[Senate Report 118-207]
[From the U.S. Government Publishing Office]


                                                      Calendar No. 471
118th Congress     }                                     {     Report
                                 SENATE
 2d Session        }                                     {    118-207

======================================================================



 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 2025
                                _______
                                

                 August 1, 2024.--Ordered to be printed

                                _______
                                

          Ms. Baldwin, from the Committee on Appropriations, 
                        submitted the following

                                 REPORT

                         [To accompany S. 4942]

    The Committee on Appropriations reports an original bill 
(S. 4942) making appropriations for Departments of Labor, 
Health and Human Services, and Education, and related agencies 
for the fiscal year ending September 30, 2025, and for other 
purposes, reports favorably thereon without amendment and 
recommends that the bill do pass.


Amounts to new budget authority

Total of bill as reported to the Senate...............$1,463,081,956,000
Amount of 2024 
    appropriations............................         1,413,688,656,000
Amount of 2025 budget estimate.........................1,449,782,089,000
Bill as recommended to Senate compared to:
    2024 
    appropriations.......................................
                                                         +49,393,300,000
    2025 budget 
    estimate.....................................        +13,299,867,000


































56-353 PDF



































                                CONTENTS

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                                                                   Page

List of Abbreviations............................................     4
Summary of Budget Estimates and Committee Recommendations........     7
    Bill--Wide Directives........................................     7
Title I: Department of Labor:
    Employment and Training Administration.......................     9
    Veterans' Employment and Training............................    22
    Employee Benefits Security Administration....................    23
    Pension Benefit Guaranty Corporation.........................    25
    Wage and Hour Division.......................................    26
    Office of Labor-Management Standards.........................    27
    Office of Federal Contract Compliance Programs...............    27
    Office of Workers' Compensation Programs.....................    27
    Division of Energy Employees Occupational Illness 
      Compensation...............................................    29
    Occupational Safety and Health Administration................    30
    Mine Safety and Health Administration........................    32
    Bureau of Labor Statistics...................................    33
    Office of Disability Employment Policy.......................    34
    Departmental Management......................................    34
    General Provisions...........................................    38
Title II: Department of Health and Human Services:
    Health Resources and Services Administration.................    40
    Centers for Disease Control and Prevention...................    63
    National Institutes of Health................................    95
    Substance Abuse and Mental Health Services Administration....   157
    Agency for Healthcare Research and Quality...................   175
    Centers for Medicare and Medicaid Services...................   177
    Administration for Children and Families.....................   186
    Administration for Community Living..........................   207
    Administration for Strategic Preparedness and Response.......   213
    Office of the Secretary......................................   227
    General Provisions...........................................   242
Title III: Department of Education:
    Education for the Disadvantaged..............................   245
    Impact Aid...................................................   251
    School Improvement Programs..................................   252
    School Readiness.............................................   257
    Indian Education.............................................   257
    Innovation and Improvement...................................   259
    Safe Schools and Citizenship Education.......................   266
    English Language Acquisition.................................   268
    Special Education............................................   269
    Rehabilitation Services......................................   271
    Special Institutions for Persons With Disabilities:
        American Printing House for the Blind....................   272
        National Technical Institute for the Deaf................   273
        Gallaudet University.....................................   273
    Career, Technical, and Adult Education.......................   274
    Student Financial Assistance.................................   276
    Student Aid Administration...................................   277
    Higher Education.............................................   283
    Howard University............................................   291
    College Housing and Academic Facilities Loans Program........   292
    Historically Black College and University Capital Financing 
      Program Account............................................   292
    Institute of Education Sciences..............................   292
    Departmental Management:
        Program Administration...................................   297
        Office for Civil Rights..................................   305
        Office of the Inspector General..........................   305
    General Provisions...........................................   306
Title IV: Related Agencies:
    Committee for Purchase From People Who Are Blind or Severely 
      Disabled...................................................   307
    Corporation for National and Community Service...............   307
    Corporation for Public Broadcasting..........................   311
    Federal Mediation and Conciliation Service...................   312
    Federal Mine Safety and Health Review Commission.............   312
    Institute of Museum and Library Services.....................   312
    Medicaid and CHIP Payment and Access Commission..............   314
    Medicare Payment Advisory Commission.........................   314
    National Council on Disability...............................   314
    National Labor Relations Board...............................   315
    National Mediation Board.....................................   315
    Occupational Safety and Health Review Commission.............   315
    Railroad Retirement Board....................................   315
    Social Security Administration...............................   316
Title V: General Provisions......................................   323
Compliance With Paragraph 7, Rule XVI of the Standing Rules of 
  the Sen- ate...................................................   324
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules 
  of the Senate..................................................   326
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of 
  the Senate.....................................................   327
Budgetary Impact of Bill.........................................   331
Disclosure of Congressionally Directed Spending Items............   332
Comparative Statement of New Budget Authority....................   333

                         LIST OF ABBREVIATIONS

    ACA--Patient Protection and Affordable Care Act
    ACL--Administration for Community Living
    AHRQ--Agency for Healthcare Research and Quality
    ASH--Assistant Secretary for Health
    ASPR--Administration for Strategic Preparedness and 
Response
    BARDA--Biomedical Advanced Research and Development 
Authority
    CDC--Centers for Disease Control and Prevention
    CJ--Congressional Justification of Estimates for 
Appropriations Committees
    CMS--Centers for Medicare and Medicaid Services
    CNCS--Corporation for National and Community Service
    CPB--Corporation for Public Broadcasting
    DOD--Department of Defense
    DOL--Department of Labor
    EBSA--Employee Benefits Security Administration
    ESEA--Elementary and Secondary Education Act
    ETA--Employment and Training Administration
    FDA--Food and Drug Administration
    FIC--Fogarty International Center
    FMCS--Federal Mediation and Coalition Service
    FMSHRC--Federal Mine Safety and Health Review Commission
    FTE--full-time equivalent
    GAO--Government Accountability Office
    HBCUs--Historically Black Colleges and Universities
    HCFAC--Health Care Fraud and Abuse Control
    HELP--Health, Education, Labor, and Pensions
    HHS--Health and Human Services
    HRSA--Health Resources and Services Administration
    IC--Institute and Center
    IDEA--Individuals with Disabilities Education Act
    IMLS--Institute of Museum and Library Services
    LEA--local educational agency
    MACPAC--Medicaid and CHIP Payment and Access Commission
    MedPAC--Medicare Payment Advisory Commission
    MSHA--Mine Safety and Health Administration
    NCATS--National Center for Advancing Translational Sciences
    NCI--National Cancer Institute
    NEI--National Eye Institute
    NHGRI--National Human Genome Research Institute
    NHLBI--National Heart, Lung, and Blood Institute
    NIA--National Institute on Aging
    NIAAA--National Institute on Alcohol Abuse and Alcoholism
    NIAID--National Institute of Allergy and Infectious 
Diseases
    NIAMS--National Institute of Arthritis and Musculoskeletal 
and Skin Diseases
    NIBIB--National Institute of Biomedical Imaging and 
Bioengineering
    NICHD--Eunice Kennedy Shriver National Institute of Child 
Health and Human Development
    NIDA--National Institute on Drug Abuse
    NIDCD--National Institute on Deafness and Other 
Communication Disorders
    NIDCR--National Institute of Dental and Craniofacial 
Research
    NIDDK--National Institute of Diabetes and Digestive and 
Kidney Disease
    NIDRR--National Institute on Disability and Rehabilitation 
Research
    NIEHS--National Institute of Environmental Health Sciences
    NIGMS--National Institute of General Medical Sciences
    NIH--National Institutes of Health
    NIMH--National Institute of Mental Health
    NIMHD--National Institute on Minority Health and Health 
Disparities
    NINDS--National Institute of Neurological Disorders and 
Stroke
    NINR--National Institute of Nursing Research
    NLM--National Library of Medicine
    NLRB--National Labor Relations Board
    NSF--National Science Foundation
    NTID--National Technical Institute for the Deaf
    OAR--Office of AIDS Research
    OCR--Office for Civil Rights
    ODEP--Office of Disability Employment Policy
    OFCCP--Office of Federal Contract Compliance Programs
    OIG--Office of the Inspector General
    OLMS--Office of Labor-Management Standards
    OMB--Office of Management and Budget
    OMH--Office of Minority Health
    OMHA--Office of Medicare Hearings and Appeals
    ONC--Office of the National Coordinator for Health 
Information Technology
    ORWH--Office of Research on Women's Health
    OSHA--Occupational Safety and Health Administration
    OWCP--Office of Workers' Compensation Programs
    OWH--Office of Women's Health
    PBGC--Pension Benefit Guaranty Corporation
    PHS--Public Health Service
    PPH Fund--Prevention and Public Health Fund
    PRNS--Programs of Regional and National Significance
    RSA--Rehabilitation Services Administration
    SAMHSA--Substance Abuse and Mental Health Services 
Administration
    SEA--State educational agency
    SPRANS--Special Projects of Regional and National 
Significance
    SSA--Social Security Administration
    SSI--Supplemental Security Income
    STEM--science, technology, engineering, and mathematics
    UI--unemployment insurance
    USAID--U.S. Agency for International Development
    VETS--Veterans' Employment and Training Services
    VISTA--Volunteers in Service to America
    WANTO--Women in Apprenticeship and Non-Traditional 
Occupations
    WHD--Wage and Hour Division
    WIA--Workforce Investment Act
    WIOA--Workforce Innovation and Opportunity Act

 COMMITTEE REPORT FOR DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, 
     AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS BILL, 2025

       SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS

    For fiscal year 2025, the Committee recommends total budget 
authority of $1,463,081,956,000 for the Departments of Labor, 
Health and Human Services, and Education, and Related Agencies. 
This amount includes $198,655,000,000 in current year base 
discretionary funding consistent with the subcommittee's 
allocation. In addition, the bill includes $2,531,000,000 in 
program integrity cap adjustments.
    Fiscal year 2024 levels cited in this Committee Report 
reflect the enacted amounts in Public Law 118-47, the Further 
Consolidated Appropriations Act, 2024, adjusted for 
comparability where noted.

                          BILL-WIDE DIRECTIVES

    The Labor, Health and Human Services, and Education, and 
Related Agencies [Labor-HHS-Education] appropriations bill 
constitutes the largest share of non-defense discretionary 
funding and supports critical investments in a wide range of 
areas including early learning, substance use and mental 
health, biomedical research, public health and preparedness, 
elementary and secondary education, higher education, workforce 
development, and social security, among many others.
    This Committee Report provides additional direction and 
specificity on the uses of funds provided in this bill. During 
fiscal year 2025, for the purposes of the Balanced Budget and 
Emergency Deficit Control Act of 1985, as amended, with respect 
to appropriations contained in the accompanying bill, the terms 
``program, project, and activity'' [PPA] shall mean any item 
for which a dollar amount is contained in appropriations acts 
(including joint resolutions providing continuing 
appropriations) or accompanying reports of the House and Senate 
Committees on Appropriations, or accompanying conference 
reports and joint explanatory statements of the committee of 
conference. The Committee continues longstanding reprogramming 
requirements and limitations regarding changes to funding for 
PPAs. The Committee expects agencies to submit any 
reprogramming requests in compliance with requirements of this 
act and to provide a thorough explanation of the proposed 
reallocations, including a detailed justification of increases 
and reductions. The Committee expects each agency to manage the 
expenditures of its programs and activities to remain within 
the amounts appropriated by Congress.
    The Committee also continues the longstanding requirement 
that each agency submit an operating plan to the House and 
Senate Committees on Appropriations not later than 45 days 
after enactment of this act, in order to establish the baseline 
for application of reprogramming and transfer authorities 
provided in this act. The operating plan should include at 
minimum funding for PPAs as specified above.
    The Committee reminds agencies funded by this act of their 
obligation to uphold the Federal trust and treaty 
responsibilities to Tribes and Federal obligations to the 
Native Hawaiian Community. This includes upholding treaty and 
reserved rights, and any other rights and obligations under 
Federal law; supporting self-determination efforts by Native 
communities; fulfilling obligations under Presidential 
Memoranda and Executive Orders; and conducting early and robust 
government-to-government consultation with Tribes, and 
meaningful outreach and engagement with Native Hawaiians.
    The Committee also directs the Secretary of Education, 
Secretary of Health and Human Services, and Secretary of Labor 
to release public reports detailing how the Departments are 
addressing antisemitism, including by implementing the National 
Strategy to Counter Antisemitism.
    The Committee directs the Secretary of Education, Secretary 
of Health and Human Services, and Secretary of Labor to brief 
the House and Senate Committees on Appropriations no later than 
90 days after enactment of this act regarding any strategic 
plans developed by the Department over the three prior fiscal 
years outlining the ways that the Department has promoted voter 
registration, and voter participation.
    The Committee is encouraged by the General Services 
Administration's Bulletin FMR C-2024-01, ``Safety Station 
Program Guidelines in Federal Facilities'' that was issued on 
December 21, 2023. The Committee encourages all Departments 
covered in this act to implement these guidelines and establish 
safety stations in each public building that include automated 
external defibrillators, opioid reversal agents, and 
hemorrhagic control programs and requests a briefing from each 
Department within 90 days of enactment of this act on progress 
towards implementing these guidelines.
    The Committee continues to appreciate the close working 
relationship with the various budget offices of the agencies 
funded in this bill. Maintaining these relationships is 
critical for the Committee to perform its duties in both 
developing these funding requirements and recommendations and 
providing oversight over the execution of funds.
    Finally, each reference to the Committees or Committees on 
Appropriations in this Committee Report, unless otherwise 
noted, is to the House of Representatives Subcommittee on 
Labor, Health and Human Services, Education, and Related 
Agencies and the Senate Subcommittee on Labor, Health and Human 
Services, Education, and Related Agencies.

                                TITLE I

                          DEPARTMENT OF LABOR

    Any references in this title of the report to the 
``Secretary'' or the ``Department'' shall be interpreted to 
mean the Secretary of Labor or the Department of Labor, 
respectively, unless otherwise noted.

                 Employment and Training Administration

                    TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2024....................................  $4,006,421,000
Budget estimate, 2025...................................   3,930,587,000
Committee recommendation................................   4,019,669,000

    The Training and Employment Services [TES] account provides 
funding primarily for activities under the Workforce Innovation 
and Opportunity Act [WIOA] (Public Law 113-128), and is a 
decentralized, integrated system of skill training and related 
services designed to enhance the employment and earnings of 
economically disadvantaged and dislocated workers. Funds 
provided for many training programs for fiscal year 2025 will 
support the program from July 1, 2025, through June 30, 2026. A 
portion of this account's funding, $1,772,000,000, becomes 
available on October 1, 2025, for the 2025 program year.
    Advanced Robotics Manufacturing.--The Committee recognizes 
the need for workforce training and certificate programs 
targeting collaborative robotics and additive manufacturing to 
adequately prepare the current and future workforce for the 
challenges of tomorrow. The Committee encourages the Department 
to appropriately address this need through the prioritization 
of such programs, with an emphasis on programs that re-skill 
incumbent manufacturing workers.
    Apprenticeship Grants.--The Committee supports the 
expansion of apprenticeship opportunities and notes that they 
can often provide more affordable pathways to high-paying jobs. 
Not later than 180 days after the enactment of this act, the 
Department shall publicly disclose on its website grantees 
receiving funding under the Apprenticeship Program from the 
previous program year, the number of apprentices attributable 
to each grantee, and the respective employment and earnings 
outcomes of program participants as required under section 
116(b)(2)(A)(i) of WIOA. Additionally, the Department shall 
report to the Committee on the extent to which it is engaging 
with the Department of Education to address mismatches between 
worker skills or their participation in the labor force and 
employer needs and the steps that the Department has taken or 
plans to take to study the drivers of skills' mismatches, 
workforce shortages, productivity fluctuations, turnover 
fluctuations, stagnant wages, and poor working conditions 
across occupations, industries, and the economy as a whole.
    Clean Start.--The Committee is deeply concerned with the 
devastating effects of drug use on individuals, families, and 
communities around the country. Individuals who have nonviolent 
felony or misdemeanor convictions as a result of drug use often 
find it nearly impossible to rejoin the workforce. The 
Committee encourages the Secretary to support workforce and 
training options for individuals with a nonviolent felony or 
misdemeanor conviction. Further, within 180 days of enactment, 
the Secretary shall report to the Committee on additional 
actions that could be taken to support State efforts to support 
workforce and training opportunities for nonviolent offenders, 
including examining removing any barriers to the participation 
of nonviolent offenders in workforce training programs funded 
by the Department.
    Collaboration Between Workforce Development Systems and 
State and Local Educational Agencies.--The Committee recognizes 
the unique role the workforce development system plays in 
providing in-school and out-of-school youth with opportunities 
that deepen learning and create pathways into high-quality 
jobs. The Committee also remains concerned with the adverse 
impacts of COVID-19 on educational attainment, particularly for 
students from underserved communities. The Committee continues 
to encourage the Department, in partnership with the Department 
of Education, to facilitate greater collaboration between the 
workforce development system and State and local educational 
agencies to engage and support youth (particularly disconnected 
youth), and to strengthen completion rates of secondary and 
postsecondary education and improve pathways into high-quality 
jobs. The Committee looks forward to the briefing requested in 
Senate Report 118-84 on any actions taken and any 
recommendations for statutory changes that can support greater 
collaboration between the workforce development and education 
systems.
    Communities Affected by Substance Use.--The Committee 
continues to encourages the Secretary to prioritize funding for 
grants to serve or retrain workers in communities impacted by 
the health and economic effects of widespread substance use, 
including methamphetamine use, addiction, and overdose.
    Creative Economy.--The Committee recognizes that the 
creative economy was severely impacted by COVID-19 and 
encourages the Department to partner with the National 
Endowment for the Arts and the National Endowment for the 
Humanities to explore the feasibility and expansion of 
Registered Apprenticeship programs for creative workers who 
previously received income through creative, cultural, or 
artistic-based pursuits to produce ideas, content, goods, and 
services, without regard to whether such income is earned 
through employment as an independent contractor or as an 
employee for an employer.
    Direct Care Worker Shortage.--The Committee is concerned 
about worker shortages in the direct care sector, particularly 
regarding aging care and disability care. Expanding access to 
long-term care will become more urgent as the U.S. population 
of adults who are 65 and older will nearly double by 2050, with 
10,000 people turning 65 every day. The Committee encourages 
the Department, in coordination with the Department of Health 
and Human Services, to study the effects of worker shortages in 
the direct care sector and the impact that worker shortages 
will have on long-term care affordability and accessibility, 
and long-term care programs and looks forward to the report 
requested in Senate Report 118-84.
    Improving Access to Public Benefits.--The Committee 
recognizes that one-stop customers often face significant 
barriers to pursuing training and employment, including lack of 
access to quality childcare, food and nutrition, and medical 
services. Further, the Committee is concerned that the 
complexity of supportive services program eligibility 
requirements and application processes may discourage 
enrollment. To optimize use of Federal funds, the Committee 
encourages Department, in coordination with the Department of 
Education and the Department of Health and Human Services, to 
provide guidance on informing one-stop center customers about 
the availability of supportive services or assistance, 
including Medicaid, the Supplemental Nutrition Assistance 
Program, the Earned Income Tax Credit, the Child Tax Credit, 
and the Temporary Assistance for Needy Families Program, and on 
referring customers to such services or assistance. Further, 
guidance should clarify how one-stops can assist customers in 
establishing eligibility for financial aid assistance programs 
related to education and training programs that are funded 
outside of WIOA.
    Modernizing Workforce Development Programming and Serving 
Underemployed Workers.--The Committee encourages ETA to 
collaborate with State workforce agencies to modernize 
workforce development programming. The Committee is also 
concerned about the continued difficulty of underemployed 
workers transitioning to full employment and encourages ETA to 
explore new avenues for training, including the use of virtual 
resources. As part of this effort, ETA should consider the time 
constraints of underemployed workers who may work multiple jobs 
or have caretaking responsibilities that limit their ability to 
utilize the existing resources provided by ETA. Finally, the 
Committee further encourages the Department to develop a 
comprehensive long-term strategy for the delivery of online 
training and development programming.
    Occupational Barriers for Healthcare Professionals.--The 
Committee recognizes that immigrants arriving in the United 
States holding healthcare degrees and credentials from their 
home countries face significant barriers that lead to 
underemployment, including in lower-skilled healthcare jobs 
than they are trained for and jobs outside of healthcare. The 
Committee supports efforts to strengthen the healthcare 
workforce and reduce barriers for in-demand occupations. As 
such, the Committee encourages the Secretary to issue guidance 
that identifies ways to bridge the gap between unemployed 
immigrants and healthcare professions.
    Opportunity Youth.--The Committee continues to encourage 
the Department to use funds provided to carry out sections 
168(b) and 169(c) of WIOA, which may be used for technical 
assistance and demonstration projects, to support demonstration 
programs that allow at-risk youth who are out-of-school, have 
limited work experience, and live in communities experiencing 
high rates of unemployment and high rates of community 
violence, to participate in the workforce.
    Public Libraries.--The Committee continues to encourage ETA 
to expand its collaborative work with the Institute of Museum 
and Library Services [IMLS] to help States and local boards 
integrate the education, employment, and training services 
provided by public libraries into the workforce investment 
system. Libraries can play a critical role in helping people 
access benefits and get back to work and the Committee 
encourages ETA to work with IMLS to identify barriers to 
libraries participating in programs funded under WIOA and to 
develop a plan to address those barriers. The Committee looks 
forward to the briefing on the plan to identify and address 
barriers to libraries participating in programs under WIOA as 
encouraged in Senate Report 118-84.
    Pursue Workforce Data Linkages.--The Committee directs the 
Department, in coordination with the Department of Health and 
Human Services, the Department of Education, and other Federal 
agencies that support workforce development programs and that 
hold nationwide earnings data, to submit a report to Congress 
within 360 days of enactment on how to improve data quality and 
transparency regarding participation in and outcomes from 
Federal education and training programs, including but not 
limited to WIOA, and including pre-participation earnings and 
employment measures as well as outcomes reporting beyond a 
single year post-exit, while also protecting privacy. The 
Departments should seek input from States, data-linkage 
experts, including members of the Advisory Committee on Data 
for Evidence-Building, with knowledge of practices for linking 
client data with Federal and State earnings data, data privacy 
experts, and other relevant stakeholders. The report should 
explain what steps can be taken under current law to implement 
modernized data infrastructure for workforce development 
programs, barriers presented by current statutes, regulations, 
and guidance, as well as legislative changes that would be 
necessary to overcome those barriers.
    Small Businesses.--The Committee encourages the Department 
to support the employment needs of small businesses and 
entrepreneurial skills training through WIOA programs, 
particularly in underserved, disadvantaged communities.
    Submarine Construction Workforce.--The Committee continues 
to encourage ETA to collaborate with the Departments of Defense 
and Education to address critical workforce needs in the 
submarine construction pipeline.
    Water and Wastewater Operators.--The Committee continues to 
be concerned by the Nationwide shortage of water and wastewater 
operators, particularly in rural areas and continues to 
strongly urge the Secretary to make funding available through 
workforce development and apprenticeship activities funded 
under this bill for registered apprenticeship programs 
consistent with National Guideline Standards of Apprenticeship 
for Water and Wastewater System Operations Specialists and 
WIOA. The Committee continues to direct the Department to 
highlight the availability of funding opportunities that may 
support such activities, and to provide technical assistance 
and outreach to potential grantees with an emphasis on sectors 
that are underrepresented in the apprenticeship program and 
that have demonstrated shortages of workers.

Grants to States

    The Committee recommends $2,929,332,000 for Training and 
Employment Services Grants to States.
    Under WIOA, a local board is given up to 100 percent 
transfer authority between Adult and Dislocated Worker 
activities upon approval of the Governor.
    Adult Employment and Training.--The Committee recommends 
$885,649,000 for adult employment and training. Formula funding 
is provided to States and further distributed to local 
workforce investment areas through one-stop centers. The 
program provides employment and training services to 
disadvantaged, low-skilled, unemployed, and underemployed 
adults, including veterans.
    Funds are made available in this bill for adult employment 
and training activities in program year 2025, which occurs from 
July 1, 2025, through June 30, 2026. The bill provides that 
$173,649,000 is available for obligation on July 1, 2025, and 
that $712,000,000 is available on October 1, 2025. Both 
categories of funding are available for obligation through June 
30, 2026.
    Youth Training.--The Committee recommends $948,130,000 for 
youth training. The purpose of this program is to provide low-
income youth who are facing barriers to employment with 
services that prepare them to succeed in the knowledge-based 
economy. Funds are made available for youth training activities 
in program year 2025, which occurs from April 1, 2025, through 
June 30, 2026.
    Dislocated Worker Assistance.--The Committee recommends 
$1,095,553,000 for dislocated worker assistance. This program 
is a State-operated effort that provides training services and 
support to help permanently separated workers return to 
productive unsubsidized employment. In addition, States must 
use State-wide reserve funds for rapid response assistance to 
help workers affected by mass layoffs and plant closures. 
States must also use these funds to carry out additional State-
wide employment and training activities, such as providing 
technical assistance to certain low-performing local areas, 
evaluating State programs, and assisting with the operation of 
one-stop delivery systems. States may also use funds for 
implementing innovative training programs.
    Funds made available in this bill support activities in 
program year 2025, which occurs from July 1, 2025, through June 
30, 2026. The bill provides that $235,553,000 is available for 
obligation on July 1, 2025, and that $860,000,000 is available 
on October 1, 2025. Both categories of funding are available 
for obligation through June 30, 2026.

National Programs

            Dislocated Worker Assistance National Reserve
    The Committee recommends $302,859,000 for the Dislocated 
Worker Assistance National Reserve, which is available to the 
Secretary for activities such as responding to mass layoffs, 
plant and/or military base closings, and natural disasters, as 
well as for technical assistance, training, and demonstration 
projects.
    Funds made available for the National Reserve in this bill 
support activities in program year 2025. The bill provides that 
$102,859,000 is available for obligation on July 1, 2025, and 
that $200,000,000 is available on October 1, 2025. Both 
categories of funding are available for obligation through 
September 30, 2026.
    Automation Impacted Industries.--The Committee continues to 
support funding to support demonstration and pilot projects 
relating to the training needs of workers who are, or are 
likely to become, dislocated as a result of automation.
    Career Pathways for Youth Grants.--The Committee continues 
to recognize that multiple career pathways should be available 
to young people. The Committee also recognizes the need for 
early workforce readiness, employment, and training 
opportunities that help youth develop soft skills, such as 
responsibility, organization, and time management, as well as 
the need to learn workplace safety. The Committee 
recommendation includes $20,000,000 to utilize the 
demonstration grant authority under the dislocated worker 
national reserve 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. This programming includes soft skill 
development, career exploration, job readiness and 
certification, summer jobs, year-round job opportunities, and 
apprenticeships. Funding will also support partnerships between 
workforce investment boards and youth serving organizations. 
Additionally, the Committee encourages the Department to 
determine the feasibility of utilizing the existing one-stop 
infrastructure to develop and execute career pathways for youth 
at the local or regional level.
    Disaster Resilience and Infrastructure.--The Committee 
recognizes the need for workforce development pathways in 
disaster resilience and infrastructure sectors and the role 
that public and non-profit workforce development providers and 
apprenticeship programs should play in helping provide hands-on 
experience through projects on a pathway to jobs. The Committee 
supports funding for programs to address these issues, 
including the Department's coordination with other agencies 
implementing the Infrastructure Investment and Jobs Act, and 
Inflation Reduction Act, and the Corporation for National and 
Community Service.
    Dislocated Worker National Reserve Grantee Performance 
Reporting.--Consistent with the requirements of section 
116(b)(2)(A)(i) of WIOA (29 U.S.C. 3141), the Committee directs 
the Department to require that all grantees receiving awards 
funded through the Dislocated Worker National Reserve report on 
the employment, earnings, and credential attainment outcomes of 
program participants. The Committee further directs ETA to 
include program participant outcomes disaggregated by grantee 
on its website.
    Employee Ownership Initiative.--The Committee 
recommendation includes $2,000,000 for grants authorized by 
section 346(d) of the SECURE 2.0 Act of 2022. Funds will be 
used to establish and expand employee ownership programs 
authorized by such section. The Committee expects the Employee 
Benefits Security Administration to provide subject matter 
assistance to ETA as it develops and administers this grant 
program.
    Multi-state National Dislocated Coal Miners Assistance 
Grant Program.--The Committee is aware of the difficulties 
experienced by dislocated coal miners as a result of continuing 
energy sector restructuring. The Committee continues to 
strongly support funding for non-profit organizations that 
provide employment and training assistance, as well as related 
supportive services, to individuals who are dislocated by coal 
plant closures or substantial layoffs at coal mine operations 
and their immediate family.
    Strengthening Community College Training Grants [SCCTG].--
The Committee recommendation includes $65,000,000 for SCCTG. 
This program builds the capacity of community colleges to 
address workforce development needs in in-demand industries and 
career pathways leading to quality jobs.
    Workforce Opportunity for Rural Communities.--The Committee 
recommendation includes $50,000,000 for the Workforce 
Opportunity for Rural Communities program, to provide enhanced 
worker training in the Appalachian, Delta, and Northern Border 
regions. These funds provide reemployment and training 
assistance to dislocated workers in rural areas to help them 
adapt existing skills and learn new ones demanded by growing 
industries. The Committee strongly encourages the Department to 
develop funding opportunity announcements and make grant awards 
in coordination with the Appalachian Regional Commission [ARC], 
Delta Regional Authority [DRA], and Northern Border Regional 
Commission [NBRC], for which each award shall not exceed 
$1,500,000. Within the total, the recommendation includes 
$21,750,000 for grants in areas served by the ARC, $21,750,000 
for areas served by the DRA, and $6,500,000 for areas served by 
the NBRC.
            Indian and Native American Programs
    The Committee recommends $60,000,000 for Indian and Native 
American Programs. These programs are designed to improve the 
academic, occupational, and literacy skills of Native 
Americans, Alaskan Natives, and Native Hawaiians to aid the 
participants in securing permanent, unsubsidized employment. 
Allowable training services include adult basic education, 
general educational development attainment, literacy training, 
English language training, as well as the establishment of 
linkages with remedial education.
    The Committee supports the effective implementation of the 
Indian and Native American programs. The Committee expects that 
the Department will ensure new members of the Native American 
Employment and Training Council [NAETC] are selected as 
expeditiously as possible to avoid vacancies on the NAETC.
            Migrant and Seasonal Farmworker Programs
    The Committee recommends $97,396,000 for migrant and 
seasonal farmworkers programs, which serve members of 
economically disadvantaged families whose principal livelihood 
is derived from migratory and other forms of seasonal farm 
work, fishing, or logging activities. Enrollees and their 
families are provided with employment, training, and related 
services intended to prepare them for stable, year-round 
employment within and outside of the agriculture industry.
    The Committee recommendation provides that $90,134,000 be 
used for State service area grants. The Committee 
recommendation also includes bill language directing that 
$6,591,000 be used for migrant and seasonal farmworker housing 
grants, of which not less than 70 percent shall be for 
permanent housing. The principal purpose of these funds is to 
continue the network of local farmworker housing organizations 
working on permanent housing solutions for migrant and seasonal 
farmworkers. The Committee recommendation also includes 
$671,000 to be used for training, technical assistance, and 
related activities, including funds for migrant rest center 
activities under section 167 of WIOA.
            YouthBuild
    The Committee recommendation includes $110,000,000 for 
YouthBuild, which helps provide disconnected youth with work 
readiness and industry-driven credential attainment 
opportunities.
    The Committee encourages the Department to ensure 
YouthBuild grants reach geographically diverse areas, including 
rural areas.
            Reentry Employment Opportunities [REO]
    The Committee recommends $115,000,000 for the REO program, 
including $30,000,000 for national and regional intermediaries. 
The REO program provides current or formerly incarcerated youth 
and adults involved in the justice system with occupational 
skills training that leads to industry recognized credentials 
and apprenticeships leading to employment in good, well-paying 
jobs and careers with opportunities for advancement. Programs 
are carried out directly through State and local governmental 
entities and community-based organizations, as well as 
indirectly through intermediary organizations.
    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 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.
            Apprenticeship Grants
    The Committee recommendation includes $290,000,000 for 
Apprenticeship Grants.
    The Committee continues to support the prioritization of 
funding to expand registered apprenticeships into new 
industries and for underserved or underrepresented populations. 
The Committee supports the use of apprenticeship grants that 
provide worker education in in-demand and emerging fields, 
including first responder; disaster resilience, response, and 
recovery; utility (energy and water) and resource management; 
transportation and infrastructure; goods movement sectors such 
as global logistics, rail and other freight-related employment; 
and outdoor recreation economy-related employment. The 
Committee also encourages the Department to support 
apprenticeship opportunities that incorporate non-traditional 
industries, while providing appropriate flexibility for such 
industries. Further, the Committee encourages the Department to 
fund apprenticeship opportunities in local communities that 
have high rates of unemployment and high rates of community 
violence.
    Competency-Based Apprenticeships.--The Committee believes 
that competency-based apprenticeship programs, where program 
completion is based on the attainment of competencies, are an 
important part of the apprenticeship landscape and urges the 
Department to look for ways to include competency-based 
apprenticeships in the Registered Apprenticeship Program.
    Degree Apprenticeships.--The Committee recognizes the value 
of degree apprenticeship programs where institutions of higher 
education create initiatives that integrate the awarding of 
college degrees with the hallmarks of apprenticeships, 
including supporting paid work experiences, on-the-job 
training, related instruction, and industry involvement. The 
Committee appreciates that ETA has made degree apprenticeships 
a fundable activity in the Apprenticeship Grant program and 
urges ETA to prioritize funding for degree apprenticeships in 
future Funding Opportunity Announcements. The Committee also 
urges the Department to collaborate with the Department of 
Education in supporting the establishment of degree 
apprenticeship programs at 4-year institutions of higher 
education to align workforce development efforts and post-
secondary education in industries such as advanced 
manufacturing, information technology, healthcare, and energy, 
among others.
    Pay for Success.--The Committee looks forward to the 
Department's assessment of the feasibility of supporting a pay-
for-success initiative as directed in the fiscal year 2024 
explanatory statement.
    School Administrator Apprenticeships.--The Committee is 
encouraged by the Department's decision to make school 
administrators eligible for apprenticeship training and 
assistance. The Department should provide additional funding to 
further establish and implement a leadership development 
apprenticeship program to help educators advance their careers, 
address school principal and superintendent shortages, and meet 
growing demand.
            Workforce Data Quality Initiative
    The Committee recommendation includes $6,000,000 for the 
Workforce Data Quality Initiative, which provides competitive 
grants to support States in developing, connecting, and 
enhancing their longitudinal data systems that integrate 
education and workforce data. This supports evaluation and 
research on the effectiveness of education and workforce 
programs, and helps provide consumer-friendly information so 
that individuals can select the programs that best meet their 
needs.
            Congressionally Directed Spending
    The Committee recommendation includes $109,082,000 for the 
projects, and in the amounts, specified in the table at the end 
of this Committee Report.

