Scanlon
Administration--Training for workforce development activities,
and Employment Services. including technology and stipends.
Department of Labor................... Employment and Training Presbyterian Villages of Michigan, 600,000 Kildee
Administration--Training Flint, MI for a workforce development
and Employment Services. iniatitive, including a certification
program.
Department of Labor................... Employment and Training Prince George's County Office of Human 2,000,000 Brown
Administration--Training Resources Management, Largo, MD for a
and Employment Services. job training program.
Department of Labor................... Employment and Training Project QUEST, Inc., San Antonio, TX for 1,000,000 Castro (TX)
Administration--Training an education and training program,
and Employment Services. including supportive services.
Department of Labor................... Employment and Training Proyecto Del Barrio Inc., Arleta, CA for 300,000 Tony Cardenas
Administration--Training a job training program.
and Employment Services.
Department of Labor................... Employment and Training Quad County Urban League, Inc., Aurora, 425,000 Foster
Administration--Training IL for education and skills training to
and Employment Services. enter apprenticeships or positions in
construction or TDL industries,
including equipment.
Department of Labor................... Employment and Training San Jose Conservation Corps & Charter 275,000 Lofgren
Administration--Training School for workforce development
and Employment Services. iniatitive for youth, including
stipends and technology.
Department of Labor................... Employment and Training Second Harvest Food Bank of Central 775,000 Demings
Administration--Training Florida, Orlando, FL for a culinary
and Employment Services. workforce training program, including
internships, equipment, and supportive
services.
Department of Labor................... Employment and Training South Bay Workforce Investment Board, 500,000 Waters
Administration--Training Hawthorne, CA for workforce development
and Employment Services. activities, including supportive
services.
Department of Labor................... Employment and Training Southeast Michigan Community Alliance 850,000 Tlaib
Administration--Training Inc., Taylor, MI for a work-based
and Employment Services. learning program for at-risk in-school
youth age 14 or older, including
stipends and supportive services.
Department of Labor................... Employment and Training Southern California Regional 1,000,000 Lieu
Administration--Training Occupational Center, Torrance, CA for a
and Employment Services. workforce development initiative.
Department of Labor................... Employment and Training Southern Maine Community College, South 1,000,000 Golden
Administration--Training Portland, ME for welding workforce
and Employment Services. training, including equipment.
Department of Labor................... Employment and Training State of Hawaii Workforce Development 975,000 Case
Administration--Training Council, State of Hawaii Department of
and Employment Services. Labor and Industrial Relations,
Honolulu, HI for digital skills
literacy training.
Department of Labor................... Employment and Training Sunnyside Community Services, Sunnyside, 175,000 Ocasio-Cortez
Administration--Training NY for a workforce development
and Employment Services. initiative.
Department of Labor................... Employment and Training SUNY Maritime College, Bronx, NY for 800,000 Ocasio-Cortez; Suozzi
Administration--Training offshore wind energy training program,
and Employment Services. including equipment.
Department of Labor................... Employment and Training The Corporate Source, Garden City, NY 125,000 Rice (NY)
Administration--Training for IT training and certification
and Employment Services. training program for people with
disabilities, including equipment and
supportive services.
Department of Labor................... Employment and Training The HOPE Program, Bronx, NY for a job 800,000 Bowman
Administration--Training training program for green jobs to
and Employment Services. support justice-impacted invididuals,
including technology and equipment.
Department of Labor................... Employment and Training Tri-Council Development Fund, Aurora, IL 975,000 Foster
Administration--Training for a pre-apprenticeship program,
and Employment Services. including equipment and supportive
services.
Department of Labor................... Employment and Training TXRX LABS, Houston, TX for employment 550,000 Garcia (TX)
Administration--Training and training activities, an
and Employment Services. apprenticeship program, and a youth
STEM initiative..
Department of Labor................... Employment and Training Uintah Basin Technical College, 515,000 Moore (UT)
Administration--Training Roosevelt, UT for electrical apprentice
and Employment Services. training program and the purchase of
equipment.
Department of Labor................... Employment and Training United Community Services for Working 450,000 Houlahan
Administration--Training Families, Reading, PA for job training
and Employment Services. for youth, including stipends,
technology, and supportive services.
Department of Labor................... Employment and Training United Northeast Community Development 600,000 Andre Carson
Administration--Training Corporation, Indianapolis, IN for a job
and Employment Services. training iniativie, including
supportive services.
Department of Labor................... Employment and Training United Way of Central Jersey, Milltown, 425,000 Pallone
Administration--Training NJ for workforce development
and Employment Services. activities, including career and
supportive services.
Department of Labor................... Employment and Training United Way of Chester County, Exton, PA 100,000 Houlahan
Administration--Training for job training services.
and Employment Services.
Department of Labor................... Employment and Training United Way of Long Island, Deer Park, NY 700,000 Rice (NY)
Administration--Training for a YouthBuild program, including
and Employment Services. stipends.
Department of Labor................... Employment and Training United Way of Miami-Dade Inc., Miami, FL 250,000 Wilson (FL)
Administration--Training for job training activities and
and Employment Services. supportive services for veterans and
their families, including stipends,
technology, and supportive services.
Department of Labor................... Employment and Training University of Rochester, Rochester, NY 300,000 Morelle
Administration--Training for youth workforce development
and Employment Services. initiative for youth, including
technology and equipment.
Department of Labor................... Employment and Training UPROSE, Brooklyn, NY for workforce 175,000 Nydia M. Velazquez
Administration--Training development initiative.
and Employment Services.
Department of Labor................... Employment and Training Urban League of Hillsborough County, 300,000 Castor (FL)
Administration--Training Inc., Tampa, FL for preapprenticeships
and Employment Services. and paid internship programs, including
supportive services.
Department of Labor................... Employment and Training Vehicles for Change, Halethorpe, MD for 750,000 Sarbanes
Administration--Training a workforce training initiative,
and Employment Services. including stipends and equipment.
Department of Labor................... Employment and Training Warren County Employment & Training 205,000 Stefanik
Administration--Training Administration, Glens Falls, NY for job
and Employment Services. recruitment and training program,
including the purchase of information
technology.
Department of Labor................... Employment and Training Workforce Connections, Las Vegas, NV for 800,000 Titus
Administration--Training a workforce development initiative.
and Employment Services.
Department of Labor................... Employment and Training WorkSystems, Inc., Portland, OR for 1,000,000 Bonamici
Administration--Training registered apprenticeship opportunities
and Employment Services. in construction,including supportive
services.
Department of Labor................... Employment and Training WV Council for Community and Technical 300,000 Miller (WV)
Administration--Training College Education, Charleston, WV for
and Employment Services. aerospace training, equipment, and
curriculum.
--------------------------------------------------------------------------------------------------------------------------------------------------------
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):
SECTION 118 OF DIVISION BB OF THE CONSOLIDATED APPROPRIATIONS ACT, 2021
SEC. 118. IMPLEMENTATION FUNDING.