                               JOB CORPS

Appropriations, 2024....................................  $1,760,155,000
Budget estimate, 2025...................................   1,764,376,000
Committee recommendation................................   1,760,155,000

    The recommendation for operations of Job Corps centers is 
$1,603,325,000.
    The Committee recommendation for administrative costs is 
$33,830,000.
    The Committee recommends a total of $123,000,000 in 
construction, renovation, and acquisition [CRA] funds. This 
amount is available from July 1, 2025, to June 30, 2028. The 
Committee continues bill language allowing the Secretary to 
transfer up to 15 percent of CRA funds, if necessary, to meet 
the operational needs of Job Corps centers or to achieve 
administrative efficiencies. The bill continues to require the 
Secretary to notify the Committees on Appropriations of the 
House of Representatives and the Senate at least 15 days in 
advance of any transfer. The Committee expects any notification 
to include a justification.
    Civilian Conservation Centers.--The Committee continues to 
strongly encourage the Department to prioritize the development 
of new natural resource and conservation trade offerings, 
particularly focused on wildland firefighting and emergency 
response. The Committee encourages the Department to maximize 
the utilization of Job Corps trade offerings, particularly 
those focused on natural resources and wildland firefighting, 
including by reclassifying enrollees engaged in wildland 
firefighting or off-campus work-based learning as out of the 
career and technical training classroom so that another 
enrollee may occupy that slot.
    Continuous Campus Improvement.--The Committee encourages 
the Department to develop a process involving Job Corps youth 
service providers for setting achievable campus performance 
expectations in order to more effectively drive continuous 
improvement in student outcomes.
     Homeless Youth.--The Committee continues to strongly 
encourage the Department to streamline application requirements 
for homeless youth in Job Corps.
    Maximizing Employer Partnerships.--The Committee applauds 
the Department's efforts to develop relationships between Job 
Corps and employers associated with our Nation's strategic 
priorities including infrastructure, advanced manufacturing, 
and the defense industrial base. The Committee encourages the 
Department to fully leverage section 158(f) of WIOA to maximize 
the resources available to campuses to develop these 
partnerships and meet employers' needs.
    Rural Training Sites.--The Committee encourages the 
Department to support and incentivize high quality center 
operators to develop and enhance partnerships with existing 
rural training sites to enhance opportunities and work 
experiences for students in underserved rural or remote 
communities. Such rural partnerships should use student-focused 
industry-backed curricula, prepare students for employment in 
high-demand fields, offer students the opportunity to take 
coursework leading to college credit, and demonstrate strong 
employer partnerships within the region in which the center is 
located. Such partnerships will also promote the ability of Job 
Corps centers to meet local workforce and cultural needs in 
communities far removed from their locations.
    Substance Use and Behavioral Health.--The Committee is 
concerned about the increase in overdoses and deaths among 
youth resulting from drug use, including fentanyl. The 
Committee requests the Department make recommendations, 
including legislative changes, to address substance use and 
behavioral health challenges of Job Corps participants in its 
fiscal year 2026 CJ.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2024....................................    $405,000,000
Budget estimate, 2025...................................     405,000,000
Committee recommendation................................     405,000,000

    Community Service Employment for Older Americans [CSEOA] 
provides part-time employment in community service activities 
for unemployed, low-income persons aged 55 and older. The 
Committee recommendation includes $405,000,000 for CSEOA.
    The Committee encourages the Department to reserve amounts 
proportionate to the Pacific Islander and Asian American and 
the Indian populations for national grants to national Pacific 
Island and Asian American and Indian aging organizations who 
have a track record of reaching, in a linguistically and 
culturally competent manner, this underserved population of 
older workers across the country with significant barriers to 
employment. The Committee also directs the Department to 
provide an update in the fiscal year 2026 CJ on how recipients 
of funding under title V of the Older Americans Act of 1965 
[OAA] are serving older individuals who are Native American and 
Pacific Islander and Asian American with such funding.

              FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2024....................................     $30,700,000
Budget estimate, 2025...................................      33,900,000
Committee recommendation................................      33,900,000

    The Committee recommendation includes mandatory funds for 
the Federal unemployment benefits and allowances program that 
assists trade-impacted workers with benefits and services to 
upgrade skills and retrain in new careers. These benefits and 
services are designed to help participants find a path back 
into middle-class jobs, improve earnings, and increase 
credential and education rates.
    The Trade Adjustment Assistance [TAA] program provides 
assistance to workers who have been adversely affected by 
international trade. TAA provides benefits and services to 
those who qualify, to include job training, job search and 
relocation allowances, and wage supplements for workers age 50 
and older.

     STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Appropriations, 2024....................................  $4,006,150,000
Budget estimate, 2025...................................   4,325,429,000
Committee recommendation................................   4,038,150,000

    The Committee recommendation includes $3,954,084,000 
authorized to be drawn from the Employment Security 
Administration account of the Unemployment Trust Fund and 
$84,066,000 to be provided from the general fund of the 
Treasury.
    The funds in this account are used to provide 
administrative grants and assistance to State agencies that 
administer Federal and State unemployment compensation laws and 
operate the public employment service.

Unemployment Insurance

    The Committee recommends a total of $3,172,635,000 for 
Unemployment Insurance [UI] activities. For UI State 
operations, the Committee recommends $2,775,635,000.
    The Committee recommendation includes $388,000,000 for 
Reemployment Services and Eligibility Assessments, to expand 
intensive, individualized reemployment assistance, and to help 
address and prevent long-term unemployment, and reduce improper 
payments. This includes $117,000,000 in base funding and 
$271,000,000 in cap adjustment funding consistent with the 
Fiscal Responsibility Act. The recommendation also includes 
$9,000,000 for the UI Integrity Center of Excellence, including 
supporting an integrated data hub, training modules, and data 
analytics capacity to help States reduce fraud.
    Finally, the Committee recommends $18,000,000 for UI 
national activities, which will support activities that benefit 
the entire Federal-State UI system, including supporting the 
continuation of IT upgrades and technical assistance.
    The Committee directs the Department to include information 
in the fiscal year 2026 CJ on: (1) how the ability of State 
workforce agencies to provide federally required service levels 
for unemployment insurance programs is affected when States do 
not receive the resources they need for administration as 
identified by the Resource Justification Model; (2) whether 
improvements to the Resource Justification Model could support 
improved State administration of the unemployment insurance 
programs; (3) whether Federal funding to States fully pays for 
the administration of Federal benefit programs, including 
emergency benefit programs implemented during the COVID-19 
pandemic; (4) how ETA used CARES Act, ARPA, and annual 
appropriations to improve the administration and integrity of 
the unemployment insurance system since 2020; (5) how States 
identify fraudulent actors who apply for unemployment insurance 
payments and the nature of these actors; (6) how any new 
appropriations and authorities would help the Department 
improve access to unemployment insurance for eligible workers 
and identify and recoup fraudulent overpayments; and (7) how 
any new appropriations and authorities would enhance methods by 
which ETA helps States better administer their unemployment 
insurance programs and identify and recoup fraudulent 
overpayments.

Employment Service

    For the Employment Service allotments to States, the 
Committee recommends $675,052,000. This amount includes 
$21,413,000 in general funds together with an authorization to 
spend $653,639,000 from the Employment Security Administration 
account of the Unemployment Trust Fund.
    The Committee also recommends $25,000,000 for Employment 
Service national activities.
    The Committee recommendation includes $2,500,000 to 
continue efforts to reduce the processing backlog for the work 
opportunity tax credit [WOTC] program and for assisting States 
to modernize information technology for processing 
certification requests, which may include training and 
technical assistance. Consistent with this effort, the 
Committee strongly urges the Department to develop national 
guidelines for the consistent administration of the program, 
including flexibility for State workforce agencies with lower 
capacity. This guidance should also encourage State workforce 
agencies to enter into cooperative information exchange 
agreements with Federal and State agencies that have the data 
needed to determine WOTC eligibility. Finally, the Committee 
recognizes that processing requests for remote workers may be 
best accomplished in the State where the workers reside and not 
where the employer is located.

Foreign Labor Certification

    For carrying out the Department's responsibilities related 
to foreign labor certification activities, the Committee 
recommends $61,528,000. In addition, five percent of the 
revenue from H-1B fees is available to the Department for costs 
associated with processing H-1B alien labor certification 
applications, and $23,282,000 is available for related State 
grants.
    Examining Updates to Schedule A.--The Committee notes the 
ongoing work at the Department to gather and address public 
input on whether and how to update Schedule A. The Committee 
encourages the Department to analyze how to include healthcare, 
STEM, and non-STEM occupations experiencing labor shortages in 
any potential updates it makes to Schedule A.
    Prompt Processing of H-2B Visas.--The Committee continues 
to strongly encourage the Department to take steps to ensure 
prompt processing of H-2B visa applications and to minimize 
future interruptions to the H-2B visa program.
    Timely Processing of Permanent Labor Certification 
Applications.--The Committee strongly encourages the Department 
to take appropriate actions using existing authority and 
resources to improve the processing of Permanent Labor 
Certification Applications, including Prevailing Wage 
Determinations filed through Foreign Labor Application Gateway 
[FLAG] system. Historically, processing took less than 6 
months, but currently takes well over a year. The Prevailing 
Wage Determinations for the process should be processed in no 
more than 2 weeks and the Department should return to 
processing times of less than 1 month, notwithstanding backlogs 
at other departments involved in the visa process. Within 60 
days of enactment, the Department shall provide the Committee 
with a report detailing efforts being taken to improve 
processing timeframes by using existing authority and 
resources, including automating the self-attestation process to 
speedily approve submissions, while flagging potential bad 
actors for further investigation and audits.

One Stop Career Centers/Labor Market Information

    For one-stop career centers and labor market information, 
the Committee recommends $62,653,000.
    The Committee is encouraged by progress made through the 
Department's efforts to incentivize States to reduce barriers 
to entry into licensed occupations and increase license 
portability to facilitate mobility of workers in such 
occupations, with an emphasis on transitioning service members, 
veterans, and military spouses. The Committee encourages the 
Department to expand on these past efforts to encourage 
occupational licensing reform, which could include grants to 
States, and associations of States, to review, eliminate and 
reform licensing requirements, and to promote portability of 
State licenses. Grant funding would support institutions of 
higher education and occupational licensing partners to address 
barriers to licensure for veterans and transitioning service 
members, immigrants with work authorization, individuals with a 
criminal history, and dislocated, low-wage workers. The 
Department, in consultation with the Departments of Defense and 
Veterans Affairs, is also encouraged to improve the information 
made publicly available on credentials and licenses that 
facilitate entry into or advancement in occupations.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

    The Committee bill continues language providing such sums 
as necessary in mandatory funds for this account. The 
appropriation is available to provide advances to several 
accounts for purposes authorized under various Federal and 
State unemployment compensation laws and the Black Lung 
Disability Trust Fund, whenever balances in such accounts prove 
insufficient.

                         PROGRAM ADMINISTRATION

Appropriations, 2024....................................    $172,915,000
Budget estimate, 2025...................................     184,668,000
Committee recommendation................................     172,915,000

    The Committee recommendation of $172,915,000 for program 
administration includes $118,900,000 in general funds and 
$54,015,000 from the Employment Security Administration account 
of the Unemployment Trust Fund.
    General funds in this account pay for the Federal staff 
needed to administer employment and training programs under 
WIOA, OAA, the Trade Act of 1974 (Public Law 93-618), and the 
National Apprenticeship Act. Trust funds provide for the 
Federal administration of employment security, training and 
employment, and executive direction functions.

                   Veterans' Employment and Training

Appropriations, 2024....................................    $335,341,000
Budget estimate, 2025...................................     337,301,000
Committee recommendation................................     335,341,000

    The Committee recommendation of $335,341,000 for the 
Veterans' Employment and Training Service [VETS] includes 
$65,500,000 in general revenue funding and $269,841,000 to be 
expended from the Employment Security Administration account of 
the Unemployment Trust Fund.
    This account provides resources for VETS to maximize 
employment opportunities for veterans and transitioning service 
members, including protecting their employment rights. VETS 
carries out its mission through a combination of grants to 
States, competitive grants, and Federal enforcement and 
oversight.
    The Committee provides $185,000,000 for the Jobs for 
Veterans State Grants [JVSG] program. This funding will enable 
Disabled Veterans' Outreach Program specialists and Local 
Veterans' Employment Representatives to continue providing 
intensive employment services to veterans and eligible spouses; 
transitioning service members early in their separation from 
military service; wounded warriors recuperating in military 
treatment facilities or transition units; and spouses and 
family caregivers to help ensure the family has income to 
provide sufficient support. The Committee maintains language 
providing authority for JVSG funding to be used for data 
systems and contract support to allow for the tracking of 
participant and performance information. The Committee includes 
new language providing authority for JVSG funding to be used to 
support surviving spouses of service members.
    The Committee provides $34,379,000 for the Transition 
Assistance Program [TAP] to support apprenticeship 
opportunities and employment workshops at military 
installations, and in virtual classrooms, worldwide for exiting 
service members and spouses.
    The Committee recommendation includes $47,048,000 for 
Federal administration costs. This funding level will support 
oversight and administration of the VETS grant programs, TAP 
employment workshops, and compliance and enforcement 
activities.
    The Committee recommends $65,500,000 for the Homeless 
Veterans' Reintegration Program [HVRP] to help homeless 
veterans attain the skills they need to gain meaningful 
employment. The bill allows Incarcerated Veterans' Transition 
funds to be awarded to serve veterans who have recently been 
released from incarceration but are at risk of homelessness.
    The Committee recommendation includes $3,414,000 for the 
National Veterans' Training Institute, which provides training 
to Federal staff and veteran service providers.
    The Committee recommendation includes $500,000 to support 
the HIRE Vets Medallion program.

               Employee Benefits Security Administration


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $191,100,000
Budget estimate, 2025...................................     205,663,000
Committee recommendation................................     206,100,000

    The Committee recommends $206,100,000 for the Employee 
Benefits Security Administration [EBSA]. EBSA is responsible 
for the enforcement of title I of the Employee Retirement 
Income Security Act [ERISA] in both civil and criminal areas 
and for enforcement of sections 8477 and 8478 of the Federal 
Employees' Retirement Security Act of 1986 (Public Law 99-335). 
EBSA administers an integrated program of regulation, 
compliance assistance and education, civil and criminal 
enforcement, and research and analysis. The Committee bill does 
not include requested authority for EBSA to obligate these 
funds during the period of 2 fiscal years and spend 
indefinitely up to $3,000,000 for the expert witness program. 
Bill language continues to allow EBSA to obligate up to 
$3,000,000 for 2 fiscal years for the expert witness program. 
The authority is needed for services on cases extending beyond 
fiscal year limitation.
    The Committee requests that DOL's required operating plan 
and future CJs continue to include budget activity detail 
provided in the prior year CJ.
    Implementation of Employee Ownership Initiative.--Within 
available resources, the Committee expects EBSA to continue its 
efforts to create and widely disseminate educational materials 
focused on promoting best practices in employee ownership 
through the Employee Ownership Initiative authorized by section 
346 of the SECURE 2.0 Act of 2022. The Committee also includes 
$2,000,000 within ETA for the grant program authorized by such 
section to help establish and expand employee ownership 
programs. The Committee expects EBSA to provide subject matter 
assistance to ETA as it develops and administers this grant 
program.
    Adequate Consideration Guidance.--The Committee notes that 
the SECURE 2.0 Act of 2022 also directs the Department to issue 
formal guidance on the adequate consideration exemption, as 
defined in section 407(d)(6) of ERISA. The Committee is 
disappointed that EBSA failed to achieve the latest regulatory 
agenda goal of issuing an adequate consideration notice of 
proposed rulemaking in March of this year. The Committee urges 
the Department to prioritize a timely, formal notice and 
comment rulemaking on the adequate consideration exemption that 
ensures taxpayers benefit from stakeholder input and 
experience, consistent with congressional intent.
    Mental Health Parity.--The Committee supports additional 
efforts directed toward systemic and targeted audits of health 
plans, to ensure parity between mental and physical healthcare 
coverage as required by current law.
    Vision and Dental Plans.--The Committee is concerned that 
stand-alone vision and dental insurance plans may be using 
ERISA preemption authorities to avoid certain State laws that 
protect consumers and providers from abusive practices. ERISA 
preemption authorities were not intended to preempt State laws 
to prevent market manipulation, including protections against 
price fixing and steering enrollees to plan-owned products and 
services. The Committee requests a briefing of any reported 
State law violations within 90 days of enactment.
    ERISA Requirements.--The Committee notes that firms 
domiciled in or otherwise controlled by the People's Republic 
of China can be opaque in their auditing and accounting work 
and practices. The Committee encourages EBSA to consider 
whether these transparency risks have any implications for 
requirements on plan fiduciaries under ERISA.

                  Pension Benefit Guaranty Corporation

Appropriations, 2024....................................    $512,900,000
Budget estimate, 2025...................................     514,063,000
Committee recommendation................................     514,063,000

    The Pension Benefit Guaranty Corporation's [PBGC] estimated 
obligations for fiscal year 2025 include single-employer 
benefit payments of $8,006,000,000, multi-employer financial 
assistance of $207,000,000, Investment Management Fees Program 
of $139,800,000, Custodian Bank Fees of $4,000,000, and 
consolidated administrative expenses of $514,063,000, including 
no less than $8,384,000 available for the Office of Inspector 
General. The program amount for Custodian Bank Fees was 
included in prior year administrative expenses. Administrative 
expenses are comprised of three activities: pension insurance 
activities, pension plan termination expenses, and operational 
support. These expenditures are financed by permanent 
authority. PBGC also anticipates obligations of $3,302,000,000 
for Special Financial Assistance and $15,000,000 for related 
administrative expenses from the American Rescue Plan Act of 
2021.
    Previously, the Committee accepted the PBGC's proposal to 
reform the administrative apportionment classifications from 
three budget activities to one budget activity to make 
operations more efficient and improve stewardship of resources. 
That consolidated approach for the three activities is 
continued, but PBGC is directed to continue providing detail 
every year on the three activities in its annual CJ.
    The PBGC is a wholly owned Government corporation 
established by ERISA. The law places it within DOL and makes 
the Secretary the chair of its board of directors. The 
Corporation receives its income primarily from insurance 
premiums collected from covered pension plans, assets of 
terminated pension plans, collection of employer liabilities 
imposed by the act, and investment earnings. The primary 
purpose of the PBGC is to guarantee the payment of pension plan 
benefits to participants if covered defined benefit plans fail 
or go out of existence.
    The bill continues authority for a contingency fund for the 
PBGC that provides additional administrative resources when the 
number of new plan participants in terminated plans exceeds 
100,000. When that threshold is reached, an additional 
$9,200,000 becomes available through September 30, 2029, for 
every 20,000 additional participants in terminated plans. The 
bill also continues authority allowing the PBGC additional 
obligation authority for unforeseen and extraordinary pre-
termination expenses, after approval by the Office of 
Management and Budget and notification to the Committees. 
Finally, the bill includes authority for PBGC to expend not 
more than an additional $100 per affected person for credit or 
identity monitoring to individuals upon suffering a security 
incident or privacy breach in the event PBGC's costs exceed 
$250,000. Those funds are available for obligation through 
September 30, 2029.

                         Wage and Hour Division


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $260,000,000
Budget estimate, 2025...................................     294,901,000
Committee recommendation................................     267,500,000

    The Committee recommends $267,500,000 for the Wage and Hour 
Division [WHD]. The Committee bill does not include requested 
authority for WHD to obligate these funds during the period of 
2 fiscal years.
    WHD is responsible for administering and enforcing laws 
that provide minimum standards for wages and working conditions 
in the United States. The Fair Labor Standards Act [FLSA] 
(Public Law 75-718), employment rights under the Family and 
Medical Leave Act (Public Law 103-3), and the Migrant and 
Seasonal Agricultural Worker Protection Act (Public Law 97-470) 
are several of the important laws that WHD is charged with 
administering and/or enforcing.
    WHD administers and enforces laws covering more than 165 
million workers in 11 million workplaces in the United States 
and its territories. The Committee supports WHD in its efforts 
to be more strategic in enforcement activities, which can lead 
to more significant results for workers at an industry-level 
and deter employers from violating the law, particularly in key 
areas of protecting the rights and wages of workers, ensuring 
prevailing wage protections, and combatting exploitative child 
labor.
    Preventing Exploitative Child Labor.--The Committee 
recommendation includes an increase of $7,500,000 to help 
support efforts to combat exploitative child labor and 
violations of child labor provisions of the FLSA and work with 
employers on removing illegal child labor from their supply 
chains. WHD should continue to utilize strategic enforcement in 
industries known to have high incidence of child labor 
violations. The Committee also continues to support the 
improved collaboration and information sharing established 
between the Department of Labor, WHD, and the Department of 
Health and Human Services Administration for Children and 
Families, including through the interagency taskforce to combat 
child labor exploitation and data sharing memorandum of 
agreement between the Departments. The Committee requests 
quarterly briefings on WHD activities in identifying and 
preventing exploitative child labor in the prior quarter and 
plans for the current quarter. The briefings must include the 
provision of information on the systematic use of data and 
information-sharing, compliance efforts, use of enforcement 
tools and remedies achieved, community engagement, and 
referrals to law enforcement. The Committee also requests the 
Department describe in its fiscal year 2026 CJ how civil 
monetary penalty collections for child labor violations are 
treated as compared to other violations of the FLSA and how a 
portion of such funds could be used to further reduce and 
prevent exploitative child labor.

                  Office of Labor-Management Standards


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $48,515,000
Budget estimate, 2025...................................      50,845,000
Committee recommendation................................      48,515,000

    The Committee recommends $48,515,000 for the Office of 
Labor-Management Standards [OLMS]. The Committee bill does not 
include requested authority for OLMS to obligate these funds 
during the period of 2 fiscal years.
    OLMS administers the Labor-Management Reporting and 
Disclosure Act of 1959 [LMRDA] (Public Law 86-257) and related 
laws. These laws establish safeguards for union democracy and 
financial integrity. They also require public disclosure by 
unions, union officers, employers, labor relations consultants 
and others. In addition, the Office administers employee 
protections under federally sponsored transportation programs.

             Office of Federal Contract Compliance Programs


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $110,976,000
Budget estimate, 2025...................................     116,132,000
Committee recommendation................................     110,976,000

    The Committee recommends $110,976,000 for the Office of 
Federal Contract Compliance Programs [OFCCP]. The Committee 
bill does not include requested authority for OFCCP to obligate 
these funds during the period of 2 fiscal years.
    This Office protects workers and potential employees of 
Federal contractors from employment discrimination prohibited 
under Executive Order 11246, section 503 of the Rehabilitation 
Act of 1973, and the Vietnam Era Veterans' Readjustment 
Assistance Act of 1974. These prohibitions make it unlawful for 
contractors and subcontractors doing business with the Federal 
Government to discriminate in employment because of race, 
color, religion, sex (including sexual orientation and gender 
identity), national origin, disability, or status as a 
protected veteran.
    VAHBP Enforcement Moratorium.--The Committee notes that 
OFCCP Directive 2021-01 Revision 1 indicates OFCCP's intent to 
exercise prosecutorial discretion with regard to the 
affirmative obligations of Veterans Affairs Health Benefits 
Program [VAHBP] providers until May 2025. The Committee 
encourages OFCCP to work with stakeholders and lawmakers to 
ensure appropriate implementation of OFCCP programs and robust 
access to care for veterans and their families.

                Office of Workers' Compensation Programs


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $122,705,000
Budget estimate, 2025...................................     130,545,000
Committee recommendation................................     122,705,000

    The Committee recommends $122,705,000 for the Office of 
Workers' Compensation Programs [OWCP]. This includes $2,205,000 
from the special fund established by the Longshore and Harbor 
Workers' Compensation Act. In addition, $51,580,000 is 
available by transfer from the Black Lung Disability Trust 
Fund.
    OWCP administers four distinct compensation programs: the 
Federal Employees' Compensation Act [FECA], the Longshore and 
Harbor Workers' Compensation Act (Public Law 69-803), the Black 
Lung Benefits programs, and the Energy Employees Occupational 
Illness Compensation Program Act (Public Law 106-398). In 
addition, OWCP houses the Division of Information Technology 
Management and Services.
    WHCA Claims Processing.--The Committee is aware of 
substantial deficiencies in the Department's operations for 
processing claims under the War Hazards Compensation Act 
[WHCA]. While the Committee understands that the Department has 
taken some action to address its backlog and processing of WHCA 
claims, the Committee requests a briefing on this topic within 
90 days of enactment of this act. Such briefing shall include, 
at a minimum, information regarding: (1) the Department's 
consideration and, if applicable, implementation of statistical 
sampling methods for reducing the amount of time needed by 
examiners and reviewers to process claims; (2) the Department's 
review and considered changes to the $300 threshold for 
sampling reimbursement for medical claims; and (3) historical, 
current, and future proposed FTE levels employed by the 
Department for processing WHCA claims.

                            SPECIAL BENEFITS

Appropriations, 2024....................................    $700,000,000
Budget estimate, 2025...................................     726,670,000
Committee recommendation................................     726,670,000

    The Committee recommends $726,670,000 for this account. 
This mandatory appropriation, which is administered by OWCP, 
primarily provides benefits under FECA.
    The Committee continues to provide authority to require 
disclosure of Social Security numbers by individuals filing 
claims under FECA or the Longshore and Harbor Workers' 
Compensation Act (Public Law 69-803) and its extensions.
    The Committee continues language that provides authority to 
use FECA funds to reimburse a new employer for a portion of the 
salary of a newly reemployed injured Federal worker. FECA funds 
will be used to reimburse new employers during the first 3 
years of employment, not to exceed 75 percent of salary in the 
worker's first year, and declining thereafter.
    The Committee continues language that allows carryover of 
unobligated balances to be used in the following year and 
provides authority to draw such sums as needed after August 15 
to pay current beneficiaries. Such funds are charged to the 
subsequent year appropriation.
    The Committee continues language to provide authority to 
deposit into the special benefits account of the employees' 
compensation fund those funds that the Postal Service, the 
Tennessee Valley Authority, and other entities are required to 
pay to cover their fair share of the costs of administering the 
claims filed by their employees under FECA.
    Finally, the Committee maintains language consistent with 
long-standing interpretations and implementation of this 
appropriation stating that, along with the other compensation 
statutes already specifically enumerated, the appropriation is 
used to pay obligations that arise under the War Hazards 
Compensation Act (Public Law 77-784), and the appropriation is 
deposited in the Employees' Compensation Fund and assumes its 
attributes, namely availability without time limit as provided 
by 5 U.S.C. section 8147.33.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2024....................................     $33,140,000
Budget estimate, 2025...................................      31,367,000
Committee recommendation................................      31,367,000

    The Committee recommends a mandatory appropriation of 
$24,367,000 in fiscal year 2025 for special benefits for 
disabled coal miners. This is in addition to the $7,000,000 
appropriated last year as an advance for the first quarter of 
fiscal year 2025, for a total program level of $31,367,000 in 
fiscal year 2025.
    These mandatory funds are used to provide monthly benefits 
to coal miners disabled by black lung disease, their widows, 
and certain other dependents, as well as to pay related 
administrative costs.
    The Committee also recommends an advance appropriation of 
$6,000,000 for the first quarter of fiscal year 2026. These 
funds will ensure uninterrupted benefit payments as promised to 
coal miners, their widows, and dependents.

     Division of Energy Employees Occupational Illness Compensation


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $66,532,000
Budget estimate, 2025...................................      66,966,000
Committee recommendation................................      66,966,000

    The Committee recommends $66,966,000 for the Division of 
Energy Employees Occupational Illness Compensation Program 
[EEOICP]. This is a mandatory appropriation for administrative 
expenses for administration of Part B of the Energy Employees 
Occupational Illness Compensation program.
    The Division administers the Energy Employees Occupational 
Illness Compensation Program Act [EEOICPA] (Public Law 106-
398), which provides benefits to eligible employees and former 
employees of the Department of Energy, its contractors and 
subcontractors, or to certain survivors of such individuals. 
The mission also includes delivering benefits to certain 
beneficiaries of the Radiation Exposure Compensation Act 
(Public Law 106-245). The Division is part of OWCP.

                    BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2024....................................    $452,867,000
Budget estimate, 2025...................................     485,706,000
Committee recommendation................................     485,706,000

    The bill provides an estimated $485,706,000 as requested 
for this mandatory appropriations account. This estimate is 
comprised of $93,879,000 for administrative expenses and an 
estimated $391,827,000 for benefit payment and interest costs. 
The Committee bill does not include requested authority to 
obligate funds available for administrative expenses during the 
period of 2 fiscal years.
    The bill continues to provide indefinite authority for the 
Black Lung Disability Trust Fund to provide for benefit 
payments. The Trust Fund pays all black lung compensation/
medical and survivor benefit expenses when no responsible mine 
operation can be assigned liability or refuses to pay for such 
benefits, as well as all administrative costs that are incurred 
in administering the benefits program and operating the trust 
fund. As proposed in the President's budget, the bill provides 
for transfers from the trust fund for administrative expenses 
for the following Department agencies: up to $51,580,000 for 
the part C costs of the Division of Coal Mine Workers' 
Compensation Programs; up to $41,570,000 for Departmental 
Management, Salaries and Expenses; and up to $373,000 for 
Departmental Management, Inspector General. The bill also 
allows a transfer of up to $356,000 for the Department of the 
Treasury.

             Occupational Safety and Health Administration


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $632,309,000
Budget estimate, 2025...................................     655,463,000
Committee recommendation................................     637,309,000

    The Committee recommends $637,309,000 for the Occupational 
Safety and Health Administration [OSHA], which is responsible 
for enforcing the Occupational Safety and Health Act of 1970 
(Public Law 91-596) in the Nation's workplaces. The Committee 
bill does not include requested authority for OSHA to obligate 
these funds during the period of 2 fiscal years.
    The Committee continues bill language to allow OSHA to 
retain course tuition and fees for training institute courses 
used for occupational safety and health training and education 
activities in the private sector. The cap established by the 
bill is $499,000 per year, consistent with current law.
    The Committee also continues bill language to exempt farms 
employing 10 or fewer people from the provisions of the 
Occupational Safety and Health [OSH] Act, with the exception of 
those farms having a temporary labor camp. The exemption of 
small farming operations from OSHA regulation has been in place 
since 1976. OSHA clarified the limits of its authority under 
the appropriations rider to conduct enforcement on small farms 
in July 2014, particularly regarding post-harvest activities of 
a farming operation. It is also important the Department of 
Agriculture and National Institute for Occupational Safety and 
Health are consulted in any future attempt by OSHA to redefine 
or modify any aspect of the small farm exemption. The Committee 
also continues language exempting employers with fewer than 10 
employees in industry classifications having a lost workday 
injury rate less than the National average from general 
schedule safety inspections, except for the small farms covered 
by the broader exemption.
    State Plan States.--The Committee recommends $121,000,000 
for grants to States under section 23(g) of the Occupational 
Safety and Health Act (Public Law 91-596). These funds 
primarily are provided to States that have taken responsibility 
for administering their own occupational safety and health 
programs for the private sector and/or the public sector. State 
plans must be at least as effective as the Federal program and 
are monitored by OSHA. The bill continues language that allows 
OSHA to provide grants of up to 50 percent for the costs of 
State plans approved by the agency.
    Workplace Violence in Healthcare and Social Services.--A 
survey in 2019 reported one in four nurses were assaulted at 
work, with more recent data showing physical and verbal 
violence against healthcare workers continuing to rise. The 
Healthcare and Social Assistance industry sector includes 
nearly 21 million employees and these workers face an increased 
risk of workplace violence that is nearly six times that of 
workers in all other industries. This violence dramatically 
impacts nurse well-being and burnout. It exacerbates the nurse 
staffing crisis and affects the quality of patient care. The 
Committee notes OSHA's progress to release a workplace violence 
prevention standard for healthcare and social assistance. The 
Committee requests that OSHA provide a briefing within 180 days 
of enactment of this act on progress made toward releasing this 
standard, a timeline for publishing a final rule, and the 
agency's implementation plan, including related training and 
support required to prepare Compliance Safety and Health 
Officers for the new workplace violence prevention standard.
    Smoke-Related Health Issues for Workers.--The Committee 
appreciates the Department's actions to increase awareness on 
steps that employers can take to minimize worker exposure to 
hazardous outdoor air, including wildfire smoke. The Committee 
directs the Department to work with the National Institute for 
Occupational Safety and Health [NIOSH] and other relevant 
agencies to gather evidence on best practices and make 
recommendations that protect workers from the consequences of 
long-term exposure to adverse air. Further, the Committee 
requests that the Department provide a briefing on their joint 
efforts with NIOSH on this issue, particularly supporting 
vulnerable workers exposed to adverse air. This briefing shall 
be provided not later than 90 days after enactment.
    Emergency Response Standard.--The Committee is concerned 
with the proposed rule entitled ``Emergency Response Standard'' 
and its potential impact on volunteer fire and emergency 
service departments. The Committee understands this standard 
has not been updated in decades and some updates may be 
warranted. The Committee strongly encourages OSHA to conduct 
listening sessions or other stakeholder engagement to fully 
understand the impact on various emergency response and 
firefighter stakeholders, including whether or not it is 
economically feasible for volunteers to comply with the 
proposed regulation, prior to issuing any final rule.
    Compliance Assistance.--The Committee continues language 
requiring OSHA to dedicate no less than $3,500,000 for 
administering the Voluntary Protection Program [VPP] in its 
Federal Compliance Assistance budget. OSHA shall not reduce 
funding levels or the number of employees administering the 
VPP, the Safety and Health Achievement Recognition Program, or 
Federal Compliance Assistance, and shall not collect any monies 
from participants for the purpose of administering these 
programs.
    The Committee recommendation also includes $12,787,000 for 
the OSHA Susan Harwood Training Grant program. The program 
provides disadvantaged, underserved, low-income, or other hard-
to-reach, at-risk workers with identifying and avoiding 
workplace hazards, training to protect them from on-the-job 
hazards, and to inform workers of their rights and employers of 
their responsibilities under the OSH Act. The Committee notes 
OSHA's fiscal year 2024 funding opportunity announcements 
include grant categories of: Capacity Building, Targeted Topic, 
and Training and Educational Materials. The Committee urges 
OSHA to prioritize these funds to support non-profit, 
community-based groups and other non-profit organizations with 
the capability to reach and effectively train vulnerable, 
underserved workers, and industries with high injury, illness, 
and fatality rates.

                 Mine Safety and Health Administration


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $387,816,000
Budget estimate, 2025...................................     406,538,000
Committee recommendation................................     392,816,000

    The Committee recommendation includes $392,816,000 for the 
Mine Safety and Health Administration [MSHA]. The Committee 
bill does not include requested authority for MSHA to obligate 
these funds during the period of 2 fiscal years.
    MSHA enforces the Federal Mine Safety and Health Act 
(Public Law 91-173) by conducting inspections and special 
investigations of mine operations, promulgating mandatory 
safety and health standards, cooperating with the States in 
developing effective State programs, and improving training in 
conjunction with States and the mining industry.
    The Committee continues language authorizing MSHA to use up 
to $2,000,000 for mine rescue and recovery activities. It also 
retains the provision allowing the Secretary to use any funds 
available to the Department to provide for the costs of mine 
rescue and survival operations in the event of a major 
disaster. To prepare properly for an emergency, the Committee 
also directs MSHA to continue to devote sufficient resources 
toward a competitive grant activity for effective emergency 
response and recovery training in various types of mine 
conditions.
    In addition, bill language continues to allow the National 
Mine Health and Safety Academy to collect not more than 
$750,000 for room, board, tuition, and the sale of training 
materials to be available for mine safety and health education 
and training activities. Bill language also allows MSHA to 
retain up to $2,499,000 from fees collected for the approval 
and certification of equipment, materials, and explosives for 
use in mines, and to utilize such sums for these activities.
    The Committee continues to emphasize the importance of mine 
safety enforcement, and instructs MSHA to fully implement the 
requirements of section 103 of the Federal Mine Safety and 
Health Act of 1977 (Public Law 91-173). MSHA shall make 
inspections of each underground coal mine in its entirety at 
least four times a year and each surface coal or other mine in 
its entirety at least two times a year. Further, MSHA shall 
fully and effectively enforce the Final Rule Reducing Miners' 
Exposure to Coal Dust and should not use any funds to weaken or 
eliminate the Final Rule Lowering Miners' Exposure to 
Respirable Coal Mine Dust.

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $697,952,000
Budget estimate, 2025...................................     712,786,000
Committee recommendation................................     702,952,000

    The Committee recommends $702,952,000 for the Bureau of 
Labor Statistics [BLS]. This amount includes $68,000,000 from 
the Employment Security Administration account of the 
Unemployment Trust Fund and $634,952,000 in Federal funds. The 
Committee bill does not include requested authority for BLS to 
obligate these funds during the period of 2 fiscal years.
    BLS is the principal fact-finding agency in the Federal 
Government in the broad field of labor economics. The Committee 
recognizes that the Nation requires current, accurate, detailed 
workforce statistics for Federal and non-Federal data users as 
provided by BLS. This should include, to the extent 
practicable, appropriate methods to gather data on sexual 
orientation, gender identity, and variations on sex 
characteristics.
    Current Population Survey.--The Committee recommendation 
includes additional resources intended to support the 
modernization of the Current Population Survey [CPS]. Declining 
response rates facing all survey programs and other challenges 
necessitate actions by BLS and the Census Bureau to modernize 
the operations of the CPS and maintain this resource. The 
Committee understands work on an Internet self-response mode 
and other improvements are underway. The Committee requests a 
CPS modernization plan, including an implementation timeline 
and resource needs, not later than 30 days after enactment of 
this act and follow-up briefing not later than 30 days after 
submission of the plan. Further, the Committee expects such 
plan and briefing to include input from and participation of 
the Census Bureau.
    National Longitudinal Survey of Youth.--The Committee 
continues to recognize the importance of the National 
Longitudinal Survey of Youth [NLSY], which has provided 
valuable information about labor market trends for decades. The 
Committee maintains current funding for the purposes of 
continuing to plan and develop the new NLSY cohort established 
by the Further Consolidated Appropriations Act, 2020 and 
maintained in the last 4 fiscal years.
    The Committee expects BLS will develop an appropriate 
methodology that will maintain continuity in key measurements 
across the cohorts, which will be of value to understanding our 
changing economy and society. The Committee intends for the 
funds to be used to support continued planning and development 
of the new cohort. The Committee expects BLS to continue 
fielding the NLSY79 and NLSY97 cohorts and maintain the current 
design, methodology, and data quality. Further, BLS shall brief 
the Committees on its plans for executing these directives and 
carrying out its implementation of the new NLSY cohort plan.
    Nonprofit Sector Employment and Wage Data.--The Committee 
looks forward to the release of BLS data on employment and wage 
estimates for the nonprofit sector for the years 2018-2022. 
This release will include State- and county-level information 
that will provide important insight into this area of the 
economy. The Committee directs BLS to develop cost-effective 
options to make this information available on a more frequent 
basis and report its progress to the Committee no later than 
120 days after the enactment of this act.

                 Office of Disability Employment Policy

Appropriations, 2024....................................     $43,000,000
Budget estimate, 2025...................................      44,876,000
Committee recommendation................................      43,000,000

    The Committee recommends $43,000,000 for the Office of 
Disability Employment Policy [ODEP] to provide leadership, 
develop policy and initiatives, support technical assistance 
and implementation, and award grants, cooperative agreements, 
and contracts furthering the objective of eliminating physical 
and programmatic barriers to the training, labor force 
participation and employment of people with disabilities and to 
design and implement research and technical assistance grants 
and contracts that support the transition to competitive, 
integrated employment for youth and adults with disabilities. 
The Committee bill does not include requested authority for 
ODEP to obligate these funds during the period of 2 fiscal 
years. The bill also includes language continuing to allow not 
less than $9,000,000 to be used for research and demonstration 
projects related to testing effective ways to promote greater 
labor force participation of people with disabilities. These 
funds may be transferred to the ``State Unemployment Insurance 
and Employment Service Operations'' account for such purpose. 
The Committee requests notification at least 14 days prior to 
any such transfer.

                        Departmental Management


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $388,197,000
Budget estimate, 2025...................................     465,601,000
Committee recommendation................................     395,197,000

    The Committee recommendation includes $395,197,000 for the 
Departmental Management, Salaries and Expenses account. Of this 
amount, $394,889,000 is available from general funds and 
$308,000 is available by transfer from the Employment Security 
Administration account of the Unemployment Trust Fund. In 
addition, $41,570,000 is available by transfer from the Black 
Lung Disability Trust Fund. The Committee bill does not include 
requested authority for these funds to be available for 
obligation for a period of 2 fiscal years.
    The Departmental Management, Salaries and Expenses 
appropriation pays the salaries and related expenses of staff 
responsible for formulating and overseeing the implementation 
of departmental policy and management activities in support of 
that goal. In addition, this appropriation includes a variety 
of operating programs and activities that are not involved in 
departmental management functions, but for which other 
appropriations for salaries and expenses are not suitable.
    Preventing Exploitative Child Labor.--The Committee 
recommendation includes an increase of $4,000,000 to help 
support efforts of the Office of the Solicitor to combat 
exploitative child labor and violations of child labor 
provisions of the FLSA and work with employers to remove 
illegal child labor from their supply chains. The Secretary is 
directed to report to the Committees not later than 45 days 
after the end of the fiscal year on the Department's efforts to 
enforce child labor provisions of the FLSA with particular 
focus on hazardous occupations, child labor trafficking and 
child labor exploitation, including by reporting for fiscal 
year 2025: enforcement resources expended by agency including 
on child labor enforcement; the number of concluded cases and 
violations by industry; the number and type of enforcement 
actions imposed by industry, including the number of employers 
held liable for child labor violations; the number of referrals 
to other agencies for support or legal services for effected 
children and youth, and the number of criminal referrals to law 
enforcement for violations of child labor provisions.
    The Committee is also concerned by the Department's limited 
referrals to the Department of Justice in response to reports 
of children, including unaccompanied children, suspected of 
being subject to child labor trafficking and exploitation. The 
Committee directs the Department to submit a report not later 
than 180 days after enactment detailing the referrals in the 
previous fiscal year on suspected violations of child labor 
trafficking laws. The report should provide the number of 
referrals initiated and, to the extent that the information is 
available, the disposition of each including the number of 
arrests, convictions, pending cases, and case dismissals.
    Bureau of International Labor Affairs [ILAB].--The 
Committee recommendation includes $118,125,000 for ILAB to 
carry out its statutory responsibilities, of which $82,725,000 
is available for obligation through December 31, 2025. These 
funds are in addition to the supplemental appropriations for 
ILAB in Public Law 116-113, the United States-Mexico-Canada 
Agreement Implementation Act, for its responsibilities under 
that law.
    ILAB's appropriation is available to help improve working 
conditions and labor standards for workers around the world by 
carrying out ILAB's statutory mandates and international 
responsibilities, including in promoting the elimination of the 
worst forms of child labor and forced labor. ILAB works to 
ensure workers and businesses in the United States are not put 
at a competitive disadvantage by trading partner countries not 
adhering to their labor commitments under trade agreements and 
trade preference programs. The bill continues language setting 
aside funding for grants, contracts and other arrangements for 
technical assistance on worker rights and for combatting child 
labor, with no less than $30,175,000 available for worker 
rights programs and no less than $30,175,000 for combatting 
exploitative child labor internationally. This flexibility will 
allow ILAB to target additional resources where conditions on 
the ground and other factors create the greatest opportunities 
to make significant progress on these issues and maintain a 
robust level of support for both critically important 
activities.
    The Department shall report on plans for and uses of all 
funds made available to the Department in the United States-
Mexico-Canada Agreement Implementation Act (Public Law 116-113) 
in the fiscal year 2026 and subsequent year CJs. Such plans and 
updates shall also include information on how funds are being 
used for monitoring, oversight, and technical assistance in 
support of the purposes of such act, including Mexico's 
implementation of nationwide labor reforms and compliance with 
labor obligations.
    The Committee continues to support the critical role ILAB 
plays in working to eradicate child labor, forced labor, and 
human trafficking, including through its research and reporting 
in its Findings on the Worst Forms of Child Labor, List of 
Goods Produced by Child Labor or Forced Labor, and List of 
Products Produced by Forced or Indentured Child Labor. The 
appropriation will support continued publication of these 
important reports, including the tracking of goods through 
supply chains and identifying inputs made with child and forced 
labor.
    Evaluation, and Evidence-Building and Use.--The Committee 
recommendation provides $4,281,000 for program evaluation and 
allows these funds to be available for obligation through 
September 30, 2026. The Committee bill also continues the 
authority of the Secretary to transfer these funds to any other 
account in the Department for evaluation purposes. The 
Committee bill continues authority to use up to 0.75 percent of 
certain Department appropriations for evaluation activities 
identified by the chief evaluation officer. The Committee 
expects to be notified of the planned uses of funds derived 
from this authority.
    Foundation for Evidence-Based Policymaking Act.--The 
Committee continues to believe that the execution of the 
Foundations for Evidence-Based Policymaking Act will enhance 
the evidence-building capacity of Federal agencies, strengthen 
privacy protections, improve secure access to data, and provide 
more and higher quality evidence to policymakers. Therefore, 
the Committee directs the Department to continue to include in 
the fiscal year 2026 and future CJs updates on the 
implementation and planned implementation of such act for the 
current and future budget years. These updates shall describe 
important changes being made by agencies using research 
findings and evidence to improve their operations.
    Women's Bureau.--The Committee recommendation provides 
$24,000,000 for the Women's Bureau. The Committee continues 
bill language allowing the Bureau to award grants, including 
not less than $5,000,000 for grants authorized by the Women in 
Apprenticeship and Nontraditional Occupations Act. The 
Committee is particularly supportive of the Bureau's plans to 
expand WANTO grants and continue to support paid leave 
programs.
    Paid Family Leave.--The Committee is particularly 
supportive of the Women's Bureau's work and dedication to 
supporting paid leave programs as part of their mission to 
support women's workforce participation. In order to study best 
practices in paid leave programs, the Women's Bureau should 
request data from State paid leave programs in order to publish 
a report about usage rates and distribution of paid leave at 
the State level as well as steps State paid leave programs are 
taking to support the full range of businesses and 
entrepreneurs.
    Menopause.--More than one million American women go through 
menopause every year and an estimated 20 percent of workers are 
in some phase of menopause transition. The symptoms of 
menopause can be severe, including extreme fatigue, anxiety, 
depression, and changes in bone and heart health, and, in some 
cases, can cause women to miss work. The Committee is pleased 
that the Women's Bureau has engaged this important workforce 
topic and encourages the Bureau to expand its work to identify 
model workplace practices that support women going through 
menopause transition, document the economic benefits of such 
practices, and suggest options to encourage wider adoption of 
such practices.
    Excess Personal Property.--The Committee directs the 
Department to include in the fiscal year 2026 CJ information on 
the value and recipient of excess personal property provided to 
apprenticeship programs under section 112 of this act.
    Persistent Poverty.--The Committee encourages the 
Department to develop and implement measures to increase the 
share of funding targeted to areas experiencing high and 
persistent poverty. The Committee directs the Department to 
include information in its fiscal year 2026 CJ on the 
percentage of DOL funding targeted to such areas.

                  INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2024....................................     $29,269,000
Budget estimate, 2025...................................      35,286,000
Committee recommendation................................      29,269,000

    The Committee recommends $29,269,000 for the Information 
Technology [IT] Modernization account. Funds available in this 
account have been used for two primary activities. The first is 
departmental support systems, for which $6,889,000 is provided. 
The second activity, IT Infrastructure Modernization, is 
provided $22,380,000 to support necessary activities associated 
with the Federal Data Center Consolidation Initiative and other 
efforts. These funds are available for obligation through 
September 30, 2026.
    The Committee continues to request that the Department 
submit a report to the Committees not later than 90 days after 
enactment of this act that provides an update on projects to be 
funded, planned activities and associated timelines, expected 
benefits, and planned expenditures. The report should also 
include completed activities, remaining activities and 
associated timelines, actual and remaining expenditures, 
explanation of any cost overruns and delays, and corrective 
actions, as necessary, to keep the project on track and within 
budget.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2024....................................     $97,028,000
Budget estimate, 2025...................................     106,237,000
Committee recommendation................................      97,028,000

    The Committee recommends $97,028,000 for the DOL Office of 
the Inspector General. The bill includes $91,187,000 in general 
funds and authority to transfer $5,841,000 from the Employment 
Security Administration account of the Unemployment Trust Fund. 
In addition, an amount of $373,000 is available by transfer 
from the Black Lung Disability Trust Fund. The Committee bill 
does not include requested authority to obligate these funds 
during the period of 2 fiscal years. The bill continues to 
allow up to $2,000,000 of the appropriation to be available 
until expended.
    Through a comprehensive program of audits, investigations, 
inspections, and program evaluations, the Inspector General 
attempts to reduce the incidence of fraud, waste, abuse, and 
mismanagement, and to promote economy, efficiency, and 
effectiveness.
    Emergency Programs.--The Committee directs the OIG to 
include information in the fiscal year 2026 CJ on: 1) without 
disclosing law enforcement sensitive information, how it 
identifies fraudulent actors who apply for unemployment 
insurance payments and the nature of these actors; (2) how any 
new appropriations and authorities would help the OIG identify 
and recoup fraudulent overpayments; (3) how the OIG used CARES 
Act, ARPA, and annual appropriations to recommend improvements 
to the administration and program integrity of the unemployment 
insurance system since 2020; and (4) recommendations intended 
to improve the Department's programs and operations in future 
emergencies.

                           General Provisions

    Section 101. The bill continues a provision limiting the 
use of Job Corps funding for compensation of an individual that 
is not a Federal employee at a rate not to exceed Executive 
Level II.
    Section 102. The bill continues a provision providing for 
general transfer authority.
    Section 103. The bill continues a provision prohibiting 
funding for the procurement of goods and services utilizing 
forced or indentured child labor in industries and host 
countries already identified by the Department in accordance 
with Executive Order 13126.
    Section 104. The bill continues a provision requiring that 
funds available under section 414(c) of the American 
Competitiveness and Workforce Improvement Act (Public Law 106-
313) may only be used for competitive grants that train 
individuals over the age of 16 who are not enrolled in school, 
in occupations and industries for which employers are using H-
1B visas to hire foreign workers.
    Section 105. The bill continues a provision limiting the 
use of the Employment and Training Administration [ETA] funds 
by a recipient or subrecipient for compensation of an 
individual at a rate not to exceed Executive Level II.
    Section 106. The bill modifies a provision regarding 
transfer authority related to funds for technical assistance 
and program integrity.
    Section 107. The bill continues a provision allowing up to 
0.75 percent of discretionary appropriations provided in this 
act for all Department 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.
    Section 108. The bill continues a longstanding provision 
regarding the application of the Fair Labor Standards Act 
(Public Law 74-718) after the occurrence of a major disaster.
    Section 109. The bill continues a longstanding provision 
that provides flexibility with respect to the crossing of H-2B 
nonimmigrants.
    Section 110. The bill continues a provision related to the 
wage methodology under the H-2B program.
    Section 111. The bill continues a provision regarding the 
three-fourths guarantee and definitions of corresponding 
employment and temporary need for purposes of the H-2B program.
    Section 112. The bill modifies a provision providing 
authority related to the disposition of excess property related 
to the training of apprentices.
    Section 113. The bill includes a new provision permanently 
authorizing a security detail at the Department of Labor. The 
Department is directed to report for each fiscal year starting 
in fiscal year 2025 and continuing through fiscal year 2030 on 
the protection provided, and the expenditures made, in the 
preceding fiscal year pursuant to this section. Such report 
shall be provided to the Committees on Appropriations of the 
Senate and the House of Representatives and the Committee on 
Health, Education, Labor and Pensions of the Senate and the 
Committee on Education and the Workforce of the House not later 
than 30 days after the close of each fiscal year.
    Section 114. The bill continues a provision related to Job 
Corps property.
    Section 115. The bill continues a provision related to Job 
Corps Civilian Conservation Centers.
    Section 116. The bill modifies a provision rescinding funds 
from the H-1B program.
    Section 117. The bill modifies a provision rescinding 
certain funds available to the Employment and Training 
Administration.
    Section 118. The bill includes a new provision regarding 
the provision of technical assistance.
    Section 119. The bill includes a new provision allowing up 
to 1 percent of accounts available for salaries and expenses to 
be transferred to the Working Capital Fund for specified 
purposes. The Department is required to notify the Committees 
at least 15 days in advance of any transfer.

                                TITLE II

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

    Any references in this title of the report to the 
``Secretary'' or the ``Department'' shall be interpreted to 
mean the Secretary of HHS or the Department of HHS, 
respectively, unless otherwise noted.

              Health Resources and Services Administration

    The Health Resources and Services Administration [HRSA] 
activities support programs to provide healthcare services to 
disadvantaged, medically underserved, and special populations; 
mothers and infants; the elderly and homeless; and rural 
communities. HRSA supports cooperative programs in maternal and 
child health, AIDS care, healthcare provider training, and 
healthcare delivery systems and facilities.

                          PRIMARY HEALTH CARE

Appropriations, 2024....................................  $1,858,772,000
Budget estimate, 2025...................................   1,858,772,000
Committee recommendation................................   1,858,772,000

Community Health Centers

    The Committee provides $1,858,772,000 for the Bureau of 
Primary Health Care. Programs supported by this funding include 
community health centers, migrant health centers, healthcare 
for the homeless, school-based, and public housing health 
service grants. The Committee continues to support the ongoing 
effort to increase the number of people who have access to 
medical services at health centers. Health centers play a vital 
role in ensuring access to primary care in underserved areas of 
the country, including urban, rural, and frontier areas.
    In addition, within the amount provided, the Committee 
provides up to $120,000,000 under the Federal Tort Claims Act 
[FTCA] (Public Law 102-501 and Public Law 104-73), available 
until expended. These funds are used to pay judgments and 
settlements, occasional witness fees and expenses, and related 
administrative costs. The Committee intends FTCA coverage 
funded through this bill to be inclusive of all providers, 
activities, and services included within the health centers' 
federally approved scope of project.
    Addressing Intimate Partner Violence and Project 
Catalyst.--The Committee includes no less than $2,000,000 for 
the HRSA Strategy to Address Intimate Partner Violence.
    Base Grant Adjustments.--The Committee recognizes that 
health center costs have increased significantly and that it 
has been nearly a decade since the last base grant adjustment. 
The Committee encourages HRSA to consider the needs of existing 
health centers in relation to their current base grants when 
allocating health center funding.
    Children's Mental Health Services.--The Committee continues 
to urge HRSA to provide funding to Health Centers to support 
vital mental health services for children.
    Early Childhood Development.--The Committee continues no 
less than $30,000,000 to further integrate early childhood 
development services and expertise, including by hiring or 
contracting for early childhood development specialists.
    Ending the HIV Epidemic.--The Committee provides 
$157,250,000 within the health centers program for the Ending 
the HIV Epidemic initiative. The initiative provides funding to 
Health Centers in high-need jurisdictions to increase 
prevention and treatment services for people at high risk for 
HIV transmission, including pre-exposure prophylaxis [PrEP] 
related services, outreach, and care coordination through new 
grant awards in areas currently served by health centers.
    Federally Qualified Health Center [FQHC] Look-Alike 
Participation.--The Committee notes that certain health centers 
throughout the country are ineligible to apply for supplemental 
funding awards because of their status as a FQHC Look-Alike 
[LAL]. The Committee requests a briefing from HRSA within 180 
days of enactment of this act on the impacts of allowing FQHC 
LALs to apply for supplemental funding opportunities under 
section 330 of the Public Health Service [PHS] Act and ways in 
which the FQHC LAL program could be better utilized as a 
pipeline into the section 330 Health Center program.
    Free Clinics Medical Malpractice Coverage.--The Committee 
provides $1,000,000 for payments of claims under the FTCA to be 
made available for free clinic health professionals as 
authorized by section 224(o) of the PHS Act (Public Law 104-
73). This appropriation extends FTCA coverage to medical 
volunteers in free clinics to expand access to healthcare 
services to low-income individuals in medically underserved 
areas.
    Native Hawaiian Health Care.--The Committee includes no 
less than $27,000,000 for the Native Hawaiian Health Care 
Program. Of the total amount appropriated for the Native 
Hawaiian Health Care Program, not less than $10,000,000 shall 
be provided to Papa Ola Lokahi for administrative purposes 
authorized under 42 U.S.C. 11706, including to coordinate and 
support healthcare service provision to Native Hawaiians and 
strengthen the capacity of the Native Hawaiian Health Care 
Systems to provide comprehensive health education and 
promotion, disease prevention services, traditional healing 
practices, and primary health services to Native Hawaiians.
    School-Based Health Centers [SBHCs].--The Committee 
includes $55,000,000 for awards to health centers operating 
school-based service sites under section 330 of the PHS Act to 
increase their capacity to meet the increasing demand for 
health services, including mental health services.
    Type I Screenings.--The Committee supports efforts to 
increase type 1 diabetes screenings at community health centers 
[CHCs], particularly among high-risk populations, especially 
given the advances in treatments that now can delay onset of 
the disease for several years if caught early enough. HRSA is 
directed to provide an update to the Committee within 180 days 
of enactment of this act on the efforts being made to increase 
screening for type 1 diabetes at CHCs. The update should 
include the feasibility and cost estimate of expanding 
screening, as well as a plan and timeline on how to roll out 
such efforts.
    Technical Assistance.--The Committee believes funding for 
the training and technical assistance available for health 
centers through national and State cooperative agreements and 
grants is critical to the successful operation and expansion of 
the Health Centers program. Funds are available within the 
amount provided to enhance technical assistance and training 
activities and further quality improvement initiatives that 
improve health outcomes.
    Vaccination and Screening for Hepatitis B.--The Committee 
encourages HRSA to redouble efforts to support health center 
grantees to adopt the necessary practices and policies to 
comply with the November 2021 Advisory Committee on 
Immunization Practices [ACIP] recommendation that all adults 
between ages 19 and 59 be vaccinated and the March 2023 ACIP 
recommendation that all adults between ages 19 and 59 be 
screened for hepatitis B. To implement these policies, the 
Committee further encourages HRSA to ensure that health centers 
screen patients aged 19-59 for hepatitis B, offer to immunize 
all non-infected patients in the 19-59 age cohort, and navigate 
infected individuals into care. The Committee requests an 
update from HRSA before the end of fiscal year 2025 on its 
progress to meet this goal, including the number of individuals 
screened and number of individuals vaccinated for hepatitis B 
at HRSA-funded health centers.

                            HEALTH WORKFORCE

Appropriations, 2024....................................  $1,404,376,000
Budget estimate, 2025...................................   1,467,376,000
Committee recommendation................................   1,411,376,000

    The Bureau of Health Workforce provides policy leadership 
and grant support for health professions workforce development. 
The mission of the Bureau is to identify shortage areas while 
working to eliminate them. Programs are intended to ensure that 
the Nation has the right clinicians, with the right skills, 
working where they are needed.
    The Committee also encourages HRSA to conduct outreach, 
provide technical assistance, and give priority in awarding 
cooperative agreements and grants to entities in high poverty 
areas and historically marginalized communities. The Committee 
encourages HRSA to work with these communities to develop their 
mental health workforce and requests an update in the fiscal 
year 2026 CJ on best practices and strategies to attract mental 
healthcare practitioners to these disproportionately impacted 
communities.

National Health Service Corps

    The Committee provides $128,600,000 for the National Health 
Service Corps [Corps]. The Committee recognizes the success of 
the Corps program in building healthy communities in areas with 
limited access to care. The program has shown increases in 
retention of healthcare professionals located in underserved 
areas.
    Within this total, the Committee continues support for 
access to quality opioid and substance use disorder [SUD] 
treatment in rural and underserved areas nationwide. The 
Committee continues language that expands eligibility for loan 
repayment awards through the Corps to include SUD counselors. 
The Committee also continues to include section 206 of this act 
to modify the rules governing the Corps to allow every Corps 
member 60 days to cancel their contract. Further, the Committee 
encourages HRSA to explore opportunities to provide incentives 
for individuals working in their home State or the State in 
which they received their education.
    Correctional Facilities.--While Federal and State 
correctional facilities are eligible for Corps scholarships and 
loan repayment, a 1989 Federal regulation narrowed eligibility 
for Corps scholarships to exclude county jails. The Committee 
notes that county jails in large metropolitan areas are often 
the biggest correctional facilities in an area, and encourages 
HRSA to work with Congress and relevant stakeholders to develop 
a process to provide county and municipal correctional 
facilities the opportunity to participate in the Corps program 
if they would otherwise meet the requirements of a National 
Health Service Corps service site. Within 180 days of enactment 
of this act, the Committee requests a briefing detailing 
implications and considerations for participation by county 
jails.
    Maternity Care Target Areas [MCTAs].--The Committee 
recognizes HRSA's progress in determining MCTAs in order to 
begin making loan repayment awards to maternal health 
practitioners, such as OB/GYNs and Certified Nurse Midwives, 
who agree to serve in MCTAs. Within the total for the Corps, 
the Committee includes not less than $8,000,000 to support loan 
repayment and scholarships for maternity care health services 
in health professional shortage areas. The Committee requests 
that HRSA provide a briefing on this effort within 120 days of 
enactment of this act.
    Rural Health Equity.--The Committee recognizes the 
importance of the Corps Scholarship Program, especially in 
combatting the rural healthcare provider shortage, and 
encourages HRSA to increase the number of scholarships 
provided. Providing Corps scholarships, particularly to 
students from rural communities, will increase equitable access 
to medical school and help to solve the rural provider 
workforce shortages throughout the United States.

Training for Diversity

    The Committee supports programs that improve the diversity 
of the healthcare workforce. HRSA's diversity pipeline programs 
help advance patient care and ensure opportunity for all 
healthcare providers.
            Centers of Excellence
    The Committee recommends $28,422,000 for the Centers of 
Excellence [COE] program. 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 healthcare workforce.
            Health Careers Opportunity Program
    The Committee includes $16,000,000 for the Health Careers 
Opportunity Program [HCOP]. The Committee notes that HCOPs 
assist students from minority and economically disadvantaged 
backgrounds with navigating careers into the health 
professions.
            Faculty Loan Repayment
    The Committee provides $2,310,000 for the Faculty Loan 
Repayment Program. 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
    The Committee provides $55,014,000 for Scholarships for 
Disadvantaged Students. This program provides grants to 
eligible health professions and nursing schools to award 
scholarships to students from disadvantaged backgrounds who 
have financial need. The Committee recognizes the success of 
the program and encourages HRSA to prioritize institutions with 
a proven record of training diverse practitioners and placing 
practitioners in low-income communities.
    Midwifery Training.--The Committee continues $5,000,000 to 
support grants to educate midwives to address the National 
shortage of maternity care providers. The Committee encourages 
HRSA to award robust funding to increase and diversify the 
number of Certified Nurse Midwives, particularly in rural and 
underserved communities.

Primary Care Training and Enhancement

    The Committee provides $49,924,000 for the Primary Care 
Training and Enhancement [PCTE] program to support the 
expansion of training in internal medicine, family medicine, 
and pediatrics. Funds may be used to develop training programs 
or provide direct financial assistance to students and 
residents.
    Administrative Academic Units.--The Committee supports the 
inclusion of administrative academic units within medical 
schools and requests a briefing within 60 days of enactment of 
this act on HRSA's work to support administrative academic 
units within medical schools, including barriers to additional 
funding opportunities for such units.
    Community-based Clinical Rotations for Medical Students.--
The Committee recognizes that patient care is frequently 
provided in a range of community-based settings and that 
providing outpatient training opportunities in underserved 
areas encourages long-term, sustainable physician practice in 
high-need areas. The Committee encourages HRSA to evaluate and 
facilitate opportunities for medical schools to partner with 
FQHCs, Rural Health Clinics or other healthcare facilities 
located in medically underserved communities to increase 
medical school clinical rotations in rural and underserved 
areas.
    Eating Disorders Screening and Referrals.--Within the total 
for PCTE, the Committee continues to support up to $1,000,000 
in coordination with SAMHSA's Center of Excellence for Eating 
Disorders, to provide trainings for primary care health 
professionals to screen, 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 
(Public Law 114-255).