(a) In General.--For the purposes described in subsection
(b), and in addition to amounts otherwise available for such
purposes, there are appropriated, out of amounts in the
Treasury not otherwise appropriated, to the Secretary of Health
and Human Services, the Secretary of Labor, and the Secretary
of the Treasury, $500,000,000 for fiscal year 2021, to remain
available until [expended through] 2024.
(b) Permitted Purposes.--The purposes described in this
subsection are limited to the following purposes, insofar as
such purposes are to carry out the provisions of, including the
amendments made by, this title and title II:
(1) Preparing, drafting, and issuing proposed and
final regulations or interim regulations.
(2) Preparing, drafting, and issuing guidance and
public information.
(3) Preparing and holding public meetings.
(4) Preparing, drafting, and publishing reports.
(5) Enforcement of such provisions.
(6) Reporting, collection, and analysis of data.
(7) Establishment and initial implementation of the
processes for independent dispute resolution and
implementation of patient-provider dispute resolution
under such provisions.
(8) Conducting audits.
(9) Other administrative duties necessary for
implementation of such provisions.
(c) Transparency of Implementation Funds.--Each Secretary
described in subsection (a) shall annually submit to the
Committees on Energy and Commerce, on Ways and Means, on
Education and Labor, and on Appropriations of the House of
Representatives and on the Committees on Health, Education,
Labor, and Pensions and on Appropriations of the Senate a
report on funds expended pursuant to funds appropriated under
this section.
----------
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE IV--NATIONAL RESEARCH INSTITUTES
Part A--National Institutes of Health
* * * * * * *
SEC. 402A. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--
(1) This title.--For purposes of carrying out this
title, there are authorized to be appropriated--
(A) $30,331,309,000 for fiscal year 2007;
(B) $32,831,309,000 for fiscal year 2008;
(C) such sums as may be necessary for fiscal
year 2009;
(D) $34,851,000,000 for fiscal year 2018;
(E) $35,585,871,000 for fiscal year 2019; and
(F) $36,472,442,775 for fiscal year 2020.
(2) Funding for 10-year pediatric research initiative
through common fund.--For the purpose of carrying out
section 402(b)(7)(B)(ii), there is authorized to be
appropriated to the Common Fund, out of the 10-Year
Pediatric Research Initiative Fund described in section
9008 of the Internal Revenue Code of 1986, and in
addition to amounts otherwise made available under
paragraph (1) of this subsection and reserved under
subsection (c)(1)(B)(i) of this section, $12,600,000
for each of fiscal years 2014 through 2023.
(b) Office of the Director.--Of the amount authorized to be
appropriated under subsection (a) for a fiscal year, there are
authorized to be appropriated for programs and activities under
this title carried out through the Office of the Director of
NIH such sums as may be necessary for each of the fiscal years
2007 through 2009.
(c) Trans-NIH Research.--
(1) Common fund.--
(A) Account.--For the purpose of allocations
under section 402(b)(7)(B) (relating to
research identified by the Division of Program
Coordination, Planning, and Strategic
Initiatives), there is established an account
to be known as the Common Fund.
(B) Reservation.--
(i) In general.--Of the total amount
appropriated under subsection (a)(1)
for fiscal year 2007 or any subsequent
fiscal year, the Director of NIH shall
reserve an amount for the Common Fund,
subject to any applicable provisions in
appropriations Acts.
(ii) Minimum amount.--For each fiscal
year, the percentage constituted by the
amount reserved under clause (i)
relative to the total amount
appropriated under subsection (a)(1)
for such year may not be less than the
percentage constituted by the amount so
reserved for the preceding fiscal year
relative to the total amount
appropriated under subsection (a)(1)
for such preceding fiscal year, subject
to any applicable provisions in
appropriations Acts.
(C) Common fund strategic planning report.--
As part of the National Institutes of Health
Strategic Plan required under section 402(m),
the Secretary, acting through the Director of
NIH, shall submit a report to the Congress
containing a strategic plan for funding
research described in section 402(b)(7)(A)(i)
(including personnel needs) through the Common
Fund. Each such plan shall include the
following:
(i) An estimate of the amounts
determined by the Director of NIH to be
appropriate for maximizing the
potential of such research.
(ii) An estimate of the amounts
determined by the Director of NIH to be
sufficient only for continuing to fund
research activities previously
identified by the Division of Program
Coordination, Planning, and Strategic
Initiatives.
(iii) An estimate of the amounts
determined by the Director of NIH to be
necessary to fund research described in
section 402(b)(7)(A)(i)--
(I) that is in addition to
the research activities
described in clause (ii); and
(II) for which there is the
most substantial need.
(D) Evaluation.--During the 6-month period
following the end of the first fiscal year for
which the total amount reserved under
subparagraph (B) is equal to 5 percent of the
total amount appropriated under subsection
(a)(1) for such fiscal year, the Secretary,
acting through the Director of NIH, in
consultation with the advisory council
established under section 402(k), shall submit
recommendations to the Congress for changes
regarding amounts for the Common Fund.
(2) Trans-nih research reporting.--
(A) Limitation.--With respect to the total
amount appropriated under subsection (a) for
fiscal year 2008 or any subsequent fiscal year,
if the head of a national research institute or
national center fails to submit the report
required by subparagraph (B) for the preceding
fiscal year, the amount made available for the
institute or center for the fiscal year
involved may not exceed the amount made
available for the institute or center for
fiscal year 2006.
(B) Reporting.--Not later than 2 years after
the date of enactment of 21st Century Cures
Act, the head of each national research
institute or national center shall submit to
the Director of the National Institutes of
Health a report, to be included in the
triennial report under section 403, on the
amount made available by the institute or
center for conducting or supporting research
that involves collaboration between the
institute or center and 1 or more other
national research institutes or national
centers.
(C) Determination.--For purposes of
determining the amount or percentage of funds
to be reported under subparagraph (B), any
amounts made available to an institute or
center under section 402(b)(7)(B) shall be
included.
(D) Verification of amounts.--Upon receipt of
each report submitted under subparagraph (B),
the Director of NIH shall review and, in cases
of discrepancy, verify the accuracy of the
amounts specified in the report.
(E) Waiver.--At the request of any national
research institute or national center, the
Director of NIH may waive the application of
this paragraph to such institute or center if
the Director finds that the conduct or support
of research described in subparagraph (B) is
inconsistent with the mission of such institute
or center.
(d) Transfer Authority.--Of the total amount appropriated
[under subsection (a)(1)] to carry out this title for a fiscal
year, the Director of NIH may (in addition to the reservation
under subsection (c)(1) for such year) transfer not more than 1
percent for programs or activities that are authorized in this
title and identified by the Director to receive funds pursuant
to this subsection. In making such transfers, the Director may
not decrease any appropriation [account under subsection
(a)(1)] by more than 1 percent.
(e) Rule of Construction.--This section may not be construed
as affecting the authorities of the Director of NIH under
section 401.