Training in Oral Health Care

    The Committee provides $42,673,000 for Training in Oral 
Health Care Programs, which includes not less than $13,000,000 
for General Dentistry Programs and not less than $13,000,000 
for Pediatric Dentistry Programs, and not less than $15,000,000 
for State Oral Health Workforce grants. The Committee directs 
HRSA to provide continuation funding for section 748 post-
doctoral training grants, predoctoral dental grants, and dental 
faculty loan repayment program [DFLRP] grants. The Committee 
directs HRSA to initiate a new DFLRP grant cycle with a 
preference for pediatric dentistry faculty supervising dental 
students or residents and providing clinical services in dental 
clinics located in dental schools, hospitals, and community-
based affiliated sites.

Medical Student Education

    The Committee recommends $36,000,000 to support colleges of 
medicine at public universities located in the top half of 
States projected to have a primary care provider shortage. The 
Committee notes that this program has significant unspent 
balances from previous fiscal year appropriations that will 
continue to be available to public universities that meet the 
program criteria.

Interdisciplinary, Community-Based Linkages

            Area Health Education Centers
    The Committee provides $47,000,000 for Area Health 
Education Centers [AHECs]. The program links university health 
science centers with community health service delivery systems 
to provide training sites for students, faculty, and 
practitioners. The program supports three types of projects: 
core grants to plan and implement programs; special initiative 
funding for schools that have previously received AHEC grants; 
and model programs to extend AHEC programs with 50 percent 
Federal funding.
    Health Care Simulation Labs.--The Committee provides no 
less than $3,000,000 to continue competitive grants for AHEC 
recipients to expand experiential learning opportunities 
through simulation labs designed to educate and train 
healthcare professionals serving rural, medically underserved 
communities. HRSA shall include as an allowable use the 
purchase of simulation training equipment.
            Behavioral Health Workforce Education and Training Program
    The Committee provides $113,000,000 for the Behavioral 
Health Workforce Education and Training [BHWET] program. This 
program establishes and expands internships or field placement 
programs in behavioral health serving populations in rural and 
medically underserved areas. The Committee expresses ongoing, 
strong support for the Substance Use Disorder Treatment and 
Recovery [STAR] Loan Repayment program that was previously 
funded under BHWET, but is now funded as a standalone program.
    Addiction Medicine Fellowship [AMF] Program.--Within the 
total for BHWET, the Committee includes $25,000,000 for AMF to 
foster robust community-based clinical training of addiction 
medicine or addiction psychiatry physicians in underserved, 
community-based settings who see patients at various access 
points of care and provide addiction prevention, treatment, and 
recovery services across healthcare sectors.
    Peer Support Specialists.--Within BHWET, the Committee 
includes $14,000,000 to fund training, internships, and 
certification for mental health and substance use peer support 
specialists to create an advanced peer workforce prepared to 
work in clinical settings.
    Provider Distribution.--The Committee recognizes that some 
communities may disproportionately experience a high prevalence 
of substance use disorders, high suicide rates, and high 
poverty rates, combined with severe mental health provider 
shortages. The Committee encourages HRSA to assess the 
distribution of behavioral health students and providers who 
have participated in behavioral health workforce development 
programs and examine best practices to support healthcare and 
mental health providers serving in such communities.
            Geriatric Programs
    The Committee provides $49,245,000 for the Geriatric 
Programs, including the Geriatric Workforce Enhancement Program 
and the Geriatrics Academic Career Awards [GACA] Program. These 
programs support training to integrate geriatrics into primary 
care delivery and develop academic primary care community-based 
partnerships to address gaps in healthcare for older adults.
            Mental and Behavioral Health Programs
    The Committee includes $44,053,000 for Mental and 
Behavioral Health programs.
    Graduate Psychology Education [GPE].--Within the total for 
Mental and Behavioral Health programs, the Committee includes 
$25,000,000 for the inter-professional GPE program to increase 
the number of health service psychologists trained to provide 
integrated services to high-need, high-demand populations in 
rural and urban communities. The Committee recognizes the 
growing need for highly trained mental and behavioral health 
professionals to deliver evidence-based behavioral 
interventions for pain management in addressing the opioid 
epidemic. The Committee also notes data from CDC demonstrating 
a mental health crisis among youth and adolescents and urges 
HRSA to strengthen investments in the training of health 
service psychologists to help meet these demands.

Substance Use Disorder Treatment and Recovery [STAR] Loan Repayment 
        Program

    The Committee provides $65,000,000, an increase of 
$25,000,000 above the fiscal year 2024 enacted level. 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. The Committee also encourages HRSA to actively recruit 
SUD counselors to take advantage of its STAR Loan Repayment 
Program, so that underserved communities may benefit from the 
presence of these professionals.

Health Professions Workforce Information and Analysis

    The Committee provides $5,663,000 for health professions 
workforce information and analysis. This program provides for 
the collection and analysis of targeted information on the 
Nation's healthcare workforce, research on high-priority 
workforce questions, the development of analytic and research 
infrastructure, and program evaluation and assessment.
    Real-Time Data to Improve U.S. Healthcare Workforce.--The 
Committee recognizes the benefit of using real-time information 
in order to assess whether such programs are leading to 
improved physician supply in medically underserved areas. The 
Committee supports development of a data dashboard for all 
graduate medical education training position participants to 
include real-time information on residency applications, 
interviewee demographics, and residency fulfillment rates. The 
Committee requests a professional judgment estimate for the 
development of such a data dashboard, and any potential 
barriers, within 180 days of enactment of this act.

Public Health Workforce Development

    The Committee provides $18,000,000 for Public Health 
Workforce Development. This program line, also called Public 
Health and Preventive Medicine, funds programs that are 
authorized in titles III and VII of the PHS Act (Public Law 
111-148) and supports awards to schools of medicine, 
osteopathic medicine, public health, and integrative medicine 
programs.

Nursing Workforce Development Programs

    The Committee provides $310,472,000 for Nursing Workforce 
Development programs. These programs provide funding to address 
all aspects of nursing workforce demand, including education, 
practice, recruitment, and retention.
    Palliative Care Nursing Workforce.--Palliative care is 
patient and family-centered care, involving the support of an 
inter-professional team of doctors, nurses, social workers, and 
other providers and specialists who provide care for people 
with serious illnesses. As the healthcare needs of the Nation 
evolve and grow in complexity, the Committee encourages HRSA to 
expand opportunities to train and strengthen the palliative 
care nursing workforce through existing programs and 
activities.
    State-Based Nursing Workforce Centers.--The Committee notes 
interest in State-based nursing workforce centers. Such centers 
can collect local workforce research data, conduct strategic 
nursing workforce planning and program development, support 
programs to decrease workplace violence against nurses, develop 
programs to increase the recruitment and retention of nurses, 
and coordinate nurse leadership development programs. The 
Committee encourages HRSA to work with Congress and 
stakeholders to examine ways to establish new or enhance 
existing State-based nursing workforce centers to advance 
training.
            Advanced Education Nursing
    The Committee recommends $89,581,000 for Advanced Education 
Nursing programs, which increase the number of qualified nurses 
in the workforce by improving nursing education through 
curriculum and faculty development. The Committee recognizes 
the importance of strengthening the primary care workforce and 
training providers to work in community-based settings, 
particularly by funding Advanced Nursing Education and 
Residency Programs.
    Certified Nurse Midwives.--The Committee includes 
$8,000,000 to grow and diversify the maternal and perinatal 
nursing workforce by increasing and diversifying the number of 
Certified Nurse Midwives with a focus on practitioners working 
in rural and underserved communities. The program will help 
advance equity and address disparities in maternal mortality by 
awarding scholarships to students and Registered Nurses to 
cover the cost of tuition for the duration of the nurse 
midwifery program.
    Sexual Assault Nurse Examiners Program.--The Committee 
provides $15,000,000 to support training and certification of 
Registered Nurses, Advanced Practice Registered Nurses, and 
Forensic Nurses to practice as sexual assault nurse examiners.
            Nurse Education, Practice, Quality and Retention Program
    The Committee includes $69,413,000, an increase of 
$5,000,000 above the fiscal year 2024 enacted level, for 
competitive grants within the Nurse Education, Practice, 
Quality and Retention program to enhance nurse education and 
strengthen the nursing workforce through the expansion of 
experiential learning opportunities. Within this total, the 
Committee continues no less than $10,750,000 for grants to 
enhance nurse education through the expansion of experiential 
learning opportunities. HRSA is directed to ensure that these 
grants include as an allowable use the purchase of simulation 
training equipment.
    Traineeships to Address the Nursing Shortage and Prepare 
Academic Faculty.--The National Academies of Science, 
Engineering, and Medicine [NASEM] issued a report that provided 
recommendations to Congress to ease the nursing shortage in 
America. The Committee recognizes the urgent need to address 
the nursing shortage existing in all parts of the United States 
and grow the pipeline of nurse educators to meet the demand to 
grow the workforce. Therefore, the Committee encourages HRSA to 
provide traineeships and fellowships, including stipends, for 
eligible entities at both public and private institutions to 
expand opportunities that prepare individuals for careers in 
nursing.
    Registered Nurse [RN] Shortages.--The Committee provides 
$7,000,000 to increase the supply of registered nurses. 
Further, the Committee directs HRSA to give priority in new 
funding announcements to public entities for training 
additional RNs, specifically for long-term and acute care 
settings, and to give priority to applicants in States listed 
by HRSA as having the greatest shortages.
            Nurse Practitioner Fellowship Program
    The Committee provides $6,000,000 for grants to community-
based nurse practitioner residency and fellowship training 
programs that are accredited, or in the accreditation process, 
for practicing postgraduate nurse practitioners in primary care 
or behavioral health, where supported education and training 
specialties will include family, adult family, adult 
gerontology, pediatric, women's healthcare, nurse midwife, and 
psychiatric mental health.
            Nurse Corps Scholarship and Loan Repayment
    The Committee includes $92,635,000 for Nurse Corps. This 
program supports scholarships and loan repayment assistance for 
nurses and nursing students committed to working in communities 
with inadequate access to care.
            Nurse Faculty Loan Repayment
    The Committee includes $28,500,000 for Nurse Faculty Loan 
Repayment to expand the number of qualified nursing faculty 
nationwide by providing low interest loans for individuals 
studying to be nurse faculty and loan cancellation for those 
who then go on to work as faculty.
            Nursing Workforce Diversity
    The Committee includes $24,343,000 for Nursing Workforce 
Diversity to increase nursing education opportunities for 
individuals from disadvantaged backgrounds by providing student 
stipends, scholarships, and preparation and retention 
activities.

Children's Hospitals Graduate Medical Education

    The Committee provides $390,000,000 for the Children's 
Hospitals Graduate Medical Education [CHGME] program. The 
Committee strongly supports the CHGME program, which provides 
support for graduate medical education training programs in 
both ambulatory and inpatient settings within freestanding 
children's teaching hospitals. CHGME payments are determined by 
a per-resident formula that includes an amount for direct 
training costs added to a payment for indirect costs. Payments 
support training of resident physicians as defined by Medicare 
in both ambulatory and inpatient settings.

Pediatric Specialty Loan Repayment Program

    The Committee recognizes that significant shortages of 
pediatric medical subspecialists, pediatric surgical 
specialists, child and adolescent psychiatrists, and other 
pediatric mental health professionals are impeding access to 
care for children and adolescents in underserved areas. The 
Committee includes $10,000,000 for section 775 of the PHS Act. 
The Committee understands that high student loan debt is a 
significant barrier to providers choosing to complete training 
that would enable them to provide specialized care to children 
with special needs. The Committee directs HRSA to work with 
stakeholders with expertise in pediatric specialty care to 
ensure that the program and application process reflects the 
unique nature of pediatric specialty care, including ensuring 
that any clinical and service hour requirements and service 
site eligibility criteria are consistent with pediatric 
specialty practice and reflect the regionalization of pediatric 
specialty care.

National Practitioner Data Bank

    The Committee provides $18,814,000 for the National 
Practitioner Data Bank. As mandated by the Health Care Quality 
Improvement Act (Public Law 99-660), the National Practitioner 
Data Bank does not receive appropriated funds, but instead is 
financed by the collection of user fees.
    The National Practitioner Data Bank collects certain 
adverse information, medical malpractice payment history, and 
information related to healthcare fraud and abuse. The data 
bank is open to healthcare agencies and organizations that make 
licensing and employment decisions.

                       MATERNAL AND CHILD HEALTH

Appropriations, 2024....................................  $1,170,430,000
Budget estimate, 2025...................................   1,234,944,000
Committee recommendation................................   1,181,180,000

    The mission of the Maternal and Child Health Bureau is to 
improve the physical and mental health, safety, and well-being 
of the Nation's women, infants, children, adolescents, and 
their families. This population includes fathers and children 
with special healthcare needs.

Maternal and Child Health [MCH] Block Grant

    The Committee provides $603,584,000 for the MCH Block 
Grant, which provides a flexible source of funding that allows 
States to target their most urgent maternal and child health 
needs. Within this total, the Committee also proposes increases 
for a number of special projects to address the Nation's rising 
rate of maternal mortality. The program supports a broad range 
of activities, including providing prenatal care, well-child 
services, and immunizations; reducing infant mortality; 
preventing injury and violence; expanding access to oral 
healthcare; addressing racial and ethnic disparities; and 
providing comprehensive care through clinics, home visits, and 
school-based health programs.
    Congenital Syphilis [CS].--The Committee is concerned by 
reports of record high cases of CS, which is preventable during 
pregnancy and can result in bone deformities, deafness, 
blindness, stillbirth or death. The Committee encourages HRSA 
to expand efforts to increase prenatal screening and testing 
throughout pregnancy and to implement proper education for 
pregnant women and providers on screening, diagnosis, and 
treatment of CS.

MCH Block Grant-Special Projects of Regional and National Significance 
        [SPRANS]

    The Committee recommends $213,116,000, an increase of 
$3,000,000, for SPRANS. The Committee recommendation includes 
funding for the following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Early Childhood Development Expert          10,000,000        10,000,000
 Grants.............................
Epilepsy............................         3,642,000         3,642,000
Fetal Alcohol Syndrome..............         1,000,000         1,000,000
Fetal Infant and Child Death Review.         5,000,000         5,000,000
Hereditary Hemorrhagic                       2,000,000         2,000,000
 Telangiectasia.....................
Infant-Toddler Court Teams..........        18,000,000        18,000,000
Minority-Serving Institutions.......        10,000,000        10,000,000
Oral Health.........................         5,250,000         5,250,000
Regional Pediatric Pandemic Network.        25,000,000        25,000,000
Sickle Cell Disease.................         7,000,000         7,000,000
State Maternal Health Innovation            55,000,000        55,000,000
 Grants.............................
------------------------------------------------------------------------

    Early Childhood Development Expert Grants.--The Committee 
provides $10,000,000 to continue support for placements of 
early childhood development experts in pediatric settings with 
a high percentage of Medicaid and Children's Health Insurance 
Program patients.
    Infant-Toddler Court Teams.--The Committee includes 
$18,000,000 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.
    Minority-Serving Institutions.--The Committee continues 
$10,000,000 for a research network that is comprised of and 
supports minority-serving institutions to study health 
disparities in maternal health outcomes and develop curricula 
for training health professionals to identify and address the 
risks that climate change poses for vulnerable individuals and 
individuals that plan to become pregnant.
    Regional Pediatric Pandemic Network.--The Committee 
provides $25,000,000 within SPRANS to continue the work of the 
Regional Pediatric Pandemic Network to coordinate among the 
Nation's pediatric hospitals and their communities to prepare 
for and coordinate research-informed responses to future 
pandemics.
    State Maternal Health Innovation Grants.--The Committee 
provides $55,000,000 to support innovation among States to 
improve maternal health outcomes and address disparities in 
maternal health. With this funding, States collaborate with 
maternal health experts to implement State-specific action 
plans in order to improve access to maternal care services, 
identify and address workforce needs, and support postpartum 
and inter-conception care services.
    Stillbirth Prevention Technical Assistance.--The Committee 
is encouraged by HRSA's efforts to update its materials and 
guidance to clarify that stillbirth prevention activities are 
an allowable use of funds under the Maternal and Child Health 
Services Block Grant program. The Committee urges HRSA to 
continue to provide for ongoing technical assistance and other 
activities to support States' stillbirth prevention activities.

Maternal and Child Health Programs

Sickle Cell Disease Treatment Demonstration Program

    The Committee provides $8,205,000 for grants and contracts 
to help coordinate service delivery for individuals with sickle 
cell disease, including genetic counseling and testing, long-
term follow-up and care coordination, and training of health 
professionals.

Autism and Other Developmental Disorders

    The Committee provides $56,344,000 for the Autism and Other 
Developmental Disorders program. The program supports 
surveillance, early detection, education, and intervention 
activities for autism and other developmental disorders, as 
reauthorized in the Autism Collaboration, Accountability, 
Research, Education and Support Act of 2019 (Public Law 116-
60).
    The Committee provides not less than $38,245,000 for the 
Leadership Education in Neurodevelopmental and Related 
Disabilities [LEND] programs. LEND programs are uniquely 
positioned to provide innovative strategies to integrate and 
enhance existing investments, including translating research 
findings on interventions, guidelines, tools, and systems 
management approaches to training settings, to communities, and 
into practice, and to promote life-course considerations-from 
developmental screening in early childhood to transition to 
adulthood issues. The funding is critical to the LEND's role in 
providing direct clinical assessment and evidence-based 
interventions.

Healthy Start

    The Committee provides $145,250,000 for Healthy Start. The 
primary purpose of Healthy Start is to reduce infant mortality 
and generally improve maternal and infant health in at-risk 
communities. Grants are awarded to State and local health 
departments and nonprofit organizations to conduct and develop 
a package of innovative health and social services for pregnant 
women and infants, and evaluate these efforts.
    Maternal Mortality.--The Committee continues to support a 
new targeted expansion of an enhanced Healthy Start program 
model that began in fiscal year 2023. The Committee also 
continues to support nurse practitioners, certified nurse 
midwives, physician assistants, and other maternal-child 
advance practice health professionals within all program sites 
nationwide.
    Self-Measured Blood Pressure Monitoring Initiative.--The 
Committee recognizes the Healthy Start blood pressure 
monitoring pilot, which distributed cuff kits to 15 Healthy 
Start sites in 12 States. The Committee provides no less than 
$250,000 for more States to benefit from this pilot project, 
and to the Healthy Start program to continue to support the 
self-measured blood pressure monitoring pilot, which works to 
identify preeclampsia at an earlier stage in high-risk 
communities by distributing blood pressure cuffs and patient 
information. Preeclampsia, the most dangerous form of 
hypertension, is a pregnancy complication that effects as many 
as one in 12 pregnancies and can easily be monitored.

Heritable Disorders in Newborns and Children

    The Committee provides $20,883,000 for the Heritable 
Disorders in Newborns and Children program, as described in the 
Newborn Screening Saves Lives Act of 2008 (Public Law 113-240). 
This program provides funding to improve States' ability to 
provide newborn and child screening for heritable disorders. 
Newborn screening provides early identification and follow-up 
for treatment of infants affected by certain genetic, 
metabolic, hormonal, and/or functional conditions.

Early Hearing Detection and Intervention

    The Committee provides $18,818,000 for universal newborn 
hearing screening and early intervention activities. This 
program awards 59 competitive grants to States and territories 
that support statewide systems of newborn hearing screening, 
audiologic diagnostic testing before 3 months of age, and 
enrollment in early intervention programs before the age of 6 
months.

Emergency Medical Services for Children

    The Committee provides $24,334,000 for the Emergency 
Medical Services for Children program which focuses on 
improving the pediatric components of the emergency medical 
services system and improving the quality of care provided to 
children in the pre-hospital setting. Funding is available to 
every State emergency medical services office to improve the 
quality of emergency care for children and to pay for research 
and dissemination of best practices.

Screening and Treatment for Maternal Mental Health and Substance Use 
        Disorders [MMHSUD]

    The Committee provides $12,000,000 for the MMHSUD program, 
which was reauthorized in the Consolidated Appropriations Act 
of 2023 (Public Law 117-328). HRSA is directed to make grants 
to States to establish, improve, or maintain programs to train 
professionals to screen, assess, and treat for maternal 
depression in women who are pregnant or who have given birth 
within the preceding 12 months.
    According to Maternal Mortality Review Committee data in 38 
States, mental health conditions accounted for over 22 percent 
of pregnancy-related deaths in 2020. Maternal mental health 
[MMH] conditions impact one in five pregnant or postpartum 
women, including as many as one in three in high-risk 
populations. MMHSUD trains healthcare providers to screen, 
assess, and treat MMH conditions and substance use disorders, 
and provides specialized psychiatric consultation to providers. 
The Committee encourages HRSA to improve or maintain existing 
State programs, prioritizing States with high rates of adverse 
maternal health outcomes. Grants shall include culturally and 
linguistically appropriate approaches to assist in the 
reduction of maternal health inequities. The Committee 
encourages HRSA to provide technical assistance to both grantee 
and non-grantee States to implement activities under this 
program. The Committee requests a report within 1 year of 
enactment of this act detailing updates since the fiscal year 
2024 report, as well as the technical assistance HRSA has 
provided to States and steps HRSA has taken to expand the 
number of grants to States.

Pediatric Mental Health Care Access

    The Committee provides $14,000,000 for expanding access to 
behavioral health services in pediatric primary care by 
supporting the development of pediatric mental healthcare 
telehealth access programs.

Poison Control Centers

    The Committee provides $28,846,000 for Poison Control 
Centers. The Committee remains concerned with longstanding geo-
routing challenges for incoming calls of poison centers. Not 
later than 18 months after the date of enactment of this act, 
the Committee directs HRSA to coordinate with the Federal 
Communications Commission and leading wireless carriers, to the 
extent technically and economically feasible, to identify, 
develop, and implement a proof-of-concept trial of a geo-
routing solution to ensure that communications with the 
National toll-free number are routed to the appropriate poison 
control center based on the physical location of the contact 
rather than the area code of the contact device.

Innovation for Maternal Health

    The Committee includes $17,800,000 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.

Integrated Services for Pregnant and Postpartum Women

    The Committee provides $10,000,000 to reduce adverse 
maternal health outcomes and maternal deaths by incentivizing 
maternal healthcare providers to provide integral healthcare 
services to pregnant women and new mothers to optimize maternal 
and infant health outcomes.

Maternal Mental Health Hotline

    The Committee provides $8,000,000 to expand support for a 
maternal mental health hotline. 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.
    Support for Servicemembers.--Maternal mental health 
conditions impact 36 percent of female servicemembers and 
military spouses, and 60 percent of retired servicemembers. The 
Committee encourages HRSA to train hotline staff on best 
practices to support the unique needs of servicemembers, 
veterans, and military families utilizing the hotline. The 
Committee further directs HRSA to ensure that public awareness 
activities reach civilian, military, and veteran pregnant and 
postpartum women, as authorized in the Consolidated 
Appropriations Act of 2023 (Public Law 117-328). The Committee 
requests a briefing within 180 days of enactment of this act on 
activities taken to promote the hotline for civilian and 
military mothers.

                      RYAN WHITE HIV/AIDS PROGRAM

Appropriations, 2024....................................  $2,571,041,000
Budget estimate, 2025...................................   2,581,041,000
Committee recommendation................................   2,571,041,000

    The Committee recommendation includes $2,571,041,000 for 
the HIV/AIDS Bureau. The mission of the Bureau is to address 
the unmet care and treatment needs of persons living with HIV/
AIDS. The Bureau administers the Ryan White Care Act (Public 
Law 111-87), which provides a wide range of community-based 
services, including primary and home healthcare, case 
management, substance use disorder treatment, mental health, 
and nutritional services.
    Ending the HIV Epidemic [EHE].--The Committee provides 
$165,000,000 for the EHE initiative. The investment will 
support HIV care and treatment services; support evidence 
informed practices to link, engage, and retain HIV-positive 
individuals in care; and continue to build capacity into the 
system.

Emergency Assistance

    The Committee provides $680,752,000 for emergency 
assistance grants to eligible metropolitan areas 
disproportionately affected by the HIV/AIDS epidemic. Grants 
are provided to metropolitan areas meeting certain criteria. 
Two-thirds of the funds are awarded by formula, and the 
remainder is awarded through supplemental competitive grants.

Comprehensive Care Programs

    The Committee provides $1,364,878,000 for HIV healthcare 
and support services. Funds are awarded to States to support 
HIV service delivery consortia, the provision of home and 
community-based care services for individuals with HIV disease, 
continuation of health insurance coverage for low-income 
persons with HIV disease, and support for State AIDS drug 
assistance programs [ADAP]. The Committee provides $900,313,000 
for AIDS medications in ADAP.

Early Intervention Services

    The Committee provides $208,970,000 for early intervention 
grants. These funds are awarded competitively to primary 
healthcare providers to enhance healthcare services available 
to people at risk of HIV and AIDS. Funds are used for 
comprehensive primary care, including counseling, testing, 
diagnostic, and therapeutic services.

Children, Youth, Women, and Families

    The Committee provides $77,935,000 for grants for 
coordinated services to women, infants, children, and youth. 
Funds are awarded to a variety of providers, including 
community health centers, comprehensive hemophilia centers, 
county and municipal health departments, and other nonprofit 
community-based programs that provide comprehensive primary 
healthcare services to populations with or at risk for HIV.

AIDS Dental Services

    The Committee provides $13,620,000 for the AIDS Dental 
Services program. This program provides grants to dental 
schools, dental hygiene schools, and post-doctoral dental 
education programs to assist with the cost of providing 
unreimbursed oral healthcare to patients with HIV.
    The Ryan White Part F program provides for the Dental 
Reimbursement Program, which covers the unreimbursed costs of 
providing dental care to persons living with HIV/AIDS. Programs 
that qualify for reimbursement are dental schools, hospitals 
with post-doctoral dental education programs, and colleges with 
dental hygiene programs.

AIDS Education and Training Centers

    The Committee provides $34,886,000 for AIDS Education and 
Training Centers [AETCs], which train healthcare practitioners, 
faculty, and students who care for AIDS patients outside of the 
traditional health professions education venues and supports 
curriculum development on the diagnosis and treatment of HIV 
infection for health professions schools and training 
organizations.

Special Projects of National Significance

    The Committee provides $25,000,000 for the Special Projects 
of National Significance program. This program supports the 
development, evaluation, and dissemination of innovative models 
of HIV care and treatment to improve the retention and health 
outcomes of Ryan White HIV/AIDS Program clients.

                             HEALTH SYSTEMS

Appropriations, 2024....................................    $122,009,000
Budget estimate, 2025...................................     135,009,000
Committee recommendation................................     135,009,000

    The Committee recommendation for the Health Care Systems 
Bureau is $135,009,000.
    The Health Care Systems Bureau protects the public health 
and improves the health of individuals through efforts to 
support and enhance the systems by which healthcare is 
delivered in America.

Organ Donation and Transplantation

    The Committee provides $67,049,000, an increase of 
$13,000,000 above the fiscal year 2024 enacted level, for organ 
donation and transplantation activities.
    Organ Procurement and Transplantation Network [OPTN] 
Modernization Initiative.--HRSA has launched the OPTN 
Modernization Initiative, which aims to accelerate progress on 
technology improvements, data transparency and analytics, 
governance, operations, and quality improvement. The Committee 
requests a briefing within 90 days of enactment of this act on 
HRSA's spend plan and progress toward its stated objectives and 
actions the Department has taken or plans to take to improve 
oversight of the OPTN contractor(s), increase public and 
stakeholder trust in the OPTN organ allocation process, and 
track and evaluate the effectiveness and impact of the 
initiative. Further, the Committee supports additional 
investments to allow HRSA to adopt the technology and 
infrastructure needed to fully implement the modernization 
initiative.
    OPTN Next Generation Technology.--The Committee supports 
HRSA's efforts to develop a technology solution to fully 
modernize the OPTN, and directs the Secretary to prioritize 
obligations from resources in the nonrecurring expenses fund 
[NEF] for such activities as outlined in HRSA's fiscal year 
2025 budget request. The Committee is encouraged by HRSA's 
progress on the organ procurement and transplantation 
modernization and Next Generation contracts. The Committee 
encourages HRSA to consider public private technology solutions 
already adopted across HHS and the private sector, particularly 
those that address complex medical and logistics supply chain 
challenges, as part of a competitive process and successful 
transition.

National Cord Blood Inventory

    The Committee provides $19,266,000 for the National Cord 
Blood Inventory [NCBI]. The purpose of this program is to 
provide funds to cord blood banks to build an inventory of the 
highest quality cord blood units for transplantation.
    NCBI builds a racially and ethnically diverse inventory of 
high-quality umbilical cord blood for transplantation. The 
Committee applauds HRSA for increasing the number of units 
collected and maintained under NCBI.

C.W. Bill Young Cell Transplantation Program

    The Committee provides $33,009,000 for the C.W. Bill Young 
Cell Transplantation Program. The Committee continues to 
support cell transplantation through the use of bone marrow, 
peripheral blood stem cells, and cord blood. The Committee 
appreciates HRSA's efforts to increase the diversity of the 
volunteer registry.

National 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 programs support inpatient, 
outpatient, and long-term care, as well as training and 
research in Baton Rouge, Louisiana; outpatient clinic sites in 
the continental U.S. and Puerto Rico; related expenses for the 
facilities of the National Hansen's Disease Center; and medical 
care and treatment of persons with Hansen's disease through the 
Hawaii Department of Health's community program administered 
from Honolulu, Hawaii.

                              RURAL HEALTH

Appropriations, 2024....................................    $364,607,000
Budget estimate, 2025...................................     352,407,000
Committee recommendation................................     385,907,000

    The Committee recommendation for Rural Health programs is 
$385,907,000, an increase of $21,300,000 above the fiscal year 
2024 enacted level.
    The Federal Office of Rural Health Policy [FORHP] 
administers HHS rural health programs, coordinates activities 
related to rural healthcare within HHS, and analyzes the 
possible effects of policy on the more than 60 million 
residents of rural communities. FORHP advises the Secretary on 
the effects of Medicare and Medicaid on rural citizens' access 
to care, the viability of rural hospitals, and the availability 
of physicians and other health professionals.
    Rural Communities Opioid Response Program [RCORP].--The 
Committee provides $155,000,000 for RCORP, an increase of 
$10,000,000 to expand the program. Within the funding provided, 
the Committee includes $11,500,000 to continue at least three 
Rural Centers of Excellence [Centers], as established by Public 
Law 115-245 and continued through Public Law 116-260 and 117-
103. The Committee recognizes the success of the Centers in 
addressing substance use disorders within rural communities 
through various evidence-based treatment and recovery models. 
The Committee supports HRSA's continued investment in the 
current Centers and encourages HRSA to consider how the Centers 
can expand their outreach into other underserved communities. 
Within the total provided for RCORP, the Committee includes 
$4,000,000 to support career and workforce training services 
and other needs related to substance use challenges within the 
Northern Border Regional Commission's rural regions to assist 
individuals affected by a substance use disorder.
    Rural-Urban Commuting Area [RUCA] Codes.--The Committee 
applauds FORHP's work to better define rural areas in difficult 
and mountainous terrain areas and encourages them to continue 
to work to adopt the Road Ruggedness Scale, as defined in the 
report Characterizing Rugged Terrain in the United States, 
published by the United States Department of Agriculture 
Economic Research Service.

Rural Health Outreach

    The Committee provides $105,975,000 for the Rural Health 
Outreach program, an increase of $5,000,000 above the fiscal 
year 2024 enacted level. This program supports projects that 
demonstrate new and innovative modes of outreach in rural 
areas, such as integration and coordination of health services. 
Outreach grant programs include Outreach Service Grants, Rural 
Network Development Grants, Delta States Network Grant Program, 
Network Planning Grants, and Small Health Care Provider Quality 
Improvement Grants.
    Regional Grant Programs.--The Committee includes not less 
than the fiscal year 2024 level for the Delta States Rural 
Development Network Grant program, including not less than 
$15,000,000 for the Delta Region Community Health Systems 
Development program. The Committee provides no less than 
$5,000,000 for HRSA's collaboration with the Northern Border 
Regional Commission to provide direct support to member States 
and help underserved rural communities with planning and 
implementing service coordination improvements that better 
population health. Lastly, the Committee provides no more than 
$2,500,000 for HRSA's collaboration with the Appalachian 
Regional Commission.
    Rural Maternity and Obstetrics Management Strategies 
[RMOMS].--The Committee provides no less than $15,000,000 for 
RMOMS to support 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

    The Committee provides $12,076,000, an increase of 
$1,000,000, for additional core research centers to increase 
the number of studies on rural health and support policy 
solutions that improve access to healthcare, health outcomes, 
and population health. The Rural Health Research Center program 
funds publicly available and policy relevant research on rural 
health to assist providers and Federal, State, and local 
governments in addressing challenges faced by rural 
communities. Additional research on the significant and 
pervasive challenges faced by rural Americans in accessing 
healthcare in support of mental health, substance use, 
nutrition and healthy eating, chronic health management, among 
other critical needs, requires additional policy research 
capacity to inform solutions to these important issues.