* * * * * * *
----------
HIGHER EDUCATION ACT OF 1965
* * * * * * *
TITLE I--GENERAL PROVISIONS
* * * * * * *
PART B--ADDITIONAL GENERAL PROVISIONS
* * * * * * *
SEC. 114. NATIONAL ADVISORY COMMITTEE ON INSTITUTIONAL QUALITY AND
INTEGRITY.
(a) Establishment.--There is established in the Department a
National Advisory Committee on Institutional Quality and
Integrity (in this section referred to as the ``Committee'') to
assess the process of accreditation and the institutional
eligibility and certification of institutions of higher
education (as defined in section 102) under title IV.
(b) Membership.--
(1) In general.--The Committee shall have 18 members,
of which--
(A) six members shall be appointed by the
Secretary;
(B) six members shall be appointed by the
Speaker of the House of Representatives, three
of whom shall be appointed on the
recommendation of the majority leader of the
House of Representatives, and three of whom
shall be appointed on the recommendation of the
minority leader of the House of
Representatives; and
(C) six members shall be appointed by the
President pro tempore of the Senate, three of
whom shall be appointed on the recommendation
of the majority leader of the Senate, and three
of whom shall be appointed on the
recommendation of the minority leader of the
Senate.
(2) Qualifications.--Individuals shall be appointed
as members of the Committee--
(A) on the basis of the individuals'
experience, integrity, impartiality, and good
judgment;
(B) from among individuals who are
representatives of, or knowledgeable
concerning, education and training beyond
secondary education, representing all sectors
and types of institutions of higher education
(as defined in section 102); and
(C) on the basis of the individuals'
technical qualifications, professional
standing, and demonstrated knowledge in the
fields of accreditation and administration in
higher education.
(3) Terms of members.--Except as provided in
paragraph (5), the term of office of each member of the
Committee shall be for six years, except that any
member appointed to fill a vacancy occurring prior to
the expiration of the term for which the member's
predecessor was appointed shall be appointed for the
remainder of such term.
(4) Vacancy.--A vacancy on the Committee shall be
filled in the same manner as the original appointment
was made not later than 90 days after the vacancy
occurs. If a vacancy occurs in a position to be filled
by the Secretary, the Secretary shall publish a Federal
Register notice soliciting nominations for the position
not later than 30 days after being notified of the
vacancy.
(5) Initial terms.--The terms of office for the
initial members of the Committee shall be--
(A) three years for members appointed under
paragraph (1)(A);
(B) four years for members appointed under
paragraph (1)(B); and
(C) six years for members appointed under
paragraph (1)(C).
(6) Chairperson.--The members of the Committee shall
select a chairperson from among the members.
(c) Functions.--The Committee shall--
(1) advise the Secretary with respect to
establishment and enforcement of the standards of
accrediting agencies or associations under subpart 2 of
part H of title IV;
(2) advise the Secretary with respect to the
recognition of a specific accrediting agency or
association;
(3) advise the Secretary with respect to the
preparation and publication of the list of nationally
recognized accrediting agencies and associations;
(4) advise the Secretary with respect to the
eligibility and certification process for institutions
of higher education under title IV, together with
recommendations for improvements in such process;
(5) advise the Secretary with respect to the
relationship between--
(A) accreditation of institutions of higher
education and the certification and eligibility
of such institutions; and
(B) State licensing responsibilities with
respect to such institutions; and
(6) carry out such other advisory functions relating
to accreditation and institutional eligibility as the
Secretary may prescribe by regulation.
(d) Meeting Procedures.--
(1) Schedule.--
(A) Biannual meetings.--The Committee shall
meet not less often than twice each year, at
the call of the Chairperson.
(B) Publication of date.--The Committee shall
submit the date and location of each meeting in
advance to the Secretary, and the Secretary
shall publish such information in the Federal
Register not later than 30 days before the
meeting.
(2) Agenda.--
(A) Establishment.--The agenda for a meeting
of the Committee shall be established by the
Chairperson and shall be submitted to the
members of the Committee upon notification of
the meeting.
(B) Opportunity for public comment.--The
agenda shall include, at a minimum, opportunity
for public comment during the Committee's
deliberations.
(3) Secretary's designee.--The Secretary shall
designate an employee of the Department to serve as the
Secretary's designee to the Committee, and the
Chairperson shall invite the Secretary's designee to
attend all meetings of the Committee.
(4) Federal advisory committee act.--The Federal
Advisory Committee Act (5 U.S.C. App.) shall apply to
the Committee, except that section 14 of such Act shall
not apply.
(e) Report and Notice.--
(1) Notice.--The Secretary shall annually publish in
the Federal Register--
(A) a list containing, for each member of the
Committee--
(i) the member's name;
(ii) the date of the expiration of
the member's term of office; and
(iii) the name of the individual
described in subsection (b)(1) who
appointed the member; and
(B) a solicitation of nominations for each
expiring term of office on the Committee of a
member appointed by the Secretary.
(2) Report.--Not later than the last day of each
fiscal year, the Committee shall make available an
annual report to the Secretary, the authorizing
committees, and the public. The annual report shall
contain--
(A) a detailed summary of the agenda and
activities of, and the findings and
recommendations made by, the Committee during
the fiscal year preceding the fiscal year in
which the report is made;
(B) a list of the date and location of each
meeting during the fiscal year preceding the
fiscal year in which the report is made;
(C) a list of the members of the Committee;
and
(D) a list of the functions of the Committee,
including any additional functions established
by the Secretary through regulation.
(f) Termination.--The Committee shall terminate on September
30, [2021] 2022.
* * * * * * *
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 D--WILLIAM D. FORD FEDERAL DIRECT LOAN PROGRAM
* * * * * * *
SEC. 458. FUNDS FOR ADMINISTRATIVE EXPENSES.
(a) Administrative Expenses.--
(1) Mandatory funds for fiscal year 2006.--For fiscal
year 2006, there shall be available to the Secretary,
from funds not otherwise appropriated, funds to be
obligated for--
(A) administrative costs under this part and
part B, including the costs of the direct
student loan programs under this part; and
(B) account maintenance fees payable to
guaranty agencies under part B and calculated
in accordance with subsections (b) and (c),
not to exceed (from such funds not otherwise
appropriated) $820,000,000 in fiscal year 2006.
(3) Authorization for administrative costs beginning
in fiscal years 2007 through 2014.--For each of the
fiscal years 2007 through 2014, there are authorized to
be appropriated such sums as may be necessary for
administrative costs under this part and part B,
including the costs of the direct student loan programs
under this part.
(4) Continuing mandatory funds for account
maintenance fees.--For each of the fiscal years 2007
through [2021] 2022, there shall be available to the
Secretary, from funds not otherwise appropriated, funds
to be obligated for account maintenance fees payable to
guaranty agencies under part B and calculated in
accordance with subsection (b).
(5) Account maintenance fees.--Account maintenance
fees under paragraph (3) shall be paid quarterly and
deposited in the Agency Operating Fund established
under section 422B.
(6) Technical assistance to institutions of higher
education.--
(A) Provision of assistance.--The Secretary
shall provide institutions of higher education
participating, or seeking to participate, in
the loan programs under this part with
technical assistance in establishing and
administering such programs.
(B) Funds.--There are authorized to be
appropriated, and there are appropriated, to
carry out this paragraph (in addition to any
other amounts appropriated to carry out this
paragraph and out of any money in the Treasury
not otherwise appropriated), $50,000,000 for
fiscal year 2010.
(C) Definition.--In this paragraph, the term
``assistance'' means the provision of technical
support, training, materials, technical
assistance, and financial assistance.
(7) Additional payments.--
(A) Provision of assistance.--The Secretary
shall provide payments to loan servicers for
retaining jobs at locations in the United
States where such servicers were operating
under part B on January 1, 2010.
(B) Funds.--There are authorized to be
appropriated, and there are appropriated, to
carry out this paragraph (in addition to any
other amounts appropriated to carry out this
paragraph and out of any money in the Treasury
not otherwise appropriated), $25,000,000 for
each of the fiscal years 2010 and 2011.
(8) Carryover.--The Secretary may carry over funds
made available under this section to a subsequent
fiscal year.
(b) Calculation Basis.--Account maintenance fees payable to
guaranty agencies under subsection (a)(4) shall be calculated
on the basis of 0.06 percent of the original principal amount
of outstanding loans on which insurance was issued under part
B.
(c) Budget Justification.--No funds may be expended under
this section unless the Secretary includes in the Department of
Education's annual budget justification to Congress a detailed
description of the specific activities for which the funds made
available by this section have been used in the prior and
current years (if applicable), the activities and costs planned
for the budget year, and the projection of activities and costs
for each remaining year for which administrative expenses under
this section are made available.
* * * * * * *
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, 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), or able 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:
If 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 inadmissable to the United State or deportable from the
United States under the immigration laws (as defined in section
101(a)(17) of the Immigration and Nationality 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.
* * * * * * *
CHANGES IN THE APPLICATION OF EXISTING LAW
Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of
the House of Representatives, the following statements are
submitted describing the effect of provisions in the
accompanying bill that directly or indirectly change the
application of existing law.
TITLE I--DEPARTMENT OF LABOR
Language is included under ``Employment and Training
Administration'' providing that allotments to outlying areas
are not required to be made through the Pacific Region
Educational Laboratory as provided by section 127 of the
Workforce Innovation and Opportunity Act (WIOA).
Language is included under ``Employment and Training
Administration'' providing amounts made available for
dislocated workers may be used for State activities or across
multiple local areas where workers remain dislocated.
Language is included under ``Employment and Training
Administration'' providing that technical assistance 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 15percent 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 for additional
administrative funds from the Unemployment Trust Fund if
unemployment claims exceed certain levels.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing authority for
States to use funds to assist other States to carry out
authorized activities in cases of a major disaster declared by
the President under the Robert T. Stafford Disaster Relief and
Emergency Assistance Act.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments on behalf of States for
the use of the National Directory of New Hires.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments from funds appropriated
for States' grants on behalf of States to the entity operating
the State Information Data Exchange System.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments from funds appropriated
for States' grants on behalf of States to the entity operating
the Unemployment Insurance Integrity Center of Excellence.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that
appropriations for establishing a national one-stop career
system may be obligated in contracts, grants or agreements with
States or non-State entities.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that States
awarded grants to support national activities of the Federal-
State unemployment insurance system may award subgrants to
other States.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that funds
available for integrated Unemployment Insurance and Employment
Service automation may be used by States notwithstanding cost
allocation principles prescribed under the Office of Management
and Budget ``Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards.''
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may reallot funds among States
participating in a consortium.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' allowing the Secretary to
collect fees 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.
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'' providing
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'' modifying
the transfer authority from unobligated balances to the Working
Capital Fund.
Language is included under ``General Provisions''
clarifying the availability of funds provided under Section
118(a) of division BB of the Consolidated Appropriations Act,
2021.
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.
Language is included under ``General Provisions''
prohibiting the Secretary from using any of the funds in the
Act to award Temporary Employment Certifications if certain
conditions are met.
Language is included under ``General Provisions'' related
to determining the prevailing wage for purposes of the H-2B
visa program.
Language is included under ``General Provisions''
prohibiting the Secretary from using any of the funds in the
Act to award Temporary Employment Certifications to employers
who have violated certain Federal laws.
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 762.
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'' 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'' 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--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--Public Health Preparedness and Response''
permitting CDC to operate and maintain an aircraft.
Language is included under ``Centers for Disease Control
and Prevention--Buildings and Facilities'' providing the use of
funds to support acquisition, renovation, or replacement, of
the National Institute Occupational Safety and Health's
underground and surface coal mining research capacity.
Language is included under ``Centers for Disease Control
and Prevention--Buildings and Facilities'' providing funds from
former employees with existing Individual Learning Accounts
unobligated to be available to support acquisition, renovation,
or replacement, of the National Institute for Occupational
Safety and Health's underground and surface coal mining
research capacity.
Language is included under ``National Institutes of
Health--Office of the Director'' 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 Abuse and Mental
Health Services Administration--Mental Health'' requiring
states to spend 10 percent of the Mental Health Block Grant for
programs for individuals with early serious mental illness.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' 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 Abuse 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 Abuse and Mental
Health Services Administration--Mental Health'' exempting the
Mental Health Block Grant from the evaluation set-aside in
section 241 of the Public Health Service Act.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Substance Abuse Treatment''
requiring states to spend not less than 10 percent of the
Substance Abuse Prevention and Treatment Block Grant for
recovery support services.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Substance Abuse Treatment''
exempting the Substance Abuse Prevention and Treatment Block
Grant from the evaluation set-aside in section 241 of the
Public Health Service Act.
Language is included under ``Centers for Medicare and
Medicaid Services--Program Management'' 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--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--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, expansion
funding for Head Start and Early Head Start programs, including
necessary administrative costs, quality improvement funding,
including quality improvement funding for Migrant and Seasonal
Head Start, extended duration funding, 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 allowing funds to be used for the
administrative costs of Family Violence Prevention and Services
Act funding appropriated in section 2204 of the American Rescue
Plan Act of 2021.
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.
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 3.0
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 provider 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 $3,500,000 per project
with a total limit for NIH of $45,000,000.
Section 217 transfers one percent of the funding made
available for National Institutes of Health National Research
Service Awards to the Health Resources and Services
Administration and Agency for Healthcare Research and Quality.
Section 218 continues the Biomedical Advanced Research and
Development Authority ten year contract authority.
Section 219 includes specific report requirements for CMS's
marketplaces activities in the fiscal year 2020 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 223 modifies a provision relating to breast cancer
screening.
Section 224 requires the NIH to continue to use existing
guidance for calculating indirect cost negotiated rates.