Rural Hospital Flexibility Grants

    The Committee provides $64,277,000 for Rural Hospital 
Flexibility grants and the Small Hospital Improvement Program. 
Under these grant programs, HRSA works with States to provide 
support and technical assistance to Critical Access Hospitals 
to focus on quality and performance improvement and to 
integrate emergency medical services.
    The Committee is keenly aware of the significant challenges 
facing emergency care for rare and chronic disease patients in 
rural America. Rural emergency medical service [EMS] providers 
have gaps in education that can lead to disparate outcomes for 
rural rare and chronic disease patients based on delays in 
proper care, administration of emergency prescription 
medications, or unforeseen side effects or drug interactions 
occurring during medical interventions. Without closing these 
care gaps, rare and chronic disease patients face risks to 
their health and lives in the event of an emergency. Therefore, 
the Committee encourages HRSA to allow education for the 
administration of patient-held drugs for rural rare and chronic 
disease patients for rural EMS personnel as an eligible use of 
funding from the Emergency Services Supplement of the Medicare 
Rural Hospital Flexibility Grant Program.
    Cybersecurity.--The Committee urges HRSA to clarify that 
funds from the Small Hospital Improvement Program may be used 
to support cybersecurity measures including purchases of 
hardware, software, and training.

State Offices of Rural Health

    The Committee provides $14,500,000 for State Offices of 
Rural Health. These offices help States strengthen rural 
healthcare delivery systems by enabling them to coordinate care 
and improve support and outreach in rural areas.

Black Lung Clinics

    The Committee provides $12,190,000 for the Black Lung 
Clinics program. 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. These clinics reduce the incidence of high-cost 
inpatient treatment for these conditions.

Radiation and Exposure Screening and Education Program

    The Committee provides $1,889,000 for activities authorized 
by the Radiation Exposure Compensation Act (Public Law 109-
482). This program provides grants for the education, 
prevention, and early detection of radiogenic cancers and 
diseases resulting from exposure to uranium during mining and 
milling at nuclear test sites.

Rural Residency Planning and Development

    The Committee provides $14,000,000 for the Rural Residency 
Planning and Development program. The Committee commends FORHP 
for 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.
    The Committee provides no more than $2,000,000 to support 
family medicine/obstetrics training programs in States with 
high infant morbidity rates. The funding will reduce infant 
mortality and maternal morbidity by improving the availability 
and accessibility of prenatal care through increasing family 
medicine/obstetrics training programs and graduates, increasing 
Family Medicine and OB/GYN faculty to train physicians, and by 
providing equipment, such as ultrasound, electronic fetal 
monitors, and telemedicine equipment with the training and 
support for this equipment to rural areas. HRSA is directed to 
brief the Committee on their plans no less than 15 days prior 
to releasing a Funding Opportunity Announcement.

Rural Hospital Stabilization Pilot Program

    The Committee includes $6,000,000 for the Rural Hospital 
Stabilization Pilot program that started in fiscal year 2024. 
The program is intended to provide support to at-risk rural 
hospitals to enhance or expand service lines to retain 
healthcare services locally and increase service volume and 
revenue that will enhance hospitals' financial viability. HRSA 
is directed to prioritize applications from hospitals that do 
not have Medicare Critical Access Hospital designation and are 
at risk of closure.

                            FAMILY PLANNING

Appropriations, 2024....................................    $286,479,000
Budget estimate, 2025...................................     390,000,000
Committee recommendation................................     286,479,000

    The Committee provides $286,479,000 for the title X Family 
Planning program. This program supports preventive and primary 
healthcare services at clinics nationwide.

                HRSA-WIDE ACTIVITIES AND PROGRAM SUPPORT

Appropriations, 2024....................................  $1,110,376,000
Budget estimate, 2025...................................     214,088,000
Committee recommendation................................   1,092,655,000

    The Committee provides $1,092,665,000 for HRSA-wide 
activities. Within the total, $165,300,000 is provided for 
program management.
    Congressionally Directed Spending.--Within the total for 
program management, the Committee also includes $871,077,000 
for projects financing the construction and renovation 
(including equipment) of healthcare and other facilities and 
for one-time grants supporting other health-related activities. 
The projects are specified in the table at the end of this 
Committee Report.

Telehealth

    The Committee provides $44,050,000 for the Office for the 
Advancement of Telehealth [OAT], which promotes the effective 
use of technologies to improve access to health services for 
people who are isolated from healthcare and to provide distance 
education for health professionals. The Committee strongly 
supports OAT and their mission to expand high quality medical 
care to rural communities that do not have adequate access to 
medical providers including many medical specialties.
    Expanding Capacity for Health Outcomes.--The Committee 
provides $10,500,000 as authorized in Public Law 116-260 to 
continue the use of technology-enabled collaborative learning 
and capacity building models. This collaborative model of 
medical education and care management helps clinicians provide 
expert-level care to patients wherever they live, and increases 
access to specialty treatment in rural and underserved areas 
for a variety of conditions. The Committee recognizes that HRSA 
has initiated activities to allow grantees to explore 
addressing Alzheimer's disease. The Committee encourages HRSA 
to expand and support such activities, including improving 
Alzheimer's person-centered care coordination and improving 
care transitions.
    Telehealth Centers of Excellence [Centers].--The Committee 
provides $8,500,000 for the Centers to continue to validate 
technologies and reimbursement mechanisms, establish training 
protocols, and develop comprehensive templates for States to 
integrate telehealth into their State health provider networks. 
The Centers identify best practices, serve as national training 
resources and test the efficacy of different telehealth 
clinical applications. The Centers 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. Funding 
should serve to promote the adoption of telehealth services 
nationwide and help address the access to care issue faced by 
rural America.
    Telehealth Network Grants.--The Committee expresses support 
for the Telehealth Network Grant program in addressing rural 
health emergencies and encourages HRSA to include telepharmacy 
as an area of interest for future awards.

Office of Pharmacy Affairs

    The Committee provides $12,238,000 for the Office of 
Pharmacy Affairs [OPA]. OPA administers the 340B drug-pricing 
program, which requires drug manufacturers to provide discounts 
or rebates to a set of programs and hospitals that serve a 
disproportionate share of low-income patients. The 340B program 
is a critical lifeline to many of its program participants, 
including FQHCs, FQHC Look-Alikes, children's hospitals, Ryan 
White HIV/AIDS clinics, and other safety-net hospitals and 
providers. These covered entities are model stewards of the 
program and reinvest 340B savings to ``stretch scarce Federal 
resources as far as possible, reaching more eligible patients 
and providing more comprehensive services'', as Congress 
intended.
    The Committee is concerned that manufacturers continue to 
deny 340B pricing for drugs purchased by covered entities for 
use in contract pharmacies, which threatens the ability of 
safety-net providers to care for patients in need. The 
Committee urges HRSA to continue to take actions to safeguard 
covered entities' lawful access to discounted drugs.

             VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2024....................................     $15,200,000
Budget estimate, 2025...................................      20,200,000
Committee recommendation................................      15,200,000

    The Committee includes $15,200,000 for administrative costs 
associated with the Vaccine Injury Compensation Program. The 
National Vaccine Injury Compensation Program provides 
compensation for individuals with vaccine-associated injuries 
or deaths. Funds are awarded to reimburse medical expenses, 
lost earnings, pain and suffering, legal expenses, and death 
benefits. The Vaccine Injury Compensation Trust Fund is funded 
by excise taxes on certain vaccines recommended for routine 
administration to children and pregnant women.
    Completion of Medical Reviews.--The Committee requests a 
report within 6 months of enactment of this act detailing 
HRSA's use of intelligent document processing [IDP] and 
artificial intelligence [AI] to complete medical reviews for 
individuals seeking compensation from the Vaccine Injury 
Compensation Program Trust Fund, including how IDP and AI have 
contributed to reducing reviewing times and reductions in the 
backlog of cases, as well as guardrails in place to ensure that 
medical reviews are accurate and complete.

                  COVERED COUNTERMEASURES PROCESS FUND

Appropriation, 2024.....................................      $7,000,000
Budget request, 2025....................................      10,000,000
Committee Recommendation................................       7,000,000

    The Committee includes $7,000,000 for compensation of 
injury claims associated with countermeasures costs to 
administer the Countermeasures Injury Compensation Program 
[CICP]. The CICP provides benefits to individuals who are 
seriously injured as a result of the administration or use of 
covered countermeasures.

               Centers for Disease Control and Prevention

    The Committee recommendation provides a program level of 
$9,395,090,000 for the Centers for Disease Control and 
Prevention [CDC], which includes $55,358,000 in mandatory funds 
under the terms of the Energy Employees Occupational Illness 
Compensation Program Act [EEOICPA], and $1,186,200,000 in 
transfers from the Prevention and Public Health [PPH] Fund.
    The activities of CDC focus on several major priorities: 
providing core public health infrastructure and functions; 
detecting and responding to urgent health threats; monitoring 
the Nation's health using sound scientific methods; preventing 
the leading causes of illness, injury, and death; assuring the 
Nation's preparedness for emerging infectious diseases and 
potential pandemics; and providing training, support, and 
leadership for the public health workforce.

                 IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2024....................................    $919,291,000
Budget estimate, 2025...................................     969,291,000
Committee recommendation................................     934,291,000

    The Committee recommendation for the activities of the 
National Center for Immunization and Respiratory Diseases is 
$934,291,000, which includes $469,350,000 in transfers from the 
PPH Fund.
    The mission of the National Center for Immunization and 
Respiratory Diseases is the prevention of disease, disability, 
and death through immunization and by control of respiratory 
and related diseases.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Section 317 Immunization Program....       681,933,000       696,933,000
Acute Flaccid Myelitis..............         6,000,000         6,000,000
Influenza Planning and Response.....       231,358,000       231,358,000
------------------------------------------------------------------------

    317 Immunization Program.--The Committee recognizes CDC's 
immunization program plays a fundamental role in achieving 
national immunization goals and sustaining high vaccination 
coverage. In addition, this program underpins the protection of 
all children being vaccinated, even those fully insured, by 
providing Federal, State, and local resources to investigate 
outbreaks, conduct surveillance, and provide public awareness 
campaigns to address vaccine hesitancy that continues to be the 
root cause of outbreaks for measles and other preventable 
diseases. The Committee continues to expect funding be used to 
promote health equity related to protection from vaccine 
preventable diseases [VPDs] as well as address vaccine 
hesitancy. CDC is encouraged to expand the existing 
immunization infrastructure, including implementing new 
strategies for hard-to-reach populations, such as those who may 
be vaccine-hesitant, those who are members of racial and ethnic 
or other minority groups, and those who are underserved due to 
socioeconomic or other reasons. The Committee requests an 
update in the fiscal year 2026 CJ on the achievements of the 
ongoing ``Vaccinate with Confidence'' campaign and the rate of 
routine vaccination across all ages, as well as a forward-
looking plan to administer missed doses.
    Accelerate the Elimination of HPV-related Cancer and 
Disease.--Human papillomavirus [HPV] -related cancers remain an 
alarming public health concern in the United States, impacting 
nearly 40,000 Americans each year. HPV is the leading cause of 
cervical cancer, which disproportionally affects communities of 
color and underrepresented populations. Each year, nearly 
200,000 women are diagnosed with cervical pre-cancer, 11,000 
women are diagnosed with cervical cancer caused by HPV, and 
approximately 4,000 women die from cervical cancer in the 
United States. The evidence shows that HPV vaccination is 
extremely effective at preventing over 90 percent of HPV-
related cancers when given between the recommended ages of 9 
and 12. Yet, CDC data from 2022 shows that only 63 percent of 
children ages 13-17 were up to date with HPV vaccination, which 
is significantly less than the ``Healthy People 2030'' goal of 
80 percent. While all childhood and adolescent vaccinations 
declined during the pandemic, the HPV vaccine rates experienced 
the largest decrease and have been the slowest to rebound to 
pre-pandemic levels. The Committee urges CDC to take immediate 
action to expand access to HPV vaccination, including by: 
updating the immunization information system at the Federal 
level to enable standardized forecasting of HPV vaccination at 
age 9 across the country; supporting providers and trusted 
voices to engage patients with a strong recommendation for HPV 
vaccination as cancer prevention; and continuing to reduce 
health disparities and barriers to care for underserved 
communities.
    Cost Estimates.--The Committee requests that the report on 
estimated funding needs of the Section 317 Immunization Program 
be updated and submitted not later than February 1, 2025, to 
the Committees on Appropriations. 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 Committee also requests that 
the report 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 HPV and 
influenza. The Committee directs CDC to provide a professional 
judgment budget estimate to the Committee that specifically 
outlines the cost to fully fund an uninsured adult immunization 
program that includes the cost of purchase, storage, and 
administration of all ACIP-recommended adult vaccines and 
allows for provider choice of product, outreach, and counseling 
grants to providers and community-based organizations. 
Estimates should also be included to address the needs of 
outbreak investigation and response, particularly as measles 
cases are increasing. Additionally, the Committee requests CDC 
to provide analysis on how the addition of new adult vaccine 
recommendations and increased vaccine costs have reduced the 
number of vaccine doses administered to uninsured adults with 
available resources. This should include estimates of how much 
additional vaccine purchase funding would be needed to reach 
both half and all of the uninsured population with a complete 
series of recommended vaccines.
    Increasing Adult Hepatitis B Vaccination.--The Committee 
urges CDC to promote hepatitis B vaccination among all adults 
ages 19 through 59 as recommended by ACIP. The Committee urges 
CDC to provide leadership to ensure the recommendation is 
implemented, and to coordinate implementation activities with 
the HHS Assistant Secretary for Health and HRSA and engage 
providers and community-based organizations as necessary. The 
Committee reiterates the request for a report as requested in 
Senate Report 118-84.
    Long COVID.--The Committee encourages CDC to monitor and 
track incidence of Long COVID among children and adults, 
including developing a patient registry for Long COVID.
    Promoting Routine Vaccination.--The Committee is concerned 
by the continued lag in vaccination throughout the life course, 
with underserved populations affected to a greater degree and 
adolescents affected disproportionately. The 2023-2024 
respiratory season saw continued stagnation in immunization 
rates coupled with significant increases in COVID, flu, and 
respiratory syncytial virus [RSV] cases. If not addressed, 
these trends will increasingly expose Americans of all ages to 
VPDs, outbreaks, including measles, and exacerbate existing 
health disparities. The Committee requests CDC provide an 
update in the fiscal year 2026 CJ on the vaccine education 
efforts and the rate of routine vaccination across all ages, as 
well as an update on the plan to administer missed doses, 
prioritizing areas with the largest reduction in routine 
coverage rates. CDC should include updated recommendations 
about what other tools it could employ to address this issue, 
as well as a plan to strengthen efforts to combat 
misinformation about vaccines and vaccination, which are 
contributing to confusion, hesitancy, and overall fatigue.
    Respiratory Viruses.--The Committee recognizes the 
importance of a strong capacity at CDC to address respiratory 
viruses and supports CDC's work to address respiratory 
illnesses holistically, with the capacity to identify and 
assess characteristics of viruses to inform vaccines and 
therapeutics, quantify the burden such viruses place on the 
health of Americans, and the effectiveness of vaccines and 
other preventive measures.

 HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND TUBERCULOSIS 
                               PREVENTION

Appropriations, 2024....................................  $1,391,056,000
Budget estimate, 2025...................................   1,391,056,000
Committee recommendation................................   1,394,056,000

    The Committee recommendation for the activities of the 
National Center for HIV, Viral Hepatitis, Sexually Transmitted 
Diseases [STDs], and Tuberculosis Prevention [TB] is 
$1,394,056,000.
    The Center administers CDC's activities on HIV/AIDS, viral 
hepatitis, STDs, and TB, with the exception of the Global AIDS 
program, which is housed in the Global Health Center.
    The Committee recommends funding for the following 
activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and         1,013,712,000     1,013,712,000
 Research...........................
    HIV Initiative..................       220,000,000       220,000,000
    School Health...................        38,081,000        38,081,000
Viral Hepatitis.....................        43,000,000        43,000,000
Sexually Transmitted Infections.....       174,310,000       176,310,000
Tuberculosis........................       137,034,000       138,034,000
Infectious Diseases and Opioid              23,000,000        23,000,000
 Epidemic...........................
------------------------------------------------------------------------

    Ending the HIV Epidemic [EHE] Initiative.--The Committee 
includes $220,000,000 for the EHE Initiative. The Committee is 
aware that having a sexually transmitted infection [STI] poses 
an increased risk of HIV acquisition. The Committee commends 
CDC for including dedicated funding in the EHE initiative for 
STI clinics, sexual health clinics and the STD Clinical 
Prevention Training Centers. Additionally, the Committee 
supports efforts to increase equitable access to pre-exposure 
prophylaxis [PrEP] medication that prevents HIV infection. CDC 
is encouraged to support the building blocks of a national 
program to increase awareness of PrEP, including by increasing 
access to PrEP medication, laboratory services, essential 
support services such as case management, counseling, linkage, 
and adherence services, robust PrEP outreach and education 
activities, and PrEP provider capacity expansion.
    Hepatitis.--The Committee encourages CDC to expand the 
viral hepatitis disease tracking and surveillance capabilities 
of States to permit an effective targeting of resources and 
evaluation of program effectiveness. In pursuit of this goal, 
the Committee recommends greater emphasis and access to testing 
for both hepatitis B and hepatitis D. The Committee requests an 
update on the prevalence and incidence of hepatitis D and the 
opportunities to enhance the analysis of this disease in the 
fiscal year 2026 CJ.
    Hepatitis B.--The Committee encourages efforts to eliminate 
the public health threat of viral hepatitis and to implement 
and help fund the HHS National Viral Hepatitis Strategic Plan, 
which offers a framework to eliminate viral hepatitis as a 
public health threat. The Committee is aware of the November 
2021 ACIP recommendation that all adults between ages 19 and 59 
be vaccinated for hepatitis B and the March 2023 CDC 
recommendation that all adults be screened for hepatitis B. The 
Committee urges a coordinated Federal effort to implement these 
goals. In addition, the Committee encourages CDC to expand 
viral hepatitis disease tracking and surveillance capabilities 
of States to permit an effective targeting of resources and 
evaluation of program effectiveness. Finally, the Committee 
encourages that funds be prioritized for implementing equitable 
strategies to make the biggest positive impact among 
underserved jurisdictions that carry a disproportionate burden 
of hepatitis B.
    Infectious Diseases and Opioids.--The Committee encourages 
CDC to prioritize jurisdictions with the highest age-adjusted 
mortality rate related to SUDs and acute hepatitis C infection. 
CDC is also encouraged to prioritize jurisdictions that are 
experiencing outbreaks or emerging clusters of infectious 
diseases associated with drug use, including those not eligible 
for EHE funding.
    School Health.--The Committee provides $38,081,000 to 
promote school-based health and disease prevention for 
adolescents, including mental health. CDC is urged to collect 
and integrate data on school policies and practices that 
support student and staff physical and emotional well-being and 
positive mental health and wellness.
    Sexually Transmitted Infections [STIs].--The Committee is 
concerned by the high rates of sexually transmitted infections 
in the United States, particularly the increase in syphilis and 
congenital syphilis. The Committee includes $176,310,000 to 
combat and prevent the high incidence of STIs. Additionally, 
the Committee directs CDC to continue to move the grant year 
forward by 1 month to provide for a more efficient expenditure 
of funds and improve grantee activities, with the intention 
that the grant year will be moved forward by 1 month for the 
next year, contingent on the availability of funds. Finally, 
the Committee encourages CDC to work with other agencies, as 
appropriate, to develop innovative approaches including the use 
of telehealth platforms and at home specimen collection to 
increase screening, treatment, and education to curb the spread 
of STIs in vulnerable populations.
    Subawards.--The Committee is concerned about the 
accountability of subawards made with funds appropriated for 
infectious diseases and the opioid epidemic and directs CDC to 
track and monitor subawards.
    Tribal Tuberculosis.--The Committee is concerned about the 
insufficient staffing of tuberculosis technicians in Tribal 
areas. The Committee encourages CDC in conjunction with State 
and local health departments, to continue supporting TB 
prevention and treatment activities in populations at highest 
risk for TB disease, including American Indian and Alaska 
Native communities.

               EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2024....................................    $760,272,000
Budget estimate, 2025...................................     780,772,000
Committee recommendation................................     805,272,000

    The Committee recommendation for the activities of the 
National Center for Emerging and Zoonotic Diseases is 
$805,272,000, which includes $52,000,000 in transfers from the 
PPH Fund.
    The National Center for Emerging and Zoonotic Infectious 
Diseases aims to detect, prevent, and control infectious 
diseases from spreading, whether they are naturally occurring, 
unintentional, or the result of terrorism.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Antibiotic Resistance Initiative....       197,000,000       200,000,000
Vector-Borne Diseases...............        63,603,000        65,603,000
Lyme Disease........................        27,000,000        29,000,000
Prion Disease.......................         8,000,000         9,000,000
Chronic Fatigue Syndrome............         5,400,000         5,400,000
Emerging Infectious Diseases........       213,997,000       245,997,000
Harmful Algal Blooms................         3,500,000         3,500,000
Food Safety.........................        72,000,000        72,000,000
National Health Care Safety Network.        24,000,000        24,000,000
Quarantine..........................        53,772,000        58,772,000
Advanced Molecular Detection........        40,000,000        40,000,000
Epidemiology and Laboratory Capacity        40,000,000        40,000,000
Healthcare-Associated Infections....        12,000,000        12,000,000
------------------------------------------------------------------------

    Advanced Molecular Detection [AMD].--The Committee includes 
$40,000,000 and recognizes the critical role the AMD program 
plays in bringing cutting edge technology to the front lines of 
public health by harnessing the power of advanced sequencing 
methods and high performance computing with bioinformatics and 
epidemiology expertise to study pathogens. The Committee 
commends CDC for advancing research in the critical area of 
lethal bacteria and special pathogens. However, the Committee 
remains concerned about the increasingly dangerous threat to 
public health of emerging and dangerous bacterial pathogens 
that can be difficult or impossible to grow in laboratory 
settings and can disproportionately affect health equity of 
underrepresented populations. Further research is required in 
advanced DNA sequencing to speed the development of 
diagnostics, therapeutics, and vaccines. The Committee requests 
a briefing on the advanced DNA sequencing and detection of 
novel emerging and dangerous pathogens no later than 180 days 
after enactment of this act.
    Antimicrobial Resistance [AMR].--The Committee continues to 
support the administration's proposal to address the problem of 
antimicrobial resistant bacteria and fungi through a ``One 
Health'' approach and by tracking and preventing the spread of 
resistance at the local, regional, national and global levels. 
The Committee notes the complexities in conducting surveillance 
of antimicrobial resistance. The Committee directs CDC to 
publish a report publicly describing national trends in the 
prescription of antibiotics. The report shall identify 
recommendations for how antibiotic stewardship programs could 
be improved, and what steps should be taken for Congress to 
help physicians improve appropriate use of antibiotics.
    Importation of Dogs.--The Committee understands the role of 
CDC in preventing the spread of disease, however, certain 
changes to the final rule entitled ``Control of Communicable 
Disease; Foreign Quarantine: Importation of Dogs and Cats'' 
were not included in the Notice of Proposed Rulemaking and did 
not receive public comment. The burden of such changes on pene-
exclaves and communities near the border of a rabies-free or 
low-risk country should be reviewed and mitigated by the CDC. 
The Committee views CDC's recent efforts to modify 
implementation of the rule as a step forward, but the Committee 
encourages CDC to consider additional ways to ensure that the 
transport of dogs into the country by rescue organizations, 
citizens who cross the border for work or other daily 
activities, including sporting events, and U.S. employees 
stationed overseas traveling with their pets are not 
unreasonably inhibited. The Committee also requests that CDC 
evaluate any flexibilities to the 6-months of age requirement, 
in order to ensure dogs from rabies-free or low-risk countries, 
and their owners or potential owners, are not unnecessarily 
penalized by the final rule.
    Lyme Disease and Related Tick-Borne Illnesses.--The 
Committee provides $29,000,000 to expand the programs 
authorized under the Kay Hagan Tick Act (Public Law 116-94) to 
promote a public health approach to combat rising cases of 
tick-borne diseases. In distributing these funds, the Committee 
directs CDC to prioritize entities focused on Lyme disease and 
related tick-borne diseases in the areas of surveillance, 
control, prevention, diagnosis, treatment, and education. The 
Committee recognizes the growing public health threat of Lyme 
disease and related tick-borne diseases and directs CDC to 
provide support in endemic areas as well as areas not yet 
considered endemic. Given the impact of Lyme disease and the 
status of ongoing clinical trials, the Committee requests a 
report within 180 days of enactment on CDC's research to date 
and recommendations on actions needed to facilitate a 
successful Lyme disease vaccine rollout that will build 
confidence and encourage uptake should a vaccine be approved by 
the FDA.
    Myalgic Encephalomyelitis/Chronic Fatigue Syndrome [ME/
CFS].--Given that a subset of patients with post-acute COVID-19 
and other post-infectious syndromes meet the diagnostic 
criteria for ME/CFS, the Committee continues to encourage CDC 
to develop a national epidemiological and disease tracking 
study of post-infectious syndromes prevalence, specifically the 
rates of ME/CFS in adults. The Committee expects CDC to 
strengthen collaboration with 1) interagency partners, 2) 
disease experts and stakeholders, and 3) the NIH's 
Collaborative Research Centers. Additionally, the Committee 
urges CDC to conduct a series of epidemiological studies into 
the causes, diagnosis, and risk factors of ME/CFS. The 
Committee also expects CDC to engage physicians and patients in 
an effort to increase awareness of ME/CFS and disseminate 
updated clinical guidance. Finally, the Committee supports 
CDC's successful Project ECHO-style primary care provider 
education programs and encourages CDC to explore expanding the 
program to additional States and regions, with a special focus 
on rural and underserved communities.
    Mycotic Diseases.--The Committee supports CDC's efforts 
relating to mycotic diseases, including its collaboration with 
the Valley Fever Institute, Valley Fever Center for Excellence, 
and the Cocci Study Group. As part of this work, the Committee 
urges CDC to grow its work to improve surveillance, awareness, 
and diagnostics for coccidioidomycosis and other fungal 
diseases. The Committee directs CDC to fund these activities at 
not less than the fiscal year 2024 enacted level.
    National Healthcare Safety Network [NHSN].--The Committee 
includes $24,000,000 for NHSN and recognizes the critical value 
of this system for healthcare quality measurement and 
improvement, as well as supporting national security needs for 
situational awareness of health systems' capacity during major 
outbreaks and pandemic responses. 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 as called 
for by the National Biodefense Strategy to create an enduring 
domestic all-hazards hospital data collection capability.
    Prion Disease Surveillance.--The Committee is concerned 
that Chronic wasting disease [CWD], a fatal condition in 
cervids (deer, elk, and moose) caused by misfolded prions, has 
been detected in over 30 States and all four regions of the 
country. Monitoring the prevalence of prion diseases, including 
determining a disease's incidence and whether it was acquired 
from animals or other humans, is critical. In light of 
scientific observations regarding the Nationwide spread of CWD 
and concerns about the potential for cross-species 
transmissions to humans and food production animals, the 
Committee includes $9,000,000 for surveillance efforts of human 
prion diseases, including Creutzfeldt-Jakob Disease, through 
the National Prion Disease Pathology Surveillance Center and 
CDC.
    Quarantine.--The Committee includes an increase for this 
program and supports efforts to detect pathogens early and 
enhance global biosecurity efforts through the Traveler-based 
Genomic Surveillance program.
    Sepsis.--The Committee includes $5,000,000 to support CDC's 
ongoing work for expanded data collection related to sepsis and 
the Sepsis Core Elements through NHSN and the Division of 
Healthcare Quality Promotion's work to develop sepsis quality 
measures. The Committee recognizes the importance of 
developing, in coordination with CMS, measures to improve the 
detection of sepsis and outcomes for patients with sepsis. 
These include a hospital sepsis programs' structural measure to 
address the implementation of structures and activities to 
improve the recognition and care of patients with sepsis, the 
Adult Sepsis Event outcome measure that will assess the number 
of cases and outcomes of adult patients hospitalized with 
sepsis, and the Pediatric Sepsis Event measure that will be 
used to estimate the National burden of pediatric sepsis. The 
Committee requests CDC release an annual report on hospital use 
of the Sepsis Core Elements, which includes how many hospitals 
use the Core Elements and CDC plans for further analysis that 
detail success and barriers to implementation of the sepsis 
Core Elements.
    Vector-Borne Diseases [VBDs].--The Committee is concerned 
about the risk of a vector-borne infectious disease outbreak in 
the United States and our readiness to quickly respond to and 
stop its spread. The Committee includes an increase of 
$2,000,000 for continued implementation of the Kay Hagan Tick 
Act and to enhance capacity to expand nation-wide surveillance 
of vector-borne disease. The Committee intends that this 
additional funding will also support the purposes of the 
Strengthening Mosquito Abatement for Safety and Health 
provisions in the All-Hazards Preparedness and Advancing 
Innovation Act (Public Law 116-22).
    Wastewater Surveillance.--The Committee provides 
$20,000,000 for Wastewater Surveillance. The Committee remains 
encouraged by CDC's infectious disease surveillance work 
through wastewater surveillance that partners with health 
laboratories and academic institutions to track multiple 
existing infectious disease threats simultaneously and to 
quickly pivot to detect both the resurgence of known pathogens 
and the emergence of new threats. The Committee continues to 
underscore the importance of a wastewater surveillance system 
that can serve as a national early-warning system. The 
Committee encourages CDC to provide recommendations on the use 
of assays and other methods to promote efficient wastewater 
surveillance for data on multiple infectious diseases and to 
quickly add new disease targets as needed. The Committee 
requests CDC provide recommendations for wastewater testing 
methods and metrics. The Committee encourages wastewater sample 
data reporting to CDC to be published by the Secretary in a 
publicly available wastewater surveillance database and 
dashboard.
    The Committee also directs CDC to provide details regarding 
the status of wastewater surveillance including specifications 
for the number, composition, capabilities, and geographic 
distribution of sites in the fiscal year 2026 CJ. This 
information should also include recommendations regarding the 
funding required annually to maintain a national wastewater 
surveillance system as well as an analysis of spending on 
wastewater surveillance for fiscal year 2023 and fiscal year 
2024.

            CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2024....................................  $1,433,914,000
Budget estimate, 2025...................................   1,559,414,000
Committee recommendation................................   1,463,914,000

    The Committee recommendation for the activities of the 
National Center for Chronic Disease Prevention and Health 
Promotion is $1,463,914,000, which includes $270,950,000 in 
transfers from the PPH Fund.
    The mission of the Center is to provide national leadership 
in promoting health and well-being through prevention and 
control of chronic diseases. More than one-half of all American 
adults have at least one chronic illness, and such diseases 
account for 70 percent of all U.S. deaths and over three-
quarters of all healthcare costs in the United States. Chronic 
diseases are the leading causes of death and disability and 
while they affect all populations, the most disadvantaged 
Americans often suffer the highest burden of disease.
    These conditions are largely preventable or improved 
through evidence-based programs and strategies. The Committee 
encourages CDC to continue working with State and local health 
departments and national organizations to maximize their 
investments in evidence-based programming and strategies at the 
community level.
    Within the total provided for the National Center for 
Chronic Disease Prevention and Health Promotion, the following 
amounts are available for the following activities:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Tobacco.............................       246,500,000       246,500,000
Nutrition, Physical Activity, and           58,420,000        58,420,000
 Obesity............................
    High Obesity Rate Counties......        16,500,000        16,500,000
School Health.......................        19,400,000        19,400,000
Health Promotion....................        64,100,000        68,100,000
    Vision and Eye Health...........         6,500,000         6,500,000
    Alzheimer's Disease.............        39,500,000        41,500,000
    Inflammatory Bowel Disease......         2,000,000         2,000,000
    Interstitial Cystitis...........         1,100,000         1,100,000
    Excessive Alcohol Use...........         6,000,000         6,000,000
    Chronic Kidney Disease..........         4,500,000         4,500,000
    Chronic Disease Education and            4,500,000         6,500,000
     Awareness......................
Prevention Research Centers.........        28,961,000        31,961,000
Heart Disease and Stroke............       155,105,000       155,105,000
Diabetes............................       156,129,000       158,129,000
National Diabetes Prevention Program        37,300,000        37,300,000
Cancer Prevention and Control.......       410,049,000       425,049,000
    Breast and Cervical Cancer......       235,500,000       243,500,000
        WISEWOMAN...................        34,620,000        34,620,000
    Breast Cancer Awareness for              6,960,000         6,960,000
     Young Women....................
    Cancer Registries...............        53,440,000        53,440,000
    Colorectal Cancer...............        44,294,000        49,294,000
    Comprehensive Cancer............        22,425,000        22,425,000
    Johanna's Law...................        11,500,000        11,500,000
    Ovarian Cancer..................        15,000,000        15,000,000
    Prostate Cancer.................        15,205,000        17,205,000
    Skin Cancer.....................         5,000,000         5,000,000
    Cancer Survivorship Resource               725,000           725,000
     Center.........................
Oral Health.........................        20,250,000        20,250,000
Safe Motherhood/Infant Health.......       110,500,000       116,500,000
Arthritis...........................        11,000,000        11,000,000
Epilepsy............................        11,500,000        11,500,000
National Lupus Registry.............        10,000,000        10,000,000
Racial and Ethnic Approaches to             68,950,000        68,950,000
 Community Health (REACH)...........
    Good Health and Wellness in             24,000,000        24,000,000
     Indian Country.................
Social Determinants of Health.......         6,000,000         6,000,000
Million Hearts......................         5,000,000         5,000,000
National Early Child Care                    5,000,000         5,000,000
 Collaboratives.....................
Hospitals Promoting Breastfeeding...         9,750,000         9,750,000
------------------------------------------------------------------------

    Alzheimer's Disease.--The Committee recommendation includes 
$41,500,000 to continue Alzheimer's and related dementias 
public health programs authorized in Public Law 115-406 and to 
strengthen the Healthy Brain Initiative, including 
implementation of the Healthy Brain Initiative Public Health 
Road Maps. HHS formally made prevention of Alzheimer's disease 
a national priority when it added Goal Six to the National plan 
to fight the disease in 2021. Goal Six calls for clear 
strategies to prevent and fight the disease including 
additional research, strengthening our Nation's public health 
infrastructure, and turning risk reduction into clinical 
practice. The Committee directs the Secretary to publish a 
report publicly within 180 days of enactment on progress made 
toward meeting the goal. The Committee is encouraged by 
research demonstrating the impact of risk reduction on dementia 
prevalence. To ensure disproportionately affected populations 
are reached, the Committee encourages CDC to increase capacity 
to support populations with a high burden of Alzheimer's and 
other dementias through public health promotion and workforce 
development.
    Breast and Cervical Cancer.--The Committee includes 
$243,500,000 for the provision of critical, lifesaving breast 
cancer screening and diagnostic services to uninsured and 
underinsured women. The Committee is aware that there are still 
substantial barriers to screening like geographic isolation, 
limited health literacy, lack of provider recommendation, 
inconvenient times to access services, and language barriers. 
The Committee directs CDC to continue efforts to reduce breast 
and cervical cancer disparities especially in underserved 
communities and to work to reach women who may have delayed 
screening services during the COVID-19 pandemic.
    Chronic Disease and Alzheimer's.--The Committee recognizes 
and applauds the work of the National Center for Chronic 
Disease Prevention and Health Promotion especially as more is 
learned about the relationship and linkage between chronic 
diseases. Research shows association between multiple chronic 
diseases, modifiable risk factors, and the development of 
Alzheimer's disease and dementia. Heart disease, obesity, 
diabetes, and other chronic conditions are being studied as 
risk factors for Alzheimer's disease and dementia. The 
Committee requests a report from CDC within 120 days of 
enactment of this act outlining efforts to educate, 
particularly underserved communities, about the relationship 
between chronic diseases and potential development of 
Alzheimer's disease and dementia.
    Chronic Disease Education and Awareness [CDEA] Program.--
The Committee is pleased with the administration of the CDEA 
program and includes $6,500,000 to support existing and 
additional grants for chronic health conditions that do not 
have a line item in CDC's budget. The CDEA program is 
supporting several important multi-year projects that are 
improving public and professional awareness, and the Committee 
urges CDC to continue to support these activities along with 
new initiatives. Multiple conditions, patient advocacy 
organizations, clinicians, and researchers could benefit from 
this program, such as postural orthostatic tachycardia syndrome 
[POTS] and similar forms of dysautonomia; tardive dyskinesia, 
which can be a debilitating movement disorder affecting 
individuals with serious mental illness; and improved 
prevention, diagnosis, and treatment of life-threatening blood 
clots.
    Comprehensive Cancer.--The Committee includes $22,425,000 
to advance the goals of the Cancer Moonshot Initiative through 
CDC's cancer prevention, early detection and treatment, 
survivor support, and health equity activities. CDC is urged to 
use a portion of this increase to expand evidence-based cancer 
survivorship programs by State, Tribal, and territorial program 
recipients in partnership with community-based organizations.
    Diabetes.--The Committee includes an increase and is 
encouraged by the health progress of many participants in CDC's 
National Diabetes Prevention Program. The Committee encourages 
CDC to continue its work to update the PreventT2 curriculum 
content to include evidence from the USDA's Dietary Guidelines 
for Americans on the importance of and access to healthy foods, 
including data on disease prevention through a balanced diet, 
and to prioritize working directly with local community 
partners who provide produce prescription programming. The 
Committee encourages CDC to explore ways to integrate food as 
medicine approaches in the National Diabetes Prevention 
Program.
    Early Child Care Collaboratives.--The Committee includes 
$5,000,000 to enable training of early care and education 
providers in the implementation of healthy eating and physical 
activity best practices. Funds will also support assistance for 
integration of healthy eating and physical activity best 
practices into existing State and local professional 
development systems' early care and education settings, and 
health initiatives.
    Eating Disorders Awareness Program.--The Committee is 
concerned that eating disorders have one of the highest 
fatality rates of any psychiatric illness, and the rate of 
diagnosis for youth ages 12-18 rose 25 percent since 2019. The 
Committee directs CDC to provide a report to the Committee 
within 180 days of enactment of this act detailing how CDC has 
assisted States in collecting data by re-including one standard 
question on unhealthy weight control practices for eating 
disorders in the Youth Risk Behavior Surveillance System.
    Epilepsy.--The Committee includes $11,500,000 and commends 
CDC for its ongoing leadership of this successful program and 
effective community collaboration, and encourages further 
efforts to eliminate stigma, improve awareness and education, 
and better connect people with epilepsy to health and community 
services. The Committee appreciates CDC's ongoing epilepsy-
related surveillance and funding of epidemiologic studies on 
epilepsy and recognizes the importance of data to accurately 
understand the incidence, prevalence, and mortality rate of 
epilepsies, along with individual and social risk factors that 
influence health outcomes. The Committee encourages CDC to 
enhance surveillance and epidemiologic studies of the 
epilepsies to generate data that can guide interventions to 
improve outcomes for people with epilepsy, including 
interventions for patients with drug-resistant epilepsy. The 
Committee looks forward to receiving the report requested in 
fiscal year 2024 on current gaps in surveillance data of people 
living with epilepsies and on the feasibility, cost, and timing 
of case reporting epilepsy through the addition of the disease 
to the National Neurological Conditions Surveillance System.
    Farm-to-School.--The Committee continues $2,000,000 within 
Nutrition, Physical Activity, and Obesity for research and 
education activities related to farm-to-school programs that 
result in promoting healthy eating habits for students. The 
Committee intends that these grants support multi-agency, 
multi-organizational State farm to early childhood initiatives. 
The Committee also directs CDC to coordinate farm-to-early 
childhood program efforts with the Office of Community Food 
Systems at the Department of Agriculture.
    Food Allergies.--The Committee recognizes the serious issue 
of food allergies, which affect approximately 8 percent of 
children in the United States. The Committee includes 
$2,000,000 for a school-based effort to address food allergies 
and reduce potentially fatal anaphylactic reactions.
    Food Service Guidelines [FSG] for Federal Facilities.--The 
Committee supports the goal set forth in the National Strategy 
on Hunger, Nutrition, and Health to implement the Federal Food 
Service Guidelines for Federal Facilities. The Committee 
encourages CDC, in consultation with the Federal FSG Work Group 
it has convened, to create a comprehensive plan including an 
assessment of resources and other needs for implementation of 
the FSG across Federal food service operations and procurement 
where practicable for food served, sold, and distributed.
    Heart Disease and Stroke.--The Committee continues funding 
for CDC's Heart Disease and Stroke Prevention program. CDC is 
encouraged to support community partnerships in additional 
States to control heart disease and stroke and help the more 
than 119 million Americans living with high blood pressure. The 
Committee continues funding to support implementation of the 
Cardiovascular Advances in Research and Opportunities Legacy 
Act (Public Law 117-224). In addition, the Committee also 
continues the WISEWOMAN program to increase the number of low-
income, uninsured and underinsured women who are assessed and 
connected to resources.
    High Obesity Rate Counties.--The Committee directs CDC to 
continue this program at no less than the fiscal year 2024 
level. CDC grantees are expected to work with State and local 
public health departments and other partners to support 
measurable outcomes through community and population-level 
evidence-based obesity intervention and prevention programs. 
Funded projects should integrate evidence-based policy, 
systems, and environmental approaches to better understand and 
address the environmental and societal implications of obesity. 
The Committee encourages CDC to also consider including the 
preponderance of obesity by State based on the CDC Behavioral 
Risk Factor Surveillance System in its eligibility criteria for 
the High Obesity Program.
    Inflammatory Bowel Disease [IBD].--The Committee commends 
CDC's ongoing efforts to continue epidemiological studies on 
Crohn's disease and ulcerative colitis, known collectively as 
IBD, and encourages CDC to establish awareness and education 
activities for patients and healthcare professionals to produce 
improved time to diagnosis and optimal disease management, 
including in medically underserved populations.
    Kidney Disease.--The Committee provides $4,500,000 to 
support the Chronic Kidney Disease [CKD] program, which 
supports activities that identify risk factors for kidney 
disease, increase awareness, diagnosis, and treatment and 
improve health outcomes of people with CKD. The Committee 
encourages CDC to continue its ongoing Kidney Disease 
Surveillance System and enhance its capacity to track the 
progress of CKD prevention, detection, and management efforts. 
The Committee also supports activities that enhance health 
systems' capacity to identify, risk-stratify, and manage 
individuals with CKD with special emphasis on populations in 
low-income, geographically underserved areas, and communities 
with high burden of disease.
    Mississippi Delta Health Collaborative.--Within the funds 
provided for Chronic Disease Prevention and Health Promotion, 
the Committee encourages CDC to continue the Mississippi Delta 
Health Collaborative project and requests that CDC provide an 
update on these activities in the fiscal year 2026 CJ.
    Prostate Cancer.--The Committee is aware of the continued 
rise in prostate cancer deaths and supports CDC's work to 
promote public awareness of prostate cancer risks, screening, 
and treatment in high-risk men. The Committee provides 
$17,205,000 for CDC's prostate cancer activities, including for 
outreach and education initiatives among African-American men 
and other high-risk groups.
    Racial and Ethnic Approaches to Community Health [REACH].--
The Committee includes $68,950,000 to support grantees in 
building capacity for collaboration and disseminating evidence-
based strategies in communities. REACH is a vital initiative to 
help eliminate healthcare disparities in minority communities. 
The Committee's recommended level includes $24,000,000 for Good 
Health and Wellness in Indian Country.
    Rural Prevention Health Research.--The Committee recognizes 
the important work of Prevention Research Centers [PRCs], in 
particular the needs of rural focused prevention research. The 
Committee encourages CDC to review their grant funding process 
to ensure appropriate funding to rural areas, including rural 
Appalachia, which consistently ranks high in incidences of 
disease, injury, and poor health outcomes, to ensure important 
rural health research continues to take place. The Committee 
also directs CDC to ensure at least 20 percent of PRC funding 
is being directed to research in rural areas.
    Safe Motherhood and Infant Health.--The Committee includes 
$116,500,000 for this portfolio of programs to improve the 
health of pregnant and postpartum individuals and their infants 
and reduce inequities in maternal and infant health outcomes. 
Maternal mortality continues to rise at an unacceptable rate in 
the United States, which reached 1,205 maternal deaths in 2021, 
a 40 percent increase from 2020. The Committee encourages CDC 
to use the funding increase to expand and increase support for 
Maternal Mortality Review Committees [MMRCs], Perinatal Quality 
Collaboratives [PQCs], and other programs including Sudden 
Unexplained Infant Death [SUID] and the Sudden Death in the 
Young [SDY] Case Registry. The Committee also encourages CDC to 
prioritize funding to help MMRCs build stronger data systems 
and improve data collection at the State level to create 
consistency and ensure accuracy and completeness 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 inform data-driven actions 
to prevent these deaths. The Committee requests a report within 
120 days of enactment of this act on barriers to effective and 
consistent data collection and opportunities to improve 
coordination among State MMRCs. Additionally, the Committee 
commends CDC for funding State-based PQCs and encourages CDC to 
prioritize funding to expand PQCs to additional States and 
territories and provide increased support to existing PQCs. The 
Committee requests an update on the expansion of PQCs beyond 
the States currently funded, as well as any barriers to 
expansion in the fiscal year 2026 CJ.
    School Health.--The Committee includes $19,400,000 to 
promote school-based health and to prevent chronic disease and 
promote the health and well-being of children and adolescents 
in schools.
    School Health Index [SHI].--The Committee understands the 
importance for educational institutions to promote health and 
wellness to their students from a holistic perspective to 
encourage stronger learning environments. The Committee 
recognizes that CDC created SHI to assist schools in evaluating 
and improving the health and well-being of students. The 
Committee encourages CDC to create and develop a tool similar 
to the SHI for higher education.
    Skin Cancer Education and Prevention.--The Committee is 
concerned with the growing number of people diagnosed with 
preventable forms of skin cancer, which is now the most 
commonly diagnosed cancer in the United States. The Committee 
provides $5,000,000 for skin cancer education and prevention 
and encourages CDC to continue its collaboration and 
partnership with local governments, business, health, 
education, community, nonprofit, and faith-based sectors.
    Sleep Health and Sleep Disorders.--The Committee is 
concerned with the troubling lack of coordinated efforts in 
public health to improve sleep health and disorder awareness, 
diagnosis, and treatment despite landmark scientific 
discoveries demonstrating the significant impact of sleep on 
disease and mental and physical health and wellness. The 
Committee encourages CDC to expand activities to improve sleep 
health and sleep disorders awareness, epidemiology, detection, 
and care particularly for rare and orphan sleep disorders, like 
narcolepsy, and requests that CDC provide an update on these 
activities in the fiscal year 2026 CJ.
    Social Determinants of Health [SDOH].--The Committee 
recognizes the important impact of SDOH on outcomes and health 
inequities in communities. The Committee provides $6,000,000 
for SDOH activities.
    Sudden Cardiac Arrest.--The Committee recognizes that 
sudden cardiac arrest is a leading cause of death among 
athletes at all ages and that timely access to automated 
external defibrillators [AEDs] can significantly improve 
survival rates. The Committee urges CDC to publish best 
practices for how to best deploy AEDs in sporting facilities, 
including schools, colleges, community centers, and stadiums. 
The best practices should include recommendations on optimal 
locations, maintenance, training, and coordination with 
emergency medical services, including the development of 
Emergency Action Plans for AED deployment. Additionally, the 
Committee encourages CDC to expand the Cardiac Arrest Registry 
to Enhance Survival [CARES] program to capture data from 
additional States. The Committee recognizes that every year, 
more than 350,000 Americans fall victim to out-of-hospital 
cardiac arrest and only about 1 in 10 will survive this event. 
Registry data is critical to improving sudden cardiac survival 
rates in all States by allowing communities to measure the 
quality of patient care, establish performance goals, and 
analyze emergency response data to identify opportunities for 
improvement.
    Tobacco.--The Committee includes $246,500,000 for CDC, 
States, Tribes and territories to continue efforts to reduce 
tobacco use among disparate populations and in areas and 
regions with high tobacco prevalence and mortality, as well as 
continue the highly successful and cost-effective Tips from 
Former Smokers media campaign. The Committee acknowledges the 
overall progress that has been made on reducing adult smoking 
prevalence, expresses concern that more than 1 in 10 U.S. 
adults continues to smoke cigarettes, and urges CDC to continue 
its evidence-based work to ensure that rates also decline in 
populations disproportionately affected by tobacco use, 
including rural communities. The Committee remains concerned 
that 10 percent of youth use at least one tobacco product and 
encourages CDC's ongoing efforts to respond to and prevent 
youth use of e-cigarettes and other tobacco products. 
Additionally, the Committee is concerned with reports of 
unauthorized, illegal tobacco products sold in the United 
States. The Committee directs CDC to provide a briefing on the 
Tobacco program, including a breakdown of funding sources, 
programs, and activities within 120 days of enactment of this 
act. Additionally, CDC is instructed to provide information on 
how funds are currently supporting, or may prospectively 
support, FDA enforcement and regulation of unauthorized 
products and State directories.
    Type 1 Diabetes.--According to CDC's National Diabetes 
Statistics Report 2021 data, approximately 2 million Americans 
have type 1 diabetes [T1D], with 304,000 of these individuals 
under the age of 20. Incidence of T1D in youth has increased 
significantly over the last 20 years. Millions of individuals 
are at an increased risk of developing T1D because they have a 
first-degree relative with the condition, and a subset of these 
individuals are in the early stages of T1D. Screening can help 
improve outcomes for people at risk of developing T1D, 
including delaying progression, preventing complications, and 
reducing the incidence of diabetic ketoacidosis [DKA] at 
diagnosis which poses increased morbidity and mortality in the 
short and long term. The Committee is concerned that CDC has 
not adequately focused education and awareness efforts on 
possible risk factors, screening, and potential avenues to 
delay onset of T1D, including available treatments and clinical 
trials. The Committee encourages CDC to update its website to 
include comprehensive information about screening, risks of DKA 
at diagnosis, and information about accessing possible 
treatments and clinical trials to delay the onset of T1D. The 
website should include information targeting physicians, school 
health workers, parents, and other adults about screening, 
provide information about populations that should be 
prioritized for screening, and direct patients (or their 
parents) to appropriate resources if their screening results 
indicate that they are at increased risk of developing T1D. CDC 
is encouraged to enact a process to continually review the 
latest scientific literature on screening for T1D and update 
information on its website to reflect new information. The 
Committee also recommends CDC to provide a plan, no later than 
60 days after enactment of this act, outlining steps the agency 
will take to increase outreach and education efforts focused on 
T1D.
    Vision and Eye Health.--The Committee provides $6,500,000 
for vision and eye health and glaucoma detection, and continues 
to direct CDC to fund these activities at not less than the 
fiscal year 2024 enacted levels. The Committee encourages CDC 
to conduct national-level surveillance on the prevalence of 
vision loss-including prevalence of risk for vision loss and 
eye disease into the Vision and Eye Health Surveillance System. 
The Committee is aware that vision impairments and eye disease 
contribute to or complicate many other serious and costly 
chronic health conditions, including diabetes, depression and 
anxiety, cardiovascular disease, and cognitive decline. Data on 
risk of vision loss and existence of vision loss in the United 
States is necessary to inform State and community partnerships 
that emphasize early detection and intervention and to address 
the biggest challenges in access to eye care that can prevent 
eye disease from progressing to permanent vision loss.

     NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, 
                         DISABILITY AND HEALTH

Appropriations, 2024....................................    $206,060,000
Budget estimate, 2025...................................     205,560,000
Committee recommendation................................     210,060,000

    The Committee recommendation for the activities of the 
National Center on Birth Defects, Developmental Disabilities, 
Disability and Health [NCBDDD] is $210,060,000.
    This Center improves the health of children and adults by 
preventing birth defects, developmental disabilities, and 
complications of hereditary blood disorders, and by promoting 
optimal child development and health and wellness among 
children and adults living with disabilities.
    Within the total provided, the following amounts are 
available for the following activities:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
  Child Health and Development......        71,300,000        71,300,000
    Other Birth Defects.............        19,000,000        19,000,000
    Fetal Death.....................           900,000           900,000
    Fetal Alcohol Syndrome..........        11,500,000        11,500,000
    Folic Acid......................         3,150,000         3,150,000
    Infant Health...................         8,650,000         8,650,000
    Autism..........................        28,100,000        28,100,000
Health and Development for People           86,410,000        88,410,000
 with Disabilities..................
    Disability and Health...........        45,500,000        46,500,000
    Tourette Syndrome...............         2,500,000         2,500,000
    Early Hearing Detection and             10,760,000        10,760,000
     Intervention...................
    Muscular Dystrophy..............         8,000,000         9,000,000
    Attention Deficit Hyperactivity          1,900,000         1,900,000
     Disorder.......................
    Fragile X.......................         2,000,000         2,000,000
    Spina Bifida....................         7,500,000         7,500,000
    Congenital Heart................         8,250,000         8,250,000
Public Health Approach to Blood             21,100,000        21,100,000
 Disorders..........................
    Hemophilia CDC Activities.......         3,500,000         3,500,000
    Hemophilia Treatment Centers....         5,100,000         5,100,000
    Thalassemia.....................         2,100,000         2,100,000
Neonatal Abstinence Syndrome........         4,250,000         5,250,000
Surveillance for Emerging Threats to        23,000,000        24,000,000
 Mothers and Babies.................
------------------------------------------------------------------------

    Autism.--The Committee includes $28,100,000 for the Autism 
Developmental Disabilities Monitoring [ADDM] Network and to 
continue surveillance of cerebral palsy to reach nearly all of 
its 16 ADDM Network sites.
    Blood Clots.--The Committee is concerned about the enormous 
toll of blood clots on patients and the healthcare system, 
particularly for pregnant women, Black Americans, and cancer 
patients. The Committee again urges CDC to develop a 
comprehensive, nationwide blood clot education and awareness 
campaign for the general public focused on the treatment and 
prevention of blood clots and education and training of 
healthcare professionals about the signs and symptoms of blood 
clots.
    Congenital Heart Disease [CHD].--CHD is the most common and 
deadliest category of birth defects in the United States. The 
Committee commends NCBDDD for its leadership in improving 
understanding of the unique, specialized care needs for the 
growing CHD population across the lifespan. The Committee 
includes $8,250,000 for surveillance, research, and awareness 
activities authorized by the Congenital Heart Futures 
Reauthorization Act (Public Law 115-342), including to support 
additional longitudinal surveillance sites, survey activities 
on long-term outcomes and patient needs, engagement with 
healthcare providers, and analysis of healthcare claims and 
clinical data.
    Duchenne and Becker Muscular Dystrophy.--The Committee 
includes $9,000,000 to continue Muscular Dystrophy research and 
disease surveillance initiatives. The Committee strongly 
encourages CDC to update research and tracking to better 
understand the outcomes for Duchenne and Becker muscular 
dystrophy treated both in and out of Certified Duchenne Care 
Centers; examine impacts of Duchenne on bone health, 
cardiovascular, and cognitive function; and investigate care 
and outcomes for adults with Duchenne, those receiving multiple 
therapies including gene therapy, and various demographic 
subpopulations. The Committee requests a report within 180 days 
of enactment of this act detailing its plan for updating 
muscular dystrophy efforts along these parameters.
    Fetal Alcohol Syndrome.--The Committee includes $11,500,000 
for the surveillance of prenatal alcohol use and fetal alcohol 
spectrum disorders [FASD], to facilitate partnerships to 
prevent alcohol use during pregnancy, improve support services 
and access to care by responding to families living with FASD, 
and disseminating practical resources and information through 
existing community-based local affiliates.
    Hemophilia Treatment Centers.--The Committee recognizes the 
important work of the Division of Blood Disorders in protecting 
people with hemophilia and other bleeding disorders and has 
included $5,100,000 for the programs' vital activities to 
support surveillance at the National network of hemophilia 
treatment centers and to provide testing for inhibitors, a 
challenging, harmful, and expensive complication of hemophilia.
    Neonatal Abstinence Syndrome [NAS] Surveillance.--The 
Committee includes $5,250,000 to address the rise in NAS 
resulting from the overuse of opioids and other related 
substances during pregnancy. Funding should be used to conduct 
research on the use of opioids and other substances during 
pregnancy and related adverse outcomes from infancy through 
childhood, and identify best practices for care, evaluation, 
and management to help children.
    Physical Activity for People with Disabilities.--The 
Committee provides an increase of $1,000,000 to strengthen 
existing programs that address healthy athletes.
    Sickle Cell Disease [SCD].--The Committee recommendation 
includes $6,000,000 for the sickle cell disease data collection 
program. The Committee encourages CDC to provide technical 
assistance to additional States with a higher prevalence of 
SCD, so that they can successfully participate in this grant 
program to better identify affected individuals in their States 
and better meet their needs.
    Spina Bifida.--The Committee recognizes that Spina Bifida 
is the most common permanently disabling congenital disability 
compatible with life in the United States, affecting 1,500 
babies in the country each year. While Spina Bifida and related 
neural tube defects are sometimes preventable through education 
and adequate daily folic acid consumption, there are an 
estimated 166,000 individuals, more than 65 percent of whom are 
adults, living with all forms of this complex birth defect. The 
Committee understands that there is a significant need for 
immediate support at CDC to address the transitional and adult 
care needs of the growing, aging Spina Bifida community and the 
Committee requests an update in the fiscal year 2026 CJ on 
efforts to address these needs. The Committee supports the 
continuation of the Spina Bifida Clinical Care Monitoring and 
Tracking Program, which works with the National Spina Bifida 
Registry to guide the healthcare community in the best 
treatment options for people living with Spina Bifida.
    Stillbirth.--Stillbirth rates remain unacceptably high, 
affecting thousands of families each year. The Committee 
appreciates the findings and recommendations included in the 
March 2023 Stillbirth Task Force report and encourages CDC to 
implement the recommendations including improved recordkeeping, 
data collection, and analysis about stillbirths, addressing 
disparities in stillbirth risk, and provide better support for 
families after a stillbirth occurs.
    Surveillance for Emerging Threats to Mothers and Babies 
Network [SET-NET].--The Committee includes $24,000,000 for SET-
NET. The program supports CDC's collaboration with State, 
Tribal, territorial, and local health departments to monitor 
the impact of emerging health threats, including COVID-19, on 
pregnant people and their babies and inform public health and 
clinical decision-making to improve the health of pregnant and 
postpartum people and infants.
    Thalassemia.--The Committee supports funding for 
thalassemia, a rare genetic blood disorder that requires 
lifelong blood transfusions, thus requiring chelation to remove 
excess iron, particularly from the heart and liver. The 
Committee is aware of the critical work done by the thalassemia 
program at CDC in identifying thalassemia patients and 
connecting them to services and to life-saving treatment 
centers. Thalassemia patients experience serious comorbidities 
that can impact almost every aspect of their lives. The 
Committee urges CDC to continue and strengthen this 
collaboration among thalassemia treatment centers, non-profit 
organizations, and patients and their families.
    Tourette Syndrome.--The Committee provides $2,500,000 and 
directs CDC to continue to educate physicians, educators, 
clinicians, allied professionals, and the general public about 
the disorder and to improve scientific knowledge on prevalence, 
risk factors, and co-occurring conditions of Tourette Syndrome. 
The Committee commends CDC for its national public health 
education and research program on Tourette syndrome. The 
Committee encourages funding be used to continue to educate 
physicians, educators, clinicians, allied professionals, and 
the general public about the disorder and to improve scientific 
knowledge on prevalence, risk factors, cost, and impact and co-
occurring conditions of Tourette syndrome.

                 PUBLIC HEALTH AND SCIENTIFIC SERVICES

Appropriations, 2024....................................    $754,497,000
Budget estimate, 2025...................................     804,097,000
Committee recommendation................................     774,497,000

    The Committee recommendation for Public Health Scientific 
Services is $774,497,000, which includes $182,900,000 in 
transfers from the PPH Fund.
    This funding supports the work of all of the CDC Centers. 
In particular, these activities compile statistical information 
to inform public health policy; assure the accuracy and 
reliability of laboratory tests; apply digital information 
technology to help detect and manage diseases, injuries, and 
syndromes; support public health workforce development 
programs; and develop and inform the public health community on 
sound public health surveillance, laboratory protocols, and 
epidemiological practices.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Health Statistics...................       187,397,000       187,397,000
Surveillance, Epidemiology, and            298,100,000       298,100,000
 Informatics........................
Advancing Laboratory Science........        23,000,000        23,000,000
Public Health Data Modernization....       175,000,000       195,000,000
Public Health Workforce.............        71,000,000        71,000,000
------------------------------------------------------------------------

    Community Health Workers and Community Health.--The 
Committee recognizes the importance of the community health 
workforce in reaching underserved communities, preventing 
illness, and reducing related healthcare costs. The Committee 
urges CDC to encourage the use of community health workers in 
communities, including Tribal communities, to support the 
delivery of person-centered care.
    Familial Hypercholesterolemia [FH].--The Committee 
continues to encourage CDC to address FH as a public health 
concern in order to improve diagnosis and care delivery and 
prevent heart disease. The Committee is concerned that an 
estimated 1.3 million people in the United States live with FH, 
yet only 10 percent of them are diagnosed. The Committee 
encourages the National Center for Chronic Disease Prevention 
and Health Promotion to work collaboratively with CDC's Public 
Health Genomics Branch to address FH as a public health concern 
in order to improve diagnosis and care delivery and prevent 
heart disease.
    Global Civil Registry and Vital Statistics.--The Committee 
strongly supports the National Center for Health Statistics' 
efforts to facilitate capacity building among low- and middle-
income countries to develop civil registry and vital statistics 
systems. The Committee requests a report within 180 days of 
enactment that includes a listing of countries that have been 
supported through these partnerships to-date and a budgetary 
estimate of the funding required to continue this work.
    National Center for Health Statistics.--The Committee 
provides $187,397,000 for the National Center for Health 
Statistics, which includes the National Health Interview 
Survey. The Committee intends this funding to support 
intersectional analyses of healthcare access, chronic health 
conditions, including Long COVID, and mental health status.
    Native Hawaiian and Pacific Islander National Health 
Interview Survey.--The Committee recognizes that it has been 10 
years since the Native Hawaiian and Pacific Islander National 
Health Interview Survey was last fielded. The Committee looks 
forward to the report as directed in Public Law 118-47 on the 
feasibility, advisability, and costs to re-issue this survey, 
as well as methods to ensure the inclusion of Native Hawaiian 
and Pacific Islanders in the annual National Health Interview 
Study.
    National Neurological Conditions Surveillance System.--The 
Committee includes $5,000,000 within Surveillance, 
Epidemiology, and Informatics to continue efforts on the two 
initial conditions-multiple sclerosis and Parkinson's disease.
    Public Health Data Modernization Initiative [DMI].--The 
Committee commends CDC's work to advance public health data 
modernization and acknowledges that efforts to enhance public 
health data system capabilities will result in fast and more 
reliable data sharing. The Committee provides $195,000,000 for 
CDC to continue bringing together State, Tribal, local and 
territorial public health jurisdictions and public and private 
sector partners with the goal of establishing modern, 
interoperable, and real-time public health data and 
surveillance systems to protect the American public. The 
Committee recommends CDC ensure that funding from DMI is 
allocated to jurisdictions through the National Center for 
Health Statistics to support necessary upgrades to their vital 
statistics systems to enable more, better, and faster vital 
records data. The Committee requests a briefing within 90 days 
of enactment of this act on the progress and plans for programs 
and activities supported by DMI funding. The Committee directs 
HHS to prioritize CDC data modernization and IT projects, 
focusing on improving enterprise capabilities and 
infrastructure. The Committee further directs HHS to continue 
to provide quarterly reports for all ongoing projects.
    Public Health Workforce.--The Committee includes 
$71,000,000 and urges CDC to invest in fellowship and training 
programs to rebuild the public health workforce that includes, 
but is not limited to, epidemiologists, contact tracers, lab 
scientists, community health workers, data scientists, 
behavioral scientists, disease intervention and prevention 
specialists, occupational health specialists, public health 
physicians, veterinarians, nurses, informaticians, program 
managers, economists, policy and evaluation experts, and 
communicators who can help protect the Nation's communities.