Section 225 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 226 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.
Section 228 allows certain donations for unaccompanied
alien children.
Section 229 limits the use of funds to house unaccompanied
children in facilities that are not State-licensed for the care
of unaccompanied children and do not come into compliance with
certain standards and requirements.
Section 230 relates to the notification requirements
regarding the use of facilities that are not State-licensed for
the care of unaccompanied children.
Section 231 modifies a provision relating to Members of
Congress and oversight of facilities responsible for the care
of unaccompanied alien children.
Section 232 continues a provision requiring monthly reports
on unaccompanied alien children who were separated from their
parents or legal guardians and transferred to the care of the
Office of Refugee Resettlement.
Section 233 prohibits the use of funds for sharing any
information pertaining to unaccompanied alien children for use
or reference in removal proceedings or immigration enforcement.
Section 234 requires the Department to make efforts to
place unaccompanied alien children who are siblings together.
Section 235 requires the Department to submit a spend plan
for the ``Department of Health and Human Services--
Administration for Children and Families--Refugee and Entrant
Assistance'' account every 60 days.
Section 236 allows for primary and secondary school costs
for eligible dependents of HHS personnel stationed in a U.S.
territory.
Section 237 rescinds balances from the Nonrecurring
Expenses Fund.
Section 238 authorizes the use of funds for a Separated
Families Services Fund, for children, parents, and legal
guardians who were separated at the United States-Mexico border
in connection with the Zero-Tolerance Policy.
Section 239 allows funds to remain available until expended
for certain types of expenses related to the completion of
CDC's high containment continuity laboratory project.
Section 240 provides certain administrative flexibility to
be available during a public health emergency.
Section 241 prohibits funds from being awarded to an
organization that does not comply with Federal
nondiscrimination regulations.
Section 242 allows an Operating or Staff Division in HHS to
enter into a reimbursable agreement with another major
organizational unit within HHS or of another agency.
Section 243 prohibits funds from being used for a CMS
Contact Center Operations contract with a total period of
performance that exceeds 24 months.
Section 244 includes notification requirements in the
Social Security Act.
Section 245 continues NIH transfer authority.
Section 246 increases flexibility for grantees of the Ryan
White HIV/AIDS program.
Section 247 requires institutions that receive NIH grants
to notify NIH if personnel funded by the grant are disciplined
due to concerns about harassment.
Section 248 extends the availability of multi-year research
grants awarded in fiscal year 2016.
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
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 promote continuity of services for
eligible infants and their families.
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'' providing funding for evidence-based middle and
high school career and technical education innovation programs.
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 the Secretary to allocate new student loan borrower
accounts to eligible student loan servicers on the basis of
their past performance and their compliance with Federal and
State law.
Language is included under ``Student Aid Administration''
requiring the Secretary to allow student loan borrowers to have
their consolidated Federal student loans serviced by any
student loan servicer.
Language is included under ``Student Aid Administration''
requiring any new servicing environment, including FSA Next
Generation Processing and Servicing Environment, to include the
participation of multiple student loan servicers.
Language is included under ``Student Aid Administration''
requiring any new servicing environment, including FSA Next
Generation Processing and Servicing Environment, to include
accountability measures that account for the performance of the
portfolio and contractor compliance with Federal Student Aid
(FSA) guidelines and Federal and State law.
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 any new servicing environment, including FSA Next
Generation Processing and Servicing Environment, to incentivize
more support to borrowers at risk of delinquency or default.
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 ``Student Aid Administration''
requiring the Department to provide a detailed spend plan.
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, 2022 through September 30, 2023.
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''
prohibiting funds being used in contravention of section 203 of
the Department of Education Organization Act.
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''
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'' providing
funds for outreach to certain borrowers of loans made under
part D of title IV of the Higher Education Act.
Language is included providing funds for providing 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'' 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''
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'' 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 ``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 2022.
Section 525 prohibits the use of funds for the Social
Security Administration to finalize or implement a rule related
to benefits appeals hearings.
APPROPRIATIONS NOT AUTHORIZED BY LAW
Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of
the House of Representatives, the following table lists the
appropriations in the accompanying bill which are not
authorized by law for the period concerned (dollars in
thousands):
----------------------------------------------------------------------------------------------------------------
Appropriations
Agency program Last year of Authorization level in last year of Appropriations
authorization authorization in this bill
----------------------------------------------------------------------------------------------------------------
DEPARTMENT OF LABOR
ETA:
Adult Employment and FY2020 $899,987,000 $854,649,000 $923,174,000
Training Activities.
Youth Employment and FY2020 963,837,000 913,130,000 988,604,000
Training Activities.
Dislocated Worker FY2020 1,436,137,000 1,052,053,000 1,183,554,000
Employment and Training
Activities.
Native Americans.......... FY2020 54,137,000 55,000,000 58,000,000
Migrant and Seasonal FY2020 96,211,000 91,896,000 96,711,000
Farmworker programs.
YouthBuild................ FY2020 91,087,000 94,534,000 145,000,000
Reintegration of Ex- FY2020 106,906,000 98,079,000 150,000,000
Offenders.
Job Corps................. FY2020 1,983,236,000 1,743,655,000 1,830,073,000
One-Stop Career Centers/ FY2020 70,667,000 62,653,000 67,653,000
Labor Market Information.
VETERANS' EMPLOYMENT AND
TRAINING SERVICE
Homeless Veterans FY2020 50,000,000 55,000,000 67,500,000
Reintegration Program.
DEPARTMENT OF HEALTH AND HUMAN
SERVICES
HRSA:
Health Careers Opportunity FY2014 Such Sums 14,153,000 20,500,000
Program.
Faculty Loan Repayment.... FY2014 5,000,000 1,187,000 2,310,000
Scholarships for FY2014 Such Sums 44,857,000 61,970,000
Disadvantaged Students.
Primary Care Training and FY2014 Such Sums 36,831,000 49,924,000
Enhancement.
Oral Health Training FY2012 25,000,000 40,673,000 42,673,000
Programs.
Area Health Education FY2014 125,000,000 30,250,000 50,000,000
Centers.
Education & Training--
Geriatrics:.
(Workforce Development)... FY2014 10,800,000 33,237,000 52,737,000
(Career Incentive Awards). FY2013 10,000,000 ................ ................
National Center for FY2014 7,500,000 4,651,000 5,663,000
Workforce Analysis.
Nurse Education, Practice, FY2016 Such Sums 41,913,000 51,913,000
Quality and Retention
Program.
Nurse Practitioner N/A N/A N/A 15,000,000
Optional Fellowship
Program.
NURSE Corps Scholarship FY2007 Such Sums 87,135,000 108,635,000
and Loan Repayment
Program.