                          ENVIRONMENTAL HEALTH

Appropriations, 2024....................................    $242,850,000
Budget estimate, 2025...................................     266,850,000
Committee recommendation................................     244,850,000

    The Committee recommendation for the National Center for 
Environmental Health is $244,850,000. The Committee 
recommendation includes $51,000,000 in transfers from the PPH 
Fund.
    The National Center for Environmental Health addresses 
emerging pathogens and environmental toxins that pose 
significant challenges to public health. The Center conducts 
surveillance and data collection to determine which substances 
in the environment are found in people and to what degree. The 
Center also determines whether, and at what level of, exposure 
to these substances are harmful to humans.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
  Environmental Health Laboratory...        70,750,000        71,750,000
      Newborn Screening Quality             21,000,000        22,000,000
       Assurance Program............
      Newborn Screening for SCID....         1,250,000         1,250,000
      Other Environmental Health....        48,500,000        48,500,000
Environmental Health Activities.....        48,600,000        49,600,000
      Safe Water....................         8,600,000         8,600,000
      Amyotrophic Lateral Sclerosis         10,000,000        11,000,000
       Registry.....................
      Trevor's Law..................         3,000,000         3,000,000
      Climate and Health............        10,000,000        10,000,000
      All Other Environmental Health        17,000,000        17,000,000
Environmental and Health Outcome            34,000,000        34,000,000
 Tracking Network...................
Asthma..............................        33,500,000        33,500,000
Childhood Lead Poisoning............        51,000,000        51,000,000
Lead Exposure Registry..............         5,000,000         5,000,000
------------------------------------------------------------------------

    Amyotrophic Lateral Sclerosis [ALS] Registry.--The 
Committee encourages CDC to continue its investment in research 
that will reduce incidence and prevalence of ALS in the United 
States. The Committee encourages CDC to continue its efforts to 
evaluate, update, and improve the National ALS Registry 
program, by ensuring that the most up to date information is 
provided to researchers, and ALS patients are connected with 
clinical trials, treatments, and resources in a timely manner. 
The Committee supports continued ALS prevalence reports, and 
urges CDC to publish these reports in a timely manner and 
provide updates regarding these prevalence reports. 
Additionally, the Committee urges CDC to collaborate with the 
Departments of Defense and Veterans Affairs to provide a 
publicly available report on the incidence and prevalence of 
ALS among military veterans.
    Asthma.--The Committee includes $33,500,000 for the 
National Asthma Control Program [NACP] so CDC can work with 
States to improve health outcomes for people living with 
asthma. As the number and severity of wildfires increases, the 
Committee also urges the NACP to continue its efforts to 
develop public health interventions aimed at protecting people 
with asthma from wildfire smoke.
    Childhood Lead Poisoning.--The Committee includes 
$51,000,000 to improve health equity and to better prevent and 
mitigate childhood lead exposure and expand the data 
capabilities of the program to rapidly identify and address 
emerging threats in communities with elevated risk of exposure 
to lead. CDC is expected to support local capacity to improve 
the health of children through efforts to eliminate lead from 
their environment.
    Climate and Health.--The Committee includes $10,000,000 for 
the program to provide guidance, data, and technical assistance 
to all States, local health departments, and additional 
assistance to Tribes and territories, to identify possible 
health effects associated with a changing climate and implement 
health adaptation plans. Communities across the country are 
vulnerable to health effects from increasingly common events 
such as heatwaves, wildfires, floods, droughts, and extreme 
storms. The Committee expects CDC to aid in the development and 
implementation of State-specific action plans to protect health 
from these threats.
    Enhancing Data-Driven Disease Detection in Newborns 
[ED3N].--Newborn screening [NBS] State programs in the United 
States are growing every year, adding new conditions to this 
life-saving public health program. Unfortunately, data silos 
have led to data analytic challenges resulting in a less 
efficient and less equitable NBS as these silos make it harder 
to track trends and best practices across States. The Committee 
supports the ED3N pilot within the Division of Laboratory 
Sciences Newborn Screening and Molecular Biology Branch.
    Extreme Heat and Data Collection.--The Committee recognizes 
the increasing frequency and severity of extreme heat events 
and the lack of currently available data to adequately 
understand the financial burden that extreme heat places upon 
healthcare systems. The Committee encourages CDC, in 
collaboration with the National Integrated Heat Health 
Information System [NIHHIS] and its participating agencies, to 
develop and implement a system for tracking and making publicly 
available the healthcare costs associated with the increased 
demand for medical assistance during extreme heat events, 
including expenses related to emergency room visits, urgent 
care treatments, hospitalizations, and associated medications.
    Pediatric Reference Intervals.--The Committee encourages 
CDC to initiate efforts to improve the accuracy of pediatric 
reference intervals. CDC is directed to include an estimate of 
the costs associated with developing pediatric reference 
intervals in the fiscal year 2026 CJ.
    Per and Polyflouroalkyl Substances [PFAS].--The Committee 
remains concerned that extended exposure to PFAS is associated 
with decreased antibody response, dyslipidemia, decreased 
infant and fetal growth, and increased risk of kidney cancer. 
CDC is encouraged to continue to provide clinical guidance to 
advise clinicians when to offer PFAS blood testing to patients 
who are likely to have a history of elevated exposure.
    Preventing Harmful Exposure to Phthalates.--The Committee 
is concerned that despite action by the Consumer Product Safety 
Commission to limit chemicals known as ortho-phthalates 
[phthalates] in 2018 from children's toys and other children's 
items in addition to the three phthalates banned by Congress in 
2008, several phthalates continue to be used in food packaging 
and food contact equipment. The Committee looks forward to 
receiving the briefing as requested in fiscal year 2024 (Senate 
Report 118-84).

                     INJURY PREVENTION AND CONTROL

Appropriations, 2024....................................    $761,379,000
Budget estimate, 2025...................................     943,379,000
Committee recommendation................................     776,379,000

    The Committee recommendation for the National Center for 
Injury Prevention and Control is $776,379,000.
    CDC is the lead Federal agency for injury prevention and 
control. Programs are designed to prevent premature death and 
disability and reduce human suffering and medical costs caused 
by nonoccupational injuries including those caused by fires and 
burns, poisoning, drowning, violence, and traffic accidents.
    The Committee recommendation includes funding for the 
following activities:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
    Intentional Injury..............       164,550,000       177,550,000
        Domestic Violence and Sexual        38,200,000        38,200,000
         Violence...................
            Child Maltreatment......         7,250,000         7,250,000
            Child Sexual Abuse               3,000,000         3,000,000
             Prevention.............
        Youth Violence Prevention...        18,100,000        18,100,000
        Domestic Violence Community          7,500,000         7,500,000
         Projects...................
        Rape Prevention.............        61,750,000        61,750,000
        Suicide Prevention..........        30,000,000        38,000,000
        Adverse Childhood                    9,000,000        14,000,000
         Experiences................
    National Violent Death Reporting        24,500,000        24,500,000
     System.........................
    Unintentional Injury............        13,300,000        13,300,000
        Traumatic Brain Injury......         8,250,000         8,250,000
        Elderly Falls...............         3,050,000         3,050,000
        Drowning Prevention.........         2,000,000         2,000,000
    Other Injury Prevention                 29,950,000        29,950,000
     Activities.....................
    Opioid Overdose Prevention and         505,579,000       507,579,000
     Surveillance...................
    Injury Control Research Centers.        11,000,000        11,000,000
    Firearm Injury and Mortality            12,500,000        12,500,000
     Prevention Research............
------------------------------------------------------------------------

    Adolescent Mental Health.--The Committee supports the 
creation of the Behavioral Health Coordinating Unit to 
coordinate and leverage existing CDC activities related to 
mental health, with a particular focus on adolescent mental 
health activities, including early intervention. The Committee 
encourages CDC to begin to develop a national strategy and 
establish goals to improve adolescent mental health, including 
linkages between adolescent mental health and substance use and 
overdose, adverse childhood experiences, suicide, and other 
areas that impact mental wellbeing. This effort is expected to 
include convening of key experts, in and out of government, 
with special considerations to ensure the voices of underserved 
communities and populations are represented. CDC is also 
encouraged to provide technical assistance, including through 
grants to partner organizations, to support collaborations and 
connections between multiple sectors in communities such as 
public health, education, community mental health organizations 
and other community-based organizations, youth serving 
organizations, parents, and social services providers to 
strengthen mental health prevention and promotion and improve 
mental health, well-being, and resilience in communities.
    Adverse Childhood Experiences [ACEs].--The Committee 
provides $14,000,000 for ACEs surveillance, research, and 
prevention efforts. The Committee commends CDC's Injury 
Prevention Center for funding States and localities, including 
those with high rates of trauma, violence, and overdoses, to 
conduct surveillance on exposure to ACEs and target community-
based interventions related to exposure to childhood trauma, 
ACEs, substance use, and violence and to promote positive 
childhood experiences. The Committee provides an increase to 
expand CDC's efforts by supporting additional prevention and 
surveillance programs, including support for additional States.
    Child Sexual Abuse Prevention.--The Committee includes 
$3,000,000 in recognition of the severe and often life-long 
physical, cognitive, and emotional impact of child sexual abuse 
and commends CDC's work in child sexual abuse prevention 
research. CDC is encouraged to improve surveillance systems and 
data collection, increase the understanding of risk and 
protective factors, and develop and disseminate effective 
prevention efforts. The Committee notes an increasing number of 
allegations of child sex abuse within youth serving 
organizations every year, including youth sports organizations. 
The Committee encourages CDC to evaluate and improve child sex 
abuse prevention policies within these types of organizations, 
including through working with non-profit organizations that 
specialize in child sexual abuse prevention.
    Community and Youth Violence Prevention.--The Committee 
commends CDC for its work to prevent youth and community 
violence through technical assistance, research, and 
partnerships between community organizations, schools, law 
enforcement, faith-based organizations, and academia to 
evaluate effective interventions to reduce violence. The 
Committee encourages CDC to scale up existing partnerships with 
organizations that have demonstrated success in reducing 
community violence and its risk factors, including those 
involving healthcare and community outreach organizations, as 
well as supporting academic-community collaborations and 
research to advance the science and practice of violence 
prevention, while reducing inequities from which such violence 
stems.
    Core State Injury Prevention Program [Core SIPP].--The 
Committee includes $29,950,000 for the Core SIPP to enhance 
efforts to identify and respond to injury threats with data-
driven public health actions.
    Domestic Violence and Sexual Violence.--The Committee 
provides $38,200,000 for CDC to collect data on the connection 
between brain injuries and domestic and sexual violence, and 
implement a data collection project that follows up on and 
operates under CDC's National Intimate Partner and Sexual 
Violence Survey and asks questions about the prevalence and 
circumstances surrounding brain injuries.
    Drowning Prevention.--The Committee continues $2,000,000 to 
prevent fatal drownings. Drowning is a leading cause of 
unintentional deaths among children and youth below the age of 
14. This funding will allow CDC to implement proven drowning 
prevention programs with national organizations working with 
underserved and diverse youth to support State drowning 
surveillance efforts, as well as to develop and begin 
implementation of a national plan on water safety.
    Firearm Injury and Mortality Prevention Research.--The 
Committee includes $12,500,000 to conduct research on firearm 
injury and mortality prevention. Given violence and suicide 
have a number of causes, the Committee recommends CDC take a 
comprehensive approach to studying these underlying causes and 
evidence-based methods of prevention of injury, including crime 
prevention. All grantees under this section will be required to 
fulfill requirements around open data, open code, pre-
registration of research projects, and open access to research 
articles consistent with the National Science Foundation's open 
science principles. The Director of CDC is to again report to 
the Committees within 30 days of enactment of this act on 
implementation schedules and procedures for grant awards, which 
strive to ensure that such awards support ideologically and 
politically unbiased research projects.
    Injury Control Research Centers.--The Committee includes 
$11,000,000 for awards for multi-disciplinary research on the 
causes, outcomes, and prevention of injuries and violence.
    Opioid Prescribing Guidelines.--The Committee applauds 
CDC's release of the 2022 Clinical Practice Guideline for 
Prescribing Opioids for Pain, which updates and replaces the 
2016 CDC prescribing guideline. The Committee directs CDC to 
continue its work educating patients and providers, and to 
encourage uptake and appropriate use of the Guidelines. The 
Committee urges CDC to continue coordination with other 
agencies including the VA, IHS, DoD, and HRSA in implementation 
and related updates in safe prescribing practices to ensure 
consistent, high-quality care standards across the Federal 
Government.
    Opioid or Other Drug Use and Overdose Prevention.--The 
Committee continues to encourage CDC to ensure that funding for 
opioid and stimulant use and overdose prevention, as well as 
other emerging substances and threats, reaches local 
communities to advance local understanding of the opioid 
overdose epidemic and to scale-up prevention and response 
activities. Additionally, CDC is directed to continue expansion 
of case-level syndromic surveillance data, improvements of 
interventions that monitor prescribing and dispensing 
practices, better timeliness and quality of morbidity and 
mortality data, as well as the enhancement of efforts with 
medical examiners and coroner offices. In addition, the 
Committee understands that CDC has focused on chronic pain as 
directed in Public Law 117-103 and requests an update in the 
fiscal year 2026 CJ on the status of these efforts. In 
particular, the update should include an analysis of the direct 
healthcare costs related to pain diagnostic, management, and 
treatment services for all forms of treatment for all payer 
sources as well as indirect costs related to pain including 
missed work, short and long-term disability, and loss of 
productivity.
    Provider Education for Opioid Alternatives.--The Committee 
remains concerned about the high mortality rate due to opioid 
overdoses and encourages CDC to provide outreach to outpatient 
surgical providers on the increased availability and wide-
ranging benefits of non-opioid pain management in both hospital 
outpatient departments and ambulatory surgery centers. The 
Committee encourages CDC to work with CMS, FDA, and continuing 
medical education associations on an education and outreach 
plan.
    Rape Prevention.--The Committee includes $61,750,000 to 
support rape prevention and education programs. In granting 
funds to States, the Secretary shall set forth procedures 
designed to ensure meaningful involvement of the State or 
territorial sexual assault coalitions and representatives from 
underserved communities in the application for and 
implementation of funding.
    Suicide Prevention.--The Committee remains concerned about 
suicide rates in the United States and includes $38,000,000. 
The Committee recognizes that suicide is a serious public 
health problem requiring strategic programming, especially 
among disproportionately impacted populations. The Committee 
also recognizes that suicide prevention requires a public 
health approach that addresses multiple risk factors at the 
individual, community, and societal levels. States, tribes, and 
territories are well positioned to lead a comprehensive public 
health approach to suicide prevention, which involves 
coordinating with multisector partners, to take a data-driven, 
evidence-based process to address the broad range of risk and 
protective factors associated with suicide. The Committee 
directs CDC to prioritize funding to State public health 
departments with the goal of expanding the Comprehensive 
Suicide Prevention program nationwide, and to help tribes and 
territories build capacity and implement strategies to prevent 
suicide.
    Traumatic Brain Injury [TBI].--The Committee provides 
$8,250,000 to initiate concussion surveillance, particularly 
among children and youth. The Committee appreciates CDC's work 
to better understand the burden of concussions in the United 
States. The Committee recognizes the need for standardized data 
collection practices across the care continuum to capture and 
integrate data on traumatic brain injury [TBI] with data 
collected for research purposes to improve patients 
identification and outcomes. The Committee encourages CDC to 
coordinate across HHS, the Departments of Defense, Veterans 
Affairs, and Transportation to identify and recommend key data 
elements and terms that should be collected to improve the 
consistency of TBI health data derived from different sources.

                     OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2024....................................    $362,800,000
Budget estimate, 2025...................................     363,200,000
Committee recommendation................................     364,030,000

    The Committee recommendation for the National Institute for 
Occupational Safety and Health [NIOSH] programs is 
$364,030,000. The Committee recognizes that NIOSH is the only 
Federal agency responsible for conducting research and making 
recommendations for the prevention of work-related illness and 
injury. The NIOSH mission is implemented by conducting basic 
and applied scientific research and translating the knowledge 
gained into products and services that impact workers in 
settings from corporate offices to construction sites to coal 
mines. Further, the Committee acknowledges that NIOSH continues 
to protect American workers through its work-related illness 
and injury research. The Committee encourages NIOSH to continue 
its objectivity so as to ensure the highest professional and 
ethical standards are maintained.
    The Committee recommendation includes funding for the 
following activities at the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
National Occupational Research            $119,500,000      $119,730,000
 Agenda.............................
    Agriculture, Forestry, Fishing          29,000,000        29,230,000
     (non--add).....................
Education and Research Centers......        32,000,000        32,000,000
Personal Protective Technology......        23,000,000        23,000,000
Mining Research.....................        66,500,000        67,500,000
National Mesothelioma Registry......         1,200,000         1,200,000
Firefighter Cancer Registry.........         5,500,000         5,500,000
Other Occupational Safety and Health       115,100,000       115,100,000
 Research...........................
    Total Worker Health (non--add)..        11,800,000        11,800,000
------------------------------------------------------------------------

    Agriculture, Forestry, and Fishing Program.--The Committee 
includes $29,230,000 for efforts to protect workers in this 
sector by providing leadership in applied research, disease and 
injury surveillance, education, and prevention. The Committee 
provides an increase of $230,000 for the administration of the 
Commercial Fishing Safety Research and Training program and 
supports the program that started in Public Law 113-281.
    Coal Workers' Health Surveillance Program Mobile Medical 
Unit.--The Committee is concerned about the prevalence of coal 
workers' pneumoconiosis, also known as black lung, and the 
recent increase in progressive massive fibrosis, the most 
severe stage of black lung, among younger miners. According to 
NIOSH, one in 10 underground coal miners who have worked in 
mines for at least 25 years were identified as having black 
lung. Coal miners in central Appalachia are disproportionately 
affected with as many as one in five having evidence of black 
lung-the highest level recorded in 25 years. Early screening 
and detection of black lung can improve health outcomes and 
reduce mortality. However, a NIOSH report has identified 
several potential barriers to screening for miners-including 
the ability to participate in screening. To improve access to 
screening for miners, this bill includes $1,000,000 for the 
purchase of an additional mobile medical unit.
    Education and Research Centers [ERCs].--The Committee 
includes $32,000,000 for ERCs in recognition of their important 
work to improve workplace safety and health by translating 
scientific discoveries into practice through effective 
education, training, and outreach. The Committee applauds the 
work of NIOSH to implement innovative approaches, and its 
translational research. The agency's priorities and efforts 
have included work on the protection of workers from heat 
hazards as well as the effects of the COVID-19 pandemic on the 
workplace, including the mental and emotional health impact on 
workers. The Committee encourages NIOSH to continue its support 
for new and existing ERCs to support education and training 
programs for graduate students, particularly in Environmental 
and Industrial Hygiene, Occupational Health Nursing, 
Occupational Medicine Residency, and Occupational Safety and 
Health Engineering.
    Heat Stress and Worker Illnesses and Injuries.--The 
Committee recognizes that working under high heat conditions 
causes symptoms of heat illness, including fatigue, loss of 
balance, nausea, headache, loss of physical and mental 
capacity, heavy sweating, muscle cramps, and other symptoms 
that cause or contribute to workplace injuries and illnesses. 
Injuries incurred may be minor, serious, life-threatening 
illnesses, or fatal and may result in long-term injuries or 
permanent disabilities. The Committee also urges CDC, in 
collaboration with appropriate partners, to research the 
relationship between heat stress and workplace illnesses and 
injuries and to identify means for more accurate data 
collection, including the recording and reporting of heat 
related injuries and illnesses, in outdoor and indoor 
workplaces.
    National Firefighter Registry for Cancer.--The Committee 
includes $5,500,000 as the registry recruits and enrolls 
participants.
    Potential PFAS Exposure Source for Firefighters.--The 
Committee is committed to advancing research on occupational 
exposure of firefighters to PFAS. NIOSH is directed to engage 
with the National Institute of Standards and Technology on 
their ongoing study to identify a firefighter's relative risk 
of exposure to PFAS released from their protective gear.
    Total Worker Health Program.--The Committee continues 
funding for 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. This funding 
supports critical priorities, including addressing the Nation's 
mental health, suicide, and substance use disorder crises, in 
the context of work design and employment.

         ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT

Appropriations, 2024....................................     $55,358,000
Budget estimate, 2025...................................      55,358,000
Committee recommendation................................      55,358,000

    The Committee recommendation for the Energy Employees 
Occupational Illness Compensation Program Act [EEOICPA] (Public 
Law 106-398) is $55,358,000. This mandatory funding supports 
NIOSH scientists who reconstruct radiation dose levels to 
inform compensation decisions.

                             GLOBAL HEALTH

Appropriations, 2024....................................    $692,843,000
Budget estimate, 2025...................................     692,843,000
Committee recommendation................................     697,613,000

    The Committee recommends $697,613,000 for global health-
related activities at CDC.
    CDC's global efforts promote health security and prevent 
disease in the United States and abroad through rapid detection 
and response to emerging and re-emerging health threats.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Global HIV/AIDS Program.............       128,921,000       128,921,000
Global Tuberculosis.................        11,722,000        11,722,000
Global Immunization Program.........       230,000,000       230,000,000
Polio Eradication...................       180,000,000       180,000,000
Measles and Other Vaccine                   50,000,000        50,000,000
 Preventable Diseases...............
Parasitic Diseases and Malaria......        29,000,000        30,000,000
Global Public Health Protection.....       293,200,000       296,970,000
------------------------------------------------------------------------

    Global Health Protection.--The Committee includes 
$296,970,000 and recognizes CDC's unique role in supporting 
public health capacity development through scientific and 
technical leadership both domestically and globally, to ensure 
that disease threats anywhere are prevented, detected early and 
responded to robustly through a coordinated, multisectoral 
approach. The Committee recognizes that accurate and swift 
diagnostics are crucial for the early detection and containment 
of infectious diseases of pandemic potential. The Committee 
encourages CDC's Global Health Center in collaboration with the 
National Center for Emerging and Zoonotic Infectious Diseases 
to prioritize the development of diagnostics for pathogens of 
pandemic potential and encourages CDC to work with Federal and 
other partners to strengthen capacity and infrastructure of 
countries to support adoption and access to diagnostics.
    Malaria and Parasitic Diseases.--The Committee provides 
$30,000,000, recognizing the important role CDC plays in the 
fight against malaria and parasitic disease, particularly 
providing parasitic lab capabilities for the United States. 
Parasitic diseases cause devastating health and economic 
effects for hundreds of millions of people around the world and 
in the United States. CDC provides life-saving services and 
expertise in research, diagnosis, treatment, surveillance, 
consultation, and education of parasitic diseases to States and 
countries, U.S. government agencies, and other public health 
partners. The Committee encourages further support for these 
activities so CDC can enhance its parasitic diseases 
laboratory, close the gap on parasitic disease-related health 
inequity in the United States, and advance global control and 
elimination of malaria and targeted neglected tropical 
diseases.
    Polio Eradication.--The Committee includes $180,000,000 to 
support CDC activities related to wild poliovirus and vaccine-
derived polio surveillance, vaccine procurement, and outbreak 
response. CDC is urged to continue to provide technical 
assistance to countries for polio immunization campaigns, 
conduct environmental surveillance of polio viruses to ensure 
prompt detection and to prevent potential outbreaks of 
paralytic polio disease.
    Population-based Surveillance Platforms.--The Committee 
continues $7,000,000 to continue to support longitudinal 
integrated population-based infectious disease surveillance 
platforms that enable comparative analysis between urban and 
rural populations in Africa.
    Soil Transmitted Helminth and Related Diseases of 
Poverty.--The Committee includes $2,000,000 to expand currently 
funded CDC projects aimed at surveillance, the implementation 
of control measures, and clinical care to reduce soil 
transmitted helminth infection and other parasitic infections 
of public concern.

                PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2024....................................    $938,200,000
Budget estimate, 2025...................................     943,300,000
Committee recommendation................................     953,200,000

    The Committee recommendation for CDC's Preparedness and 
Response activities is $953,200,000.
    CDC's preparedness and response mission is to build and 
strengthen national preparedness for public health emergencies 
including natural, biological, chemical, radiological, and 
nuclear incidents. This funding supports national response 
programs, as well as grants to States and localities to enhance 
preparedness efforts across the country.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Public Health Emergency Preparedness       735,000,000       735,000,000
 Cooperative Agreement..............
Academic Centers for Public Health           9,200,000         9,200,000
 Preparedness.......................
Center for Forecasting and Outbreak         55,000,000        70,000,000
 Analytics and Ready Response
 Enterprise Data Integration
 Platform...........................
All Other CDC Preparedness..........       139,000,000       139,000,000
------------------------------------------------------------------------


    Center for Forecasting and Outbreak Analytics [CFA] and 
Ready Response Enterprise Data Integration [RREDI] Platform.--
The Committee provides $70,000,000 for CFA and RREDI to 
facilitate the use of data, modeling, and analytics to improve 
preparedness and response. The Committee is aware of the 
unprecedented challenge recent public health emergencies, such 
as MPox, RSV, influenza, and COVID-19, pose to Federal, State, 
and local governments' ability to collect and share data in a 
meaningful way to ensure informed policy and operational 
decision making. The Committee recognizes the investment the 
U.S. government has made into these programs and includes 
funding for CDC to maintain this capability to ensure 
preparedness for future public health emergencies. The 
Committee urges CDC to continue to work with schools of public 
health and other academic institutions to engage the Nation's 
expertise in disease modeling, public health data analysis, 
research, and training to build workforce capacity in this 
emerging field. As an interagency resource for early warnings 
related to emerging infectious disease threats, the Center will 
support the public health system in detecting, responding to, 
and eventually preventing future epidemics and outbreaks.
    Centers for Public Health Preparedness and Response.--The 
Committee includes $9,200,000 and understands that despite 
unprecedented efforts to address the COVID-19 pandemic, many 
questions remain about which evidence-informed or evidence-
based practices may reduce the spread of SARS-COV-2 and its 
variants to improve public health preparedness and response. 
The Committee encourages CDC to consider equitable distribution 
across geographical regions when designating and funding 
Centers for Public Health Preparedness and Response as 
authorized in Public Law 117-328.
    Health Observatory Comprehensive Immune Profiling.--The 
Committee encourages CFA to partner with an institution of 
higher education in partnership with a major blood bank that 
collects samples across multiple States to develop a strategy 
of monitoring the population's immune status to a large variety 
of diseases including all human pathogens as well as autoimmune 
responses. The strategy should include the measurement of 
markers in the blood and a comprehensive profile of the 
antibody composition enhanced by machine learning models to 
recognize the pathogens/diseases involved.
    Public Health Emergency Preparedness Cooperative 
Agreements.--The Committee includes $735,000,000 to support 
State and local 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 continues to request a State 
distribution table in the fiscal year 2026 CJ, which should 
also include information about how funding is being allocated 
to local health departments and how States are determining 
these allocations.

                        BUILDINGS AND FACILITIES

Appropriations, 2024....................................     $40,000,000
Budget estimate, 2025...................................      40,000,000
Committee recommendation................................      40,000,000

    The Committee recommendation for Buildings and Facilities 
is $40,000,000.
    CDC-Owned Buildings and Facilities.--The Committee 
continues funding to make progress on reducing CDC's backlog of 
maintenance and repairs at its campuses nationwide, including 
its Atlanta headquarters. The Committee acknowledges that in 
order to protect Americans from health threats and to rapidly 
respond to public health emergencies, CDC needs a safe, secure, 
and fully operational infrastructure in the form of its own 
laboratories, buildings, and facilities. COVID-19 and other 
recent public health emergencies have required urgent action 
and demonstrated that CDC laboratories and facilities need to 
be ready to respond quickly and comprehensively. The Committee 
supports the completion of the CDC Masterplan Build Out, 
including continued progress with the Atlanta Masterplan Build 
Out.
    Mine Safety Research Facility.--The Committee requests the 
continuation of quarterly updates on progress in the 
construction of the new mine safety research facility and 
laboratory, costs incurred, and unanticipated challenges which 
may affect timeline or total costs, and any other pertinent 
developments until the completion of the facility.

                          CDC-WIDE ACTIVITIES

Appropriations, 2024....................................    $663,570,000
Budget estimate, 2025...................................     723,570,000
Committee recommendation................................     681,570,000

    The Committee provides $681,570,000 for public health 
leadership and support activities at CDC.
    The recommendation includes $160,000,000 in transfers from 
the PPH Fund.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Preventive Health and Health               160,000,000       160,000,000
 Services Block Grant...............
Public Health Leadership and Support       128,570,000       131,570,000
Infectious Diseases Rapid Response          25,000,000        25,000,000
 Reserve Fund.......................
Public Health Infrastructure and           350,000,000       365,000,000
 Capacity...........................
------------------------------------------------------------------------

    Infectious Diseases Rapid Response Reserve Fund [IDRRRF].--
The Committee includes $25,000,000 for the IDRRRF. The IDRRRF 
provides an immediate source of funding to ensure that funds 
are available when an emerging infectious disease crisis is 
detected. Funds are available until expended.
    Local Public Health Departments.--The Committee notes that 
Federal funding intended for both State and local health 
departments does not consistently reach local health 
departments beyond those directly-funded. The Committee 
encourages CDC to require States to fund local health 
departments when programmatically appropriate.
    Office of Rural Health [ORH].--The Committee provides 
$5,000,000 to continue ORH. The Committee is encouraged by 
efforts from the agency to establish the CDC ORH. The Committee 
directs the agency to ensure that the established ORH will 
guide CDC's rural health leadership across the entire agency. 
This includes by developing purposeful public health guidance 
for rural health departments, analyzing and developing 
initiatives to expand the rural public health workforce, 
establishing a formal partnership with the Federal Office of 
Rural Health Policy under HRSA, and otherwise serving as a 
resource and technical assistance hub for public health in 
rural communities.
    Public Health Infrastructure and Capacity.--The Committee 
includes $365,000,000 in public health funding that is not 
segmented by disease, condition, activity. Rather, it is 
provided for cross-cutting, core public health infrastructure 
needs, including but not limited to workforce, health 
information and data systems, public health policy and 
communications, equity, financial management, community 
partnership development, and organizational capacity. By 
providing maximum flexibility, this funding will allow public 
health agencies to determine and address their greatest needs 
and build core capabilities that will strengthen and support 
new and existing programmatic functions. The Committee again 
directs that no less than 70 percent of this funding be awarded 
to health departments. The Committee encourages CDC to 
strengthen infrastructure in local health departments by 
continuing to directly award funds to local health departments, 
and by urging State health department recipients to allocate 
resources to local health departments. The Committee urges CDC 
to publicly track and report to the Committee how funds 
provided to State health departments are passed through to 
local health departments.
    Public Health Leadership and Support.--The Committee 
includes $131,570,000 to support CDC's foundational public 
health activities and to facilitate partnerships. The Committee 
commends CDC for its commitment to the development of a diverse 
healthcare and public health workforce. Within this total, the 
Committee includes $6,500,000 to expand the John R. Lewis CDC 
Undergraduate Public Health Scholars Program, including the 
opportunity for more HBCUs to participate, as well as Tribal 
Colleges and Universities.

                     National Institutes of Health

    The Committee provides $48,811,518,000 in base 
discretionary resources for the National Institutes of Health 
[NIH], an increase of $2,050,000,000. Additionally, the 
Committee provides $127,000,000 in budget authority authorized 
in the 21st Century Cures Act (Public Law 114-255). Per the 
Cures Act, $45,500,000 is transferred to the National Institute 
of Neurological Disorders and Stroke [NINDS] and $45,500,000 to 
the National Institute of Mental Health [NIMH] for the BRAIN 
Initiative; and $36,000,000 to the Office of the Director [OD] 
for the All of Us precision medicine initiative. In addition, 
the Committee also includes $1,412,482,000 in transfers 
available under section 241 of the PHS Act (Public Law 78-410 
as amended), for a total program level for NIH of 
$50,351,000,000.
    More than 80 percent of NIH's appropriated budget is 
awarded for extramural research each fiscal year. This funding 
supports more than 58,000 meritorious grants to more than 2,700 
academic universities, hospitals, small businesses, and other 
organizations throughout the United States and internationally. 
This investment has allowed NIH to continue its mission 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.
    As in previous years, the Committee has targeted NIH 
funding in areas of promise of scientific advancement and 
urgency, while allowing NIH to maintain flexibility to pursue 
unplanned scientific opportunities and address unforeseen 
public health needs. The Committee increases support for mental 
health research by $275,000,000, provides an increase of 
$275,000,000 for research on Alzheimer's disease and 
Alzheimer's disease-related dementias research, increases 
support for cancer research by $266,000,000, and increases 
support for diabetes research by $50,000,000. The bill also 
includes an increase of $10,000,000 for the Helping to End 
Addiction Long-term or HEAL Initiative, and an increase of 
$20,000,000 for the Implementing a Maternal health and 
Pregnancy Outcomes Vision for Everyone [IMPROVE Initiative] to 
combat recent alarming rates of maternal mortality. Finally, 
the bill provides $1,500,000,000 for the Advanced Research 
Projects Agency for Health [ARPA-H], the President's bold and 
promising proposal to accelerate the pace of breakthroughs in 
medicine using the Defense Advanced Research Projects Agency as 
a model.
    The Committee directs NIH to include updates on the 
following research, projects, and programs in the fiscal year 
2026 Congressional Justification: future goals for each of the 
deadliest cancers (brain, esophagus, liver, lung, ovary, 
pancreas, stomach and mesothelioma); neuroblastoma; promoting 
cancer research among rural populations; pancreatic cancer 
clinical trials; update on NCI's Virtual Clinical Trials 
Office; SEER modernization activities; congenital heart 
disease; lung health disparities; pulmonary fibrosis; sleep 
disorders; biomedical research workforce training; Maternal-
Fetal Medicine Units Network; pelvic organ prolapse; severe 
maternal morbidity; Usher syndrome; Alzheimer's Disease/
Alzheimer's Disease-Related Dementias [AD/ADRD]; Alzheimer's 
Disease clinical trials; female reproductive aging; suicide 
prevention; biomedical technology development; 
epitranscriptomics database standards; cell and gene therapies; 
Childhood Post-Infectious Neuroimmune Disorders/Pediatric 
Acute-Onset Neuropsychiatric Syndrome [PANS]/Pediatric 
Autoimmune Neuropsychiatric Disorders Associated with 
Streptococcus [PANDAS]; Common Fund; focused ultrasound; lung 
health disparities; osteopathic medical schools; pelvic floor 
disorders; Von Hippel-Lindau disease; buildings and facilities 
capital planning process.