Nurse Faculty Loan Program FY2014 Such Sums 24,500,000 30,500,000
Medical Student Education. N/A N/A N/A 75,000,000
Healthy Start............. FY2013 Formula 100,746,000 145,000,000
Emergency Relief--Part A.. FY2013 789,471,000 649,373,000 700,876,000
Comprehensive Care--Part B FY2013 1,562,169,000 1,314,446,000 1,387,005,000
Early Intervention--Part C FY2013 285,766,000 205,544,000 207,079,000
Coordinated Services and FY2013 87,273,000 75,088,000 80,088,000
Access to Research for
Women, Infants, Children
and Youth--Part D.
Dental Reimbursement--Part FY2013 15,802,000 12,991,000 15,122,000
F.
AIDS Education and FY2013 42,178,000 33,275,000 44,611,000
Training Centers--Part F.
Special Projects of FY2013 25,000,000 25,000,000 30,000,000
National Significance--
Part F.
Ending the HIV/AIDS N/A N/A N/A 190,000,000
Epidemic.
Organ Transplantation..... FY1993 Such Sums 2,767,000 34,049,000
Rural Health Outreach FY2012 45,000,000 55,553,000 90,000,000
Grants.
Rural Hospital Flexibility FY2012 Such Sums 41,040,000 79,009,000
Grants.
State Offices of Rural FY2002 Such Sums 4,000,000 13,000,000
Health.
Telehealth................ FY2006 Such Sums 6,814,000 39,000,000
Family Planning Grants.... FY 1985 158,400,000 142,500,000 400,000,000
CDC:
Sexually Transmitted FY1998 Such Sums 112,117,000 166,810,000
Diseases Grants.
National Cancer Registries FY2003 Such Sums N/A 51,440,000
National Center for Health FY2003 Such Sums 125,899,000 190,397,000
Statistics.
WISEWOMAN................. FY2003 Such Sums 12,419,000 33,120,000
Asthma (Environmental).... FY2005 Such Sums 32,422,000 34,000,000
Folic Acid................ FY2005 Such Sums 2,188,000 3,150,000
Injury Prevention and FY2005 Such Sums 138,237,000 1,064,169,000
Control.
Oral Health Promotion..... FY2005 Such Sums 11,204,000 21,500,000
Screening, Referrals, and FY2005 40,000,000 36,474,000 50,000,000
Education Regarding Lead
Poisoning.
Birth Defects, FY2007 Such Sums 122,242,000 186,810,000
Developmental Disability,
Disability and Health.
Breast and Cervical Cancer FY2012 275,000,000 204,779,000 230,000,000
Johanna's Law............. FY2014 18,000,000 4,972,000 12,000,000
Public Health Workforce FY2013 39,500,000 64,000,000 106,000,000
and Career Development.
National Diabetes FY2014 Such Sums 10,000,000 34,300,000
Prevention Program.
Section 317 Immunization.. FY2014 Such Sums 610,847,000 718,572,000
Young Women's Breast FY2019 4,900,000 4,960,000 5,960,000
Health Awareness and
Support of Young Women
Diagnosed with Breast
Cancer (PHSA 399NN).
Newborn Screening FY2019 8,000,000 17,250,000 24,250,000
Laboratory Quality and
Surveillance.
SAMHSA:
Protection and Advocacy FY2003 19,500,000 36,146,000 40,000,000
for Individuals with
Mental Illness.
State Opioid Response N/A N/A N/A 2,000,000,000
Grants.
AHRQ:
Research on Health Costs, FY2005 Such Sums 324,000,000 380,000,000
Quality, and Outcomes.
ACF:
Low Income Home Energy FY2007 5,100,000,000 2,161,170,000 3,900,304,000
Assistance Program.
Child Care and Development FY2020 2,748,591,018 5,826,000,000 7,377,000,000
Block Grant.
Children and Families
Services Programs:.
Adoption and Legal FY2016 43,000,000 37,943,000 75,000,000
Guardianship Incentive
Payments.
Native American Programs.. FY2002 Such Sums 45,826,000 65,000,000
Community Services Block FY2003 Such Sums 645,762,000 800,000,000
Grant.
Head Start................ FY2012 Such Sums 7,968,544,000 12,182,095,000
Runaway and Homeless Youth FY2013 Such Sums 107,852,000 149,787,000
Programs.
CAPTA programs............ FY2015 Such Sums 143,981,000 257,000,000
Family Violence Programs.. FY2015 178,500,000 139,500,000 185,000,000
Child Welfare Services.... FY2016 325,000,000 268,735,000 489,230,000
Refugee Support Services.. FY2002 Such Sums 212,912,000 450,000,000
Transitional and Medical FY2002 Such Sums 227,243,000 605,000,000
Services.
Survivors of Torture...... FY2007 25,000,000 9,817,000 27,000,000
ACL:
Alzheimer's Diseases FY2002 Such Sums 11,483,000 34,700,000
Demonstration.
Lifespan Respite Care..... FY2011 94,810,000 2,495,000 14,220,000
State Health Insurance FY1996 10,000,000 N/A 57,115,000
Assistance Program.
Developmental Disabilities FY2007 Such Sums 155,115,000 208,514,000
Voting Access for People FY2005 17,410,000 13,879,000 12,963,000
with Disabilities.
Elder Justice/ Adult FY2014 129,000,000 0 19,400,000
Protective Services.
Assistive Technology...... FY2010 Such Sums 25,000,000 44,000,000
Traumatic Brain Injury.... FY2019 8,600,000 11,321,000 15,321,000
Paralysis Resource Center. FY2011 25,000,000 6,352,000 10.185,000
Limb Loss................. N/A N/A N/A 4,200
PHSSEF:
Preparedness and Emergency N/A N/A N/A 25,640,000
Operations.
Policy and Planning....... N/A N/A N/A 19,917,000
ASPR Operations........... N/A N/A N/A 32,176,000
Cybersecurity............. N/A N/A N/A 159,116,000
Office of National N/A N/A N/A 8,983,000
Security.
DEPARTMENT OF EDUCATION
Vocational Rehabilitation FY2021 3,675,021,000 3,675,021,000 3,719,121,000
State Grants.
Client Assistance State FY2021 14,098,000 13,000,000 13,000,000
Grants.
Supported Employment State FY2021 32,363,000 22,548,000 22,548,000
Grants.
Training.................. FY2021 39,540,000 29,388,000 29,388,000
Demonstration and Training FY2021 6,809,000 5,796,000 40,796,000
Programs.
Services for Older Blind FY2021 39,141,000 33,317,000 33,317,000
Individuals.
Protection and Advocacy of FY2021 20,735,000 18,150,000 20,150,000
Individual Rights.
Helen Keller National FY2004 Such Sums 8,666,000 18,500,000
Center for Deaf-Blind
Youths and Adults.
National Technical FY2015 Such Sums 67,016,000 84,500,000
Institute for the Deaf.
Gallaudet University...... FY2015 Such Sums 120,275,000 143,361,000
Adult Basic and Literacy FY2021 665,067,000 674,955,000 700,000,000
Education State Grants.
Adult Education National FY2021 13,573,000 13,712,000 38,712,000
Leadership Activities.
Aid for Institutional FY2015 Such Sums 429,762,000 1,134,054,000
Development.
Aid for Hispanic-Serving FY2015 Such Sums 109,223,000 236,732,000
Institutions.
International Education FY2015 Such Sums 72,164,000 93,164,000
And Foreign Language.
Teacher Quality FY2011 Such Sums 43,000,000 132,092,000
Partnerships.
Federal TRIO Programs..... FY2015 Such Sums 839,752,000 1,297,761,000
IDEA National Activities.. FY2010 Such Sums 260,203,000 428,357,000
IDEA Grants for Infants FY2010 Such Sums 439,427,000 731,850,000
and Families.
Special Programs for FY2015 Such Sums 37,474,000 66,123,000
Migrant Students.
Comprehensive Centers..... FY2008 Such Sums 57,113,000 52,000,000
RELATED AGENCIES
Corporation for Public FY1996 425,000,000 275,000,000 585,000,000
Broadcasting.
Corporation for National FY2014 Such Sums 1,049,954,000 1,315,266,000
and 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
Pursuant to clause 3(c)(6) of rule XIII of the Rules of the
House of Representatives, the following hearings were used to
develop or consider the bill:
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
February 19, 2021, entitled ``COVID-19 and the Child Care
Crisis.'' The Subcommittee received testimony from:
Melissa Boteach, Vice President, Income Security and Child
Care/Early Learning, National Women's Law Center
Georgia Goldburn, Director, Hope Child Development
Theresa Hawley, First Assistant Deputy Governor, Education,
Office of Illinois Governor JB Pritzker
Katharine Stevens, Visiting Scholar, American Enterprise
Institute
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
February 24, 2021, entitled ``Ready or Not: U.S. Public Health
Infrastructure.'' The Subcommittee received testimony from:
Marilyn Bibbs-Freeman, Ph.D., Deputy Director, Division of
Consolidated Laboratory Services, Office of the Secretary of
Administration, Commonwealth of Virginia
Jennifer Kertanis, MPH, Director of Health, Farmington
Valley Health District, Connecticut
Umair Shah, MD, MPH, Secretary of Health, State of
Washington
Kathryn Turner, Ph.D., MPH, Deputy State Epidemiologist and
Chief, Bureau of Communicable Disease Prevention, Idaho
Division of Public Health
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
March 2, 2021, entitled ``Health and Safety Protections for
Meatpacking, Poultry, and Agricultural Workers.'' The
Subcommittee received testimony from:
Deborah Berkowitz, Worker Safety and Health Program
Director, National Employment Law Project
Dulce Castaneda, Founding Member, Children of Smithfield
Iris Figueroa, Director of Economic and Environmental
Justice, Farmworker Justice
Carmen Rottenberg, Managing Director, Groundswell Group
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
March 11, 2021, entitled ``COVID-19 and the Mental Health and
Substance Use Crises.'' The Subcommittee received testimony
from:
Mark Stringer, Director, Missouri Department of Mental
Health, and member of the National Association of State Alcohol
and Drug Abuse Directors
Arthur Evans, Jr., PhD, Chief Executive Officer and
Executive Vice President, American Psychological Association
Lisa Amaya-Jackson, MD, MPH, Co-Director, UCLA-Duke
University National Center for Child Traumatic Stress
Verna Foust, MS, LPC, NBCC, Chief Executive Officer, Red
Rock Behavioral Health Services
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
March 23, 2021, entitled ``Addressing the Maternal Health
Crisis.'' The Subcommittee received testimony from:
Stacey D. Stewart, President and CEO, March of Dimes
Wendy Gordon, DM, MPH, CPM, LM, Associate Professor and
Chair of the Department of Midwifery, Bastyr University
Carol Sakala, PhD, Director for Maternal Health, National
Partnership for Women & Families
Lisa A. Asare, MPH, Assistant Commissioner, Division of
Family Health Services, New Jersey Department of Health
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on April
15, 2021, entitled ``FY 2022 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 20, 2021, entitled ``Building Capacity, Building
Community: Increasing Investments in Community Colleges.'' The
Subcommittee received testimony from:
William T. Brown, Ph.D., Chief Executive Officer, Gateway
Community College.
Walter Bumphus, Ph.D., President and CEO, American
Association of Community Colleges
Kelli Jordan, Director, IBM Career Skills and Performance.
Mary Alice McCarthy, Ph.D., Director, Center on Education
and Labor, New America.
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on April
28, 2021, entitled ``FY 2022 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 budget hearing on May 5,
2021, entitled ``FY 2022 Budget Request for the Department of
Health and Human Services.'' 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 an oversight hearing on
May 13, 2021, entitled ``Mental Health Emergencies: Building a
Robust Crisis Response System.'' The Subcommittee received
testimony from:
Charles Dike, FRCPsych, MBChB, MPH, Associate Professor of
Psychiatry; Associate Program Director, Law and Psychiatry
Fellowship Program, Yale University; Medical Director, Office
of the Commissioner, Connecticut Department of Mental Health
and Addiction Services
Robert Gebbia, Chief Executive Officer, American Foundation
for Suicide Prevention
Chris Richardson, Associate Director of Criminal Justice
Services, Mental Health Center of Denver
Tonja Myles, Certified Peer Support Specialist, Community
Liaison, The Bridge Center for Hope, RI International
Steven Casstevens, Immediate Past President, International
Association of Chiefs of Police
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a hearing on May 18, 2021,
entitled ``FY 2022 Member Day.'' The Subcommittee received
testimony from:
The Honorable Andy Barr, Member of Congress
The Honorable Gus M. Bilirakis, Member of Congress
The Honorable Jamaal Bowman, Member of Congress
The Honorable Earl L. ``Buddy'' Carter, Member of Congress
The Honorable Ed Case, Member of Congress
The Honorable Veronica Escobar, Member of Congress
The Honorable Brian K. Fitzpatrick, Member of Congress
The Honorable Jim Hagedorn, Member of Congress
The Honorable Josh Harder, Member of Congress
The Honorable Brian Higgins, Member of Congress
The Honorable Sheila Jackson Lee, Member of Congress
The Honorable Gwen Moore, Member of Congress
The Honorable Frank J. Mrvan, Member of Congress
The Honorable John W. Rose, Member of Congress
The Honorable Glenn ``GT'' Thompson, Member of Congress
The Honorable Jefferson Van Drew, Member of Congress
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held an oversight hearing on
May 19, 2021, entitled ``Public Witness Day.'' The Subcommittee
received testimony from:
E. Dale Abel, Chair in Internal Medicine & Chair in
Diabetes Research, University of Iowa, Carver, on behalf of
Friends of the National Institute of Diabetes and Digestive and
Kidney Diseases
John Auerbach, President & CEO, Trust for America's Health
Robert Blancato, Executive Director, National Association
of Nutrition and Aging Services Programs
Kevin Brown, Director of Policy, Advocacy & Legislative
Affairs, Safer Foundation
Amalia Chamorro, Director of Education Policy, UnidosUS
Michael C. Crair, William Ziegler III Professor, Vice
Provost for Research, Yale University, on behalf of National
Alliance for Eye and Vision Research
Rachael DeSpain, Head Start and Early Head Start Director,
Tri-County Opportunities Council
Lori Fogarty, Director & CEO, Oakland Museum of California,
on behalf of American Alliance of Museums
Mark Herzberg, Professor, Department of Diagnostic and
Biological Sciences, University of Minnesota School of
Dentistry, on behalf of American Association for Dental
Research
Kathleen B. Kennedy, Chair, Association of Minority Health
Professions Schools, Inc.
Angela Kimball, National Director of Advocacy & Public
Policy, National Alliance on Mental Illness
Nickolaus D. Lewis, Councilman, Lummi Indian Business
Council; Chairman, Northwest Portland Area Indian Health Board;
Vice Chairperson & Portland Area Representative, Nat, Northwest
Portland Area Indian Health Board
Lorraine M. Martin, President & CEO, National Safety
Council
Jose Munoz, Interim Director, Institute for Educational
Leadership; Director, Coalition for Community Schools, The
Institute for Educational Leadership
Joanne Pike, Chief Strategy Officer, Alzheimer's
Association
Erin Prangley, Co-Chair, Developmental Disabilities, Autism
and Family Supports Task Force, Consortium for Citizens with
Disabilities
Virgil Rambeau, Community Health Associate Clinical Social
Worker, Sacramento Native American Health Center, on behalf of
Council for Opportunity in Education
Dr. Carl Reddy, Director, Training Programs in Epidemiology
and Public Health Interventions Network, The Task Force for
Global Health
Kathryn G. Schubert, President & CEO, Society for Women's
Health Research
Laura Thomas, Director of Harm Reduction Policy, San
Francisco AIDS Foundation
David A. Tuveson, President, American Association for
Cancer Research
Brian Wallach, Co-Founder, I AM ALS
Mark Wolfe, Executive Director, National Energy Assistance
Directors Association
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on May
25, 2021, entitled ``FY 2022 Budget Request for the National
Institutes of Health.'' The Subcommittee received testimony
from:
Dr. Francis Collins, Director, National Institutes of
Health
Dr. Diana Bianchi, Director, Eunice Kennedy Shriver
National Institute of Child Health and Human Development
Dr. Anthony Fauci, Director, National Institute of Allergy
and Infectious Diseases
Dr. Gary Gibbons, Director, National Heart, Lung, and Blood
Institute
Dr. Norman Sharpless, Director, National Cancer Institute
Dr. Nora Volkow, Director, National Institute on Drug Abuse
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a budget hearing on May
26, 2021, entitled ``FY 2022 Budget Request for the Centers for
Disease Control and Prevention.'' The Subcommittee received
testimony from:
Dr. Rochelle Walensky, Director, Centers for Disease
Control and Prevention
Dr. Anne Schuchat, Principal Deputy Director, Centers for
Disease Control and Prevention
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............... 237,466 326,000 239,590 \1\327,249
Mandatory................................... 1,041,349 1,042,082 1,041,349 \1\1,042,082
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
NOTE.--Consistent with the funding recommended in the bill for disaster relief, in accordance with the
Congressional Budget Act of 1974 (including section 314(g) of such Act), and subsections (j) and (k) of
section 1 of House Resolution 467 of the 117th Congress, and after the bill is reported to the House, the
Chairman of the Committee on the Budget will provide a revised section 302(a) allocation reflecting an
additional $2,124 million in discretionary budget authority and $1,707 million in associated outlays for
amounts provided for various program integrity initiatives. That new allocation will eliminate the technical
difference prior to floor consideration.
In addition, the amounts in this report do not include $496 million in discretionary budget authority and $471
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.
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:
2022............................................. \1\1,130,360
2023............................................. 131,445
2024............................................. 43,154
2025............................................. 8,685
2026 and future years............................ 2,795
------------------------------------------------------------------------
\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 481,071 \1\586,080
local governments for 2022.......
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
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 that includes funding
priorities of Members on both sides of the aisle. Despite the
many good programs supported in the bill, Republicans oppose
this measure. In its current form, this bill is simply too
extreme and out of step with the American people.
First, the bill provides an unprecedented 36 percent, $60
billion, increase in funding over current levels. Instead of
focusing on urgent priorities for all Americans, such as
getting everyone back to work and back to school, the Majority
party has followed the President's unrealistic request in many
areas and has also elevated controversial social policies in
this bill. They have chosen to fund new, unauthorized programs
over pressing needs like strengthening our national defense and
bolstering tools to address and manage the crisis at our
southern border. With China and Russia growing their militaries
by the day, such a move is deeply misguided.
The most egregious policy change included in this measure
is the removal of the Hyde Amendment, which protects life and
prevents federal taxpayer-funded abortions. Since it was first
enacted in 1976, it is estimated that 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 full committee markup
to reinstate the important Hyde language, as well as the
language known as the ``Weldon Amendment'' that protects
American doctors, nurses, and other health care professionals
from participating in an abortion if they have a moral
objection. The amendment was cosponsored by every Republican on
the Committee, and Members made it clear in vigorous debate
that the reinstatement of this language is the first step that
must be taken to begin work toward a serious negotiation on a
final spending bill. Disappointingly, the amendment to
reinstate the Hyde/Weldon language was opposed by Committee
Democrats and was defeated. Without agreement to include this
longstanding bipartisan provision, any serious discussion about
the numerous other policy and spending problems in this measure
is premature.
Beyond the extreme position taken to require all Americans
to pay for abortion on demand, and even requiring some people
to directly participate in abortions against their own moral
beliefs and consciences, the bill as reported includes many
other troubling policies and provisions as well. Many of these
are poison pills that must also be removed to achieve a final
bipartisan spending agreement.
For example, the bill as drafted includes several new
troubling and extreme labor policy riders, including language
restricting temporary employment certifications (H2-B visas)
for certain companies. We were pleased that the Committee
accepted a Republican amendment to strike the most concerning
of these provisions that would have significantly harmed many
seasonal and small businesses by preventing them from meeting
their workforce needs through the H-2B program.
Republicans have numerous policy and programmatic concerns
about this bill, as well as serious disagreements over the
funding provided, which must be addressed. Including the
longstanding bipartisan Hyde/Weldon language related to
abortions will be the first step in any negotiation--it is just
that simple. We urge the Majority to reverse course and not
proceed with a bill that contains farreaching, extreme policies
that are out of step with the American people.
In the weeks and months ahead, we hope the Majority will
move toward the compromise they know is necessary to fund the
government. Without a bipartisan agreement, this bill and other
spending bills will not become law and our country could be
forced into a year-long continuing resolution. Our goal should
be to avoid that outcome and build on the progress we have made
in the past by working together.
Kay Granger.
Tom Cole.
[all]