                       NATIONAL CANCER INSTITUTE

Appropriations, 2024....................................  $7,224,159,000
Budget estimate, 2025...................................   7,839,141,000
Committee recommendation................................   7,490,159,000

    The Committee recommendation includes $7,490,159,000, an 
increase of $266,000,000, for the National Cancer Institute 
[NCI]. Of this amount, $30,000,000 is available for repairs and 
improvements to the NCI facility in Frederick, Maryland.
    Biliary Tract Cancers.--The Committee strongly encourages 
NIH to continue to support research to develop novel treatment 
strategies in biliary tract cancers, and for basic and 
translational research as well as clinical trials in liver 
cancers, as both are needed to improve state-of-the-art cancer 
immunotherapy. The Committee strongly supports research on 
novel cancer vaccines and immunotherapies. Targeting recurrent 
cancer neoantigens in BTC with novel cancer treatment vaccine 
in combination with other drugs that work on the human immune 
system could move the treatment paradigm in BTC forward and 
enable combinatorial immunotherapy trials, including adoptive 
cell therapies, in the future.
    Cancer Moonshot.--The Committee provides an increase of 
$216,000,000 to fully restore NCI's Cancer Moonshot program to 
its fiscal year 2023 program level.
    Childhood Cancer Data Initiative [CCDI].--The Committee 
includes no less than $50,000,000 for the CCDI, including to 
support continued enhancement of the CCDI Molecular 
Characterization Initiative.
    Childhood Cancer STAR Act.--The Committee includes 
$50,000,000, an increase of $20,000,000, for continued 
implementation 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 all 
children, adolescents, and young adults with cancer. The 
Committee has also included sufficient funding to carry out 
childhood cancer survivorship research and programs as 
authorized in the STAR Act, such as supporting research to 
inform best practices for the treatment of late effects of 
childhood cancers, research to improve collaboration among 
providers so that doctors are better able to care for this 
population as they age, and research to inform innovative 
models of care for childhood cancer survivors. This amount also 
includes $2,000,000 provided for the CDC's ongoing efforts to 
enhance cancer registry case capture efforts for childhood and 
adolescent cancers.
    Deadliest Cancers.--The Recalcitrant Cancer Research Act 
[RCRA] of 2012 (Public Law 112-239) focuses on cancers with a 
5-year survival rate below 50 percent, which account for over 
40 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 several decades, there has been 
limited progress reducing mortality for these diseases. In 
fiscal year 2020 (Public Law 116-94), Congress directed NCI to 
develop a scientific framework using the process outlined in 
the RCRA for stomach and esophageal cancers. The Committee 
commends NCI for developing the framework and notes that NCI 
has also launched a Program in Origins of Gastroesophageal 
Cancers. Given the devastating toll of all recalcitrant cancers 
and the lack of diagnostic and treatment resources currently 
available, the Committee, alongside the research and advocacy 
communities, encourages a continued focus and requests an 
update on research on each of the deadliest cancers--brain, 
liver (including cholangiocarcinoma), lung, ovary, pancreas, 
and stomach and esophageal cancers in the fiscal year 2026 CJ.
    Esophageal and Gastric Cancer.--The Committee recognizes 
the importance of screenings for cancer detection and is 
encouraged by the work of NIH in this field. However, the 
Committee believes that there is more work to be done, 
particularly with screening for GI cancers, such as esophageal 
and gastric, which have a low 5-year survival rate. The 
Committee urges NIH to explore developing, testing, and 
implementing strategies using non-endoscopic screening 
modalities, personalized clinical risk stratification for 
screening, and biomarker-based risk stratification for the 
surveillance of esophageal adenocarcinoma and gastric cardia 
adenocarcinoma.
    HPV Screening and Self-Collection.--The Committee 
recognizes the impact and potential of the Last Mile Initiative 
and applauds innovative efforts, such as the emerging network 
to study noninvasive self-collection for HPV testing to further 
improve the detection and prevention of cervical cancer to 
address disparate health outcomes. NCI is encouraged to 
continue working with a variety of stakeholders and to continue 
studying various approaches to sustain scientific progress.
    Immunomodulatory Radiopharmaceutical Therapy.--The 
Committee supports ongoing efforts for Immunomodulatory 
Radiopharmaceutical Therapy to advance translational research 
that aims to develop more effective, safe, and potentially 
curative treatments for patients with potentially any form of 
metastatic cancer using combinations of radiopharmaceutical 
therapies and immunotherapies.
    Improving Native American Cancer Outcomes.--The Committee 
urges NCI to continue to coordinate with the National Institute 
on Minority Health and Health Disparities [NIMHD] on the 
Initiative for Improving Native American Cancer outcomes to 
support efforts, including research, education, outreach, and 
clinical access related to cancer in Native American 
populations.
    Liver Cancer.--The Committee applauds NCI for seeking input 
on how best to address the need to prioritize early detection, 
screening, and prevention sciences for primary liver cancer. 
Primary liver cancer has a dismal 5-year survival rate of only 
18 percent, is the third most common cause of cancer death in 
the U.S., and unlike most cancers the rate of liver cancer 
mortality continues to increase. The Committee urges NCI to use 
submitted expert feedback to inform a national agenda for early 
detection, screening, and prevention of primary pancreatic and 
liver cancers. The Committee applauds the NCI for its Early 
Detection of Liver Cancer consortia initiatives as a means of 
fostering progress and collaboration and encourages NCI to 
continue such programs as well as Program Projects, Cooperative 
Research and Broad Agency Announcements, and other contract 
mechanisms to achieve the goals of strategic plans. The 
Committee has included funding to permit the NCI to fully 
implement this effort and looks forward to being kept informed 
as to progress.
    Natural Products Research.--Research shows that derivatives 
from natural products have been an important source of 
clinically useful anti-cancer agents, yet not enough evidence-
based research has been done to strategically identify those 
compounds that could provide potential benefits in cancer 
treatment. The Committee encourages NCI to continue to support 
research into whether and how natural products could be 
beneficial to cancer patients in reducing the toxicity of 
therapy or by enhancing therapeutic efficacy as a primary or 
adjunctive therapy. The Committee encourages NCI to continue to 
fund research to evaluate the potential value of natural 
products in reducing adverse effects of cancer therapy and in 
enhancing therapeutic efficacy through basic, translational and 
clinical trials research. NCI is encouraged to seek applicants 
that have a demonstrated expertise in natural products 
research, are capable of conducting a holistic review of drugs 
and disease states utilizing NCI's annotated inventory of 
natural products, and that are able to test the safety and 
efficacy of natural products in communities experiencing high 
rates of healthcare disparities in access to cancer care.
    Neuroblastoma.--The Committee commends NCI for its support 
of neuroblastoma research and recognizes the many complex 
challenges presented by this deadly pediatric cancer. The 
Committee encourages NCI to continue investments in this area 
and requests an update in the fiscal year 2026 CJ on; a) 
efforts to improve outcomes for CNS relapse patients, and b) 
patient access to a promising therapy targeting the ALK gene in 
NCI supported trials and protocols.
    Optimal Timing and Sequencing of Cancer Immunotherapy.--The 
Committee recognizes that cancer immunotherapy is improving 
outcomes for an increasing number of cancer patients, 
especially those for whom other treatments were ineffective. 
New research suggests that more patients might benefit if 
immunotherapy were used earlier in the course of their cancer, 
or to prevent and intercept cancers before they start. The 
Committee urges NCI to continue to support research focused on 
assessing the optimal timing for the use of cancer 
immunotherapy in individual patients. Examples of such research 
include studying the effectiveness of cancer immunotherapy in 
premalignant conditions, early-stage cancer, and as a 
neoadjuvant therapy, prior to additional treatment such as 
surgery, radiation or chemotherapy.
    Pancreatic Cancer.--Pancreatic cancer will be second only 
to lung cancer as the cause of cancer-related deaths in the 
U.S. before 2030. Despite decades of effort, survival remains 
the lowest of all the major cancers and is particularly dismal 
for Black Americans. It is critical that NCI continue its 
efforts to support early detection and clinical research that 
focuses on pancreatic cancer. The Committee remains concerned 
about the lack of early detection approaches for pancreatic 
cancer, and the need to ensure diverse enrollment in cancer 
clinical trials, including pancreatic cancer trials. The 
Committee requests an update in the fiscal year 2026 CJ 
regarding progress in early detection research and ongoing 
efforts to leverage NCI's clinical trials networks to advance 
progress for all people experiencing a pancreatic cancer 
diagnosis.
    Patient Access to Clinical Trials.--The Committee 
recognizes that local healthcare provider and patient access to 
clinical trials is critical for improving equitable access to 
research and novel therapies; diversifying the population 
participating in research; ensuring the safety and efficacy of 
new drugs; and accelerating the dissemination and 
implementation of findings and the adoption of newly approved 
therapies. However, access to trials remains out of reach for 
many patients and local oncology providers, particularly those 
in rural areas and/or at practice sites and hospitals without 
dedicated research resources and infrastructure. Leveraging 
technology can improve efficiencies of trial start-up, 
administration, and communications. A virtual research team who 
provides centralized research expertise and resources can 
ultimately support local provider participation in clinical 
trials by alleviating the need for specialized personnel 
onsite. The NCI's recently launched Virtual Clinical Trials 
Office pilot study provides virtual research personnel to NCI-
funded trials conducted at participating NCI-designated cancer 
centers and NCI Community Oncology Research Program sites. The 
Committee encourages the use of telehealth and expansion of the 
clinical trial-related remote services provided by this office. 
The Committee requests an update on the Virtual Clinical Trials 
Office in the fiscal year 2026 CJ.
    Pediatric Rare Cancer Therapeutic Development.--Recognizing 
that effective treatments for many types of childhood cancer do 
not exist yet, the Committee encourages NIH to examine novel 
systems for identifying how rare cancers develop and progress, 
and to continue supporting the development and evaluation of 
life-saving therapeutics for pediatric cancer patients.
    Pediatric Cancer Immunotherapy.--The Committee encourages 
NCI to continue to support pediatric immunotherapy 
translational and clinical research. The Committee is aware of 
the transition from the Pediatric Immunotherapy Discovery and 
Development Network to the Pediatric Immunotherapy Network.
    Rural NCI Designation.--The Committee encourages NCI to 
review its criteria for awarding Cancer Center Support Grants 
[CCSGs] to include considerations for Cancer Centers that are 
primarily providing care to rural patients, conducting cancer 
research with rural populations, or otherwise are focused on 
cancer in rural America. While recognizing the role that Cancer 
Centers play in providing patient care, the Committee also 
commends the vital work underway at community cancer clinics 
across the country and NCI's efforts to support them, including 
through the NCI Community Oncology Research Program [NCORP] and 
the recently created Working Group in Support of Efforts to 
Enhance Community Cancer Research and Quality Care. The 
Committee requests an update in the fiscal year 2026 CJ on 
NCI's efforts related to promoting cancer research among rural 
populations.
    Social Determinants of Health [SDOH].--The Committee 
recognizes that SDOH can pose significant barriers to cancer 
care and contribute to poorer health-related outcomes, 
especially for cancer patients and survivors from historically 
underserved and marginalized backgrounds. The Committee urges 
NCI to prioritize research on the impact of SDOH on cancer and 
how improvements to SDOH can lead to a higher quality of care.
    Surveillance, Epidemiology, and End Results [SEER] 
Registry.--The Committee applauds NCI for ongoing efforts to 
modernize the SEER registry and bolster data collection, 
including innovative activities to better capture the 
prevalence and progression of metastatic cancers. NCI is 
directed to further support SEER modernization activities in a 
meaningful way, and to continue to update the Committee on 
progress and unmet needs in this area in the fiscal year 2026 
CJ.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2024....................................  $3,982,345,000
Budget estimate, 2025...................................   3,997,086,000
Committee recommendation................................   3,982,345,000

    The Committee recommendation includes $3,982,345,000 for 
the National Heart, Lung, and Blood Institute [NHLBI].
    Cardiovascular Disease [CVD].--The Committee continues to 
recognize that CVD, including heart disease, stroke, and 
hypertension, is the leading cause of death in the United 
States and worldwide. The Committee provides robust funding to 
NHLBI to continue to address these issues, and to prioritize 
funding opportunities that reduce CVD among the hardest-hit 
geographic areas, such as the Southern United States.
    Congenital Heart Disease [CHD].--The Committee commends 
NHLBI for its continued work to better understand causation, 
improve treatments and outcomes, support the growth of the 
clinical and research workforce, and integrate registry data 
and research datasets to facilitate research on congenital 
heart disease across the lifespan, including through the 
Pediatric Heart Network and the Pediatric Cardiac Genomics 
Consortium. The Committee encourages NHLBI to prioritize CHD 
activities outlined in its strategic plan, including improving 
understanding of outcomes and co-morbidities, improving 
treatment options across the lifespan, and accelerating 
discovery, analysis, and translation by leveraging CHD 
registries and networks. The Committee requests NHLBI include 
in its fiscal year 2026 CJ a report on steps being taken to 
close these research gaps.
    COVID-19 Associated Illnesses.--The Committee recognizes 
the growing burden of COVID-19 associated critical illnesses 
and recovery, especially in adults with acute respiratory 
distress syndrome [ARDS], pneumonia, and/or sepsis. The 
Committee encourages NHLBI, in partnership with the National 
Institute of General Medical Sciences, to explore facilitating 
research support through ancillary studies enabled by the ARDS, 
Pneumonia, and Sepsis Phenotyping [APS] Consortium.
    Duchenne and Becker Muscular Dystrophy.--In light of 
improvements in care leading to patients living into their 
third decade, the leading cause of death in DMD patients is 
heart failure. The Committee encourages NHLBI to support 
research that characterizes fibro-fatty replacement of 
cardiomyocytes in DMD/BMD. The Committee encourages NHLBI to 
explore convening a workshop with research, clinical, and 
patient organization leaders to work towards establishing 
viable cardiac outcome measures for the development of 
therapeutic agents to delay or treat heart disease in 
individuals diagnosed with Duchenne. There is growing evidence 
to support that select individuals with DMD/BMD would benefit 
from ventricular assist device placement or heart transplant. 
The Committee encourages NHLBI to support research to further 
develop criteria for identifying patients who may benefit from 
such strategies.
    Heart Disease.--The Committee is concerned that this 
largely preventable disease disproportionately affects racial 
and ethnic minorities and those living in rural communities and 
supports ongoing population studies and community-based 
initiatives seeking to address these disparities. The Committee 
is concerned that heart disease is the leading cause of death 
during and after pregnancy and that racial and ethnic 
disparities are significant, peaking among Black women. The 
Committee supports the commitment to address maternal health 
and reduce the risk of cardiovascular disease for women before, 
during, and after pregnancy. The Committee also supports 
addressing diversity in research among racial and ethnic 
minorities and the prioritization of women's health research. 
The Committee commends NHLBI's focus on dietary interventions 
and supports incorporating access to or provision of healthy 
food into healthcare delivery systems.
    Lung Health Disparities.--The Committee is concerned about 
the disproportionate impact of lung conditions, such as asthma, 
COPD, and lung cancer on populations experiencing health 
disparities, and encourages NHLBI to work with NIMHD to advance 
research in this area. The Committee requests an update from 
both NHLBI and NIMHD in the fiscal year 2026 CJ.
    Lung Health Research.--Chronic lung diseases are among the 
leading causes of death and chronic illness in the United 
States including the over 15 million Americans diagnosed with 
chronic obstructive pulmonary disease [COPD] and related lung 
diseases. Most chronic lung disease research to date has 
focused on later stages of disease when substantial loss of 
lung function and damage to lung tissue have already occurred. 
There is a need for treatments that when applied early in the 
courses of disease can more effectively slow the progression 
and mitigate the lung tissue damage caused by chronic lung 
diseases. NHLBI supports a wide array of basic and 
translational research in these conditions. Increased research 
is needed to improve our understanding of early disease to 
identify appropriate targets to modulate disease progression 
before the irreversible tissue damage has occurred. NHLBI-
funded studies such as the COPDGene, SPIROMICS and LungMAP are 
critical to this objective and have already provided 
significant insight to begin to understand the biology of early 
disease. The Committee encourages NHLBI to increase support for 
these and other early disease research in chronic lung disease.
    Pulmonary Fibrosis [PF].--The Committee encourages the 
NHLBI to use the opportunities presented by the reorganization 
of the Division of Lung Diseases to focus on areas of need in 
PF and interstitial lung disease [ILD] research. As NHLBI 
refreshes its strategic vision with a focus on health 
disparities, the Committee urges the Institute to direct 
additional resources to addressing differences in care and 
outcomes for patients with PF and ILD that are associated with 
patient characteristics such as sex, gender, race, ethnicity, 
region of the United States, rural or urban location, and 
military service status. The Committee also encourages NHLBI to 
support research that will improve researchers' and clinicians' 
ability to predict disease progression in patients with PF and 
ILD. The Committee requests an update on these activities in 
the fiscal year 2026 CJ.
    Pulse Oximeters and Health Disparities.--Pulse oximeters 
are frequently used in clinics and in homes to measure a 
person's pulmonary health, but the devices tend to overestimate 
blood oxygen for people with dark skin. This discrepancy can 
have serious consequences, since people with darker tones are 
nearly three times more likely to suffer from silent hypoxia, a 
condition in which the oxygen saturation level in a person's 
blood is dangerously low but goes unnoticed. In addition, 
people of color were 25 percent less likely to be recognized as 
eligible for COVID-19 treatment during the recent pandemic. The 
Committee encourages NHLBI to address these health disparities 
by supporting the development of new technologies for 
monitoring blood oxygen saturation.
    Rare Blood Disorders.--The Committee recognizes NHLBI for 
its leadership of the Division of Blood Diseases and Resources, 
and appreciates efforts to advance science in the rare blood 
disorders portfolio. NHLBI is encouraged to sustain progress in 
this area and to engage in emerging opportunities for community 
and cross-agency collaboration in immune thrombocytopenia 
[ITP], warm autoimmune hemolytic anemia [wAIHA], and other 
acquired and inherited blood disorders.
    RECOVER Initiative.--The Committee notes with concern that 
the multi-organ syndrome known as Long COVID has emerged as a 
serious health condition that can cause socioeconomic burdens, 
and long-term pulmonary complications represent an important 
component of Long COVID. The Committee urges NHLBI, in its co-
leading of the RECOVER Initiative, to continue to prioritize 
research into the understanding, treatment and prevention of 
post-COVID respiratory and cardiovascular conditions in adults 
and children, particularly among populations disproportionately 
impacted by COVID-19.
    Sleep Disorders.--The Committee applauds NHLBI and other 
NIH Institutes and Centers for the ongoing commitment to sleep 
and circadian research, and notes the wealth of opportunities 
for further progress in specific sleep disorders. In December 
2021, NHLBI released the NIH Sleep Research Plan, which 
addresses topics such as minority health and health 
disparities, sex/gender, sleep across the lifespan, the impact 
of the opioid epidemic, and how poor sleep may exacerbate the 
risk and outcome of infectious diseases, such as COVID-19 and 
Long COVID. The Committee recognizes NHLBI for supporting 
research on the causes, diagnosis, prevention, and treatment of 
sleep and circadian disorders and encourages NHLBI to 
accelerate implementation of the plan. The Committee requests 
an update on these activities in the fiscal year 2026 CJ.
    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, about 25,000 people die each year in the U.S. 
from heart valve disease, primarily due to underdiagnoses and 
under-treatment of the condition. The Committee continues 
$20,000,000 and strongly supports more research into the 
causation of and risk factors for valvular heart disease. Such 
research should focus on the use of advanced technological 
imaging and other relevant methods to generate data related to 
valvular heart disease, and assessing potential risk factors 
for sudden cardiac arrest or sudden cardiac death from valvular 
heart disease. Additionally, the Committee supports efforts by 
NIH to convene a workshop of subject matter experts and 
stakeholders to identify research needs and opportunities to 
develop recommendations for the identification and treatment of 
individuals with mitral valve prolapse, including individuals 
who may be at risk for sudden cardiac arrest or sudden cardiac 
death.
    Wildland Fire Smoke.--The Committee recognizes that 
exposure to smoke from wildfires is an occurrence that is 
impacting more Americans. The Committee is concerned that 
public health experts do not yet fully understand the risk 
posed by exposure to wildland fire smoke--particularly acute 
and chronic smoke exposure to patients with existing pulmonary 
and cardiac disease. The Committee encourages NHLBI to support 
research to understand the risk smoke exposure has for patients 
with underlying health conditions and any interventions that 
can be implemented to mitigate adverse health effects.
    Women with Bleeding Disorders.--The Committee encourages 
NHLBI to continue its support of research of bleeding disorders 
in women and girls with the end goal of improving timely 
diagnoses for this population and improving services and 
treatments. It has long been considered that bleeding 
disorders, such as hemophilia and von Willebrand disease, only 
impact men, which is not accurate. As a result, women, girls 
and people with the potential to menstruate are often diagnosed 
late, do not receive timely services and treatment, and have 
been excluded from research.

         NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2024....................................    $520,163,000
Budget estimate, 2025...................................     521,695,000
Committee recommendation................................     520,163,000

    The Committee recommendation includes $520,163,000 for the 
National Institute of Dental and Craniofacial Research [NIDCR].
    Advancing Head and Neck Cancer Early Detection Research 
[AHEAD].--The Committee commends NIDCR for establishing AHEAD 
to accelerate translational and clinical research on the early 
detection of head and neck cancers [HNC]. The initiative aims 
to increase scientific knowledge of the molecular 
characteristics of dysplastic tissue lesions, which are the 
predominant precursor for HNCs. The Committee encourages NIDCR 
to support research to utilize data from The Cancer Genome 
Atlas [TCGA] and other genomic and proteomic projects to help 
match tumor defects with patient clinical outcomes, which could 
lead to tailored biomarker identification for early diagnosis 
and treatment.
    Oral Care Interventions.--The Committee reaffirms that 
dental care is integral to the medical management of numerous 
diseases and medical conditions and that the lack of medically 
necessary oral healthcare heightens the risk of costly medical 
complications. The Committee appreciates NIH's support for 
research that has demonstrated that dental care is closely 
linked to and crucial to the clinical success of other covered 
medical services. The Committee urges NIH to fund additional 
research in this area and conduct trials to determine which 
oral care interventions are most effective for reducing the 
prevalence and improving the medical management of malignant 
oral cancers and chronic diseases, preventing pneumonia in 
hospitals, and lowering hospitalization and emergency 
department admission rates for oral diseases and conditions.
    Temporomandibular Disorders [TMD].--The Committee commends 
NIDCR for developing the TMD Collaborative for Improving 
Patient-Centered Translational Research [TMD IMPACT]. The 
timely implementation of the TMD IMPACT Collaborative into a 
national consortium is essential. The Committee is pleased 
NIDCR has funded nine TMD IMPACT groups. The Committee 
encourages NIDCR to maintain a patient-centered approach in the 
implementation of this Collaborative by including patients and 
advocacy organizations in this next phase of the project. The 
Committee is encouraged to see that NIDCR has added 
collaborators including the FDA, NIAMS, NIBIB, NINDS, NCCIH, 
OBSSR, and ORWH. NIDCR should encourage other Agencies and 
Institutes, Centers, and Offices within NIH with appropriate 
scientific expertise to participate in and support this 
project. The Committee directs NIH to provide an update within 
120 days on the progress to implement the next phase of this 
important initiative including the recruitment of other NIH 
Institutes as partners, the involvement of TMD patients in all 
aspects of the initiative where possible, and NIDCR's attention 
to and utilization of research recommendations derived from the 
National Academies of Sciences, Engineering, and Medicine 
Report on TMDs and the TMJ Patient-led RoundTable in driving 
the scientific directions of this initiative.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 2024....................................  $2,310,721,000
Budget estimate, 2025...................................   2,309,991,000
Committee recommendation................................   2,360,721,000

    The Committee recommendation includes $2,360,721,000, an 
increase of $50,000,000, for the National Institute of Diabetes 
and Digestive and Kidney Diseases [NIDDK].
    Diabetes.--The Committee provides an increase of 
$50,000,000 and commends the efforts of NIDDK to prioritize the 
discovery and validation of biomarkers and urges NIDDK to 
continue to prioritize this important work that will accelerate 
the designing and conducting of clinical trials to prevent, 
treat, and cure type 1 diabetes. Given the growing prevalence 
of diabetes, the Committee is concerned that additional 
research is needed to determine how to improve the treatment of 
a common complication, diabetic foot ulcers to reduce 
amputations, and urges NIDDK to support such efforts. Further, 
given the aging population, the Committee urges NIDDK to work 
with the National Institute on Aging to explore the 
relationship between diabetes and neurocognitive conditions, 
such as dementia and Alzheimer's disease in racially and 
ethnically diverse populations.
    Hepatitis B.--The Committee applauds NIDDK efforts to 
create common resource services and materials for the research 
community and urges continued focus on clinical networks, 
databank development and precision medicine approaches. The 
Committee further urges the development of experimental animal 
and cell culture models to help advance cure research against 
the widest possible set of therapeutic targets and research 
focused on understanding the virology and immunology of people 
with low levels of HBsAg, a protein on the surface of the 
hepatitis B virus--as this category of people are more 
responsive to therapy. The Committee is aware of the view 
within the scientific community that finding a cure for 
hepatitis B, as has been achieved for hepatitis C, is a 
winnable goal and is within reach in the near term. For these 
reasons, the Committee urges that research, based on the needs 
as identified in the updated Strategic Plan for Trans-NIH 
Research to Cure Hepatitis B, be funded by NIH in fiscal year 
2025 and beyond.
    Kidney Transplant Disparities.--The Committee appreciates 
NIDDK's ongoing work on kidney disease research, particularly 
on disparities in the prevention, diagnosis, and treatment of 
kidney diseases through new studies to address disparities in 
kidney transplant care. The Committee reaffirms the importance 
of reducing health disparities and urges NIDDK to support 
health disparities research to improve kidney transplant care.
    Nutrition Science and Addressing Chronic Diseases.--The 
Committee recognizes NIDDK for its leadership advancing 
nutrition science particularly as it relates to a variety of 
chronic conditions. Further, the Committee appreciates that the 
benefit and impact of further scientific advancements goes 
beyond digestive and metabolic conditions and encourages cross-
cutting collaborative research efforts in nutrition science and 
chronic diseases with relevant NIH Institutes and Centers in 
support of ongoing and emerging efforts, many of which are 
coordinated by ONR at the Office of the Director, including the 
concept for Food is Medicine Networks or Centers of Excellence.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2024....................................  $2,603,925,000
Budget estimate, 2025...................................   2,788,327,000
Committee recommendation................................   2,951,925,000

    The Committee recommendation includes $2,951,925,000, an 
increase of $348,000,000, for the National Institute of 
Neurological Disorders and Stroke [NINDS].
    Amyotrophic Lateral Sclerosis [ALS] Research.--The 
Committee commends NINDS for its leadership in the NIH ALS 
Strategic Planning Working Group and development of the 2023 
priorities for ALS research focused on more effective 
diagnosis, prevention, treatment, and a cure. The Committee 
provides an increase of $10,000,000 to support these efforts, 
and urges NINDS to use this funding to bolster ALS clinical 
trials, therapies, targeted therapies, and treatments.
    Alzheimer's Disease and Alzheimer's Disease-Related 
Dementias [AD/ADRD].--The Committee includes an increase of 
$275,000,000 across NIH for AD/ADRD research, including an 
increase of $137,500,000 in NINDS and $137,500,000 in NIA.
    Angelman Syndrome [AS].--The Committee is aware of the AS 
natural history study supported by NIH from January 2006 to 
July 2014. The resulting data from over 300 participating 
American families, along with a later FDA prospective natural 
history study, provide a critical understanding of the most 
important symptoms of this serious condition and support the 
development of specific AS outcome measures. Further, the 
recent developments in cell and gene therapies, including a 
2023 National Center for Advancing Translational Sciences award 
for the application of a CRISPR platform technology, hold 
significant potential for disease-modifying treatments for rare 
genetic brain diseases. In order to fully support the rapidly 
increasing array of clinical studies of these and other 
treatment modalities being developed for Angelman syndrome, the 
Committee urges NINDS, in cooperation with FDA, to convene 
relevant research leaders, patient organizations, and other 
stakeholders to prepare a roadmap for clinical outcomes 
measures and biomarkers for this condition. NINDS shall provide 
a report to the Committees on this initiative within 300 days 
of enactment.
    Brain Aneurysms.--The Committee remains concerned that an 
estimated 1 out of every 50 individuals in the United States 
has a brain aneurysm and an estimated 30,000 Americans suffer a 
brain aneurysm rupture each year, with little or no warning. 
Ruptured brain aneurysms are fatal in about 50 percent of 
cases. Despite the widespread prevalence of this condition and 
the high societal cost it imposes on our Nation, the Federal 
Government only spends approximately $2.08 per year on brain 
aneurysm research for each person afflicted with a brain 
aneurysm. The Committee encourages NINDS to increase its 
support for research focused on prevention and early detection 
of brain aneurysms.
    Creutzfeldt-Jakob Disease [CJD].--The Committee commends 
the NAPA Advisory Council report from 2023 that acknowledges 
the scientific connection between prion diseases and ADRDs and 
continues to encourage NIH to recognize prion diseases as ADRDs 
and fund more research for prion diseases, like CJD. ADRDs have 
already benefited from prion disease research, and further 
integration of the fields could lead to beneficial new 
treatments and improve scientific understanding of these 
devastating diseases.
    Frontotemporal Degeneration [FTD].--The Committee 
encourages NIH to continue to support research to identify and 
validate biomarkers for FTD and other neurodegenerative 
diseases among racially and ethnically diverse cohorts. Easily 
accessible biomarkers to accurately detect and measure disease 
will facilitate greater access to diagnosis and promote 
participation in research on all forms of dementia. The 
Committee also urges NIH to support efforts to better 
understand the social determinants of health that lead to 
inequity and disparate health outcomes including decreased or 
delayed access to diagnosis and care for FTD and other 
dementias so that new treatments and best practices in care 
will be available to all, regardless of age, racial, ethnic, 
cultural, socioeconomic and geographic background. Equally 
critical is the development of a data biosphere that enhances 
secure sharing of clinical and research data and biological 
samples for FTD. Broad sharing of datasets will enable the 
larger community of researchers to bring their expertise to 
bear on the challenge of treating and preventing FTD and other 
ADRDs. The Committee also encourages NIH to find ways to 
support more effective communication across researchers, and 
between clinical science and broader society, to ensure that 
the research advances driven by NIH can have maximum effect on 
improving health. FTD is rare and tends to occur at a younger 
age than other forms of dementia. This creates additional 
challenges for clinical trials and research. To overcome these 
challenges as well as recruitment and retention issues, the 
Committee urges NIH to fund investigators who reflect the broad 
variety of study populations who can ensure culturally 
appropriate research is being conducted as well as develop 
innovative clinical trial designs that recruit diverse 
populations so that potential therapies can be tested more 
efficiently and effectively.
    Opioids, Stimulants, and Pain Management.--The Committee 
provides no less than $290,295,000, an increase of $5,000,000, 
in NINDS for the HEAL Initiative. The Committee encourages 
NINDS to continue its efforts through the HEAL Initiative, with 
a focus on grant opportunities to support research and 
education for effective and non-addictive pain management to 
improve outcomes for people with pain in diverse settings 
across the United States.
    Research on Dementia in Parkinson's Disease [PD].--The 
Committee encourages NIA and NINDS to expand the use of fiscal 
year 2025 and beyond AD/ADRD funding to fund projects studying 
dementia in PD. PD is the second most common and fastest 
growing neurodegenerative disease globally and is characterized 
by the abnormal folding of a protein in the brain, which is 
similar to what typically occurs in AD/ADRD. Channeling 
additional resources into research could help to unlock 
groundbreaking dementia-relevant discoveries in crucial areas 
like PD and other closely associated neurological disorders.
    Parkinson's Progression Markers Initiative.--The Committee 
applauds the significant recent breakthroughs in PD research 
made possible in part by public-private partnerships like the 
collaboration between NIH and the Michael J. Fox Foundation for 
Parkinson's Research's Parkinson's Progression Markers 
Initiative [PPMI] that has led to significant discovery. The 
work of the Michael J. Fox Foundation for Parkinson's Research 
PPMI program recently resulted in the discovering an 
unprecedented biomarker for PD that may result in new 
diagnostics and treatments for this common, life-altering 
neurodegenerative disease. Continued partnerships with programs 
like PPMI may greatly advance the field of PD research. The 
Committee encourages NIH and NINDS to further support such 
public-private partnership opportunities with patient groups 
and build on these exciting discoveries to accelerate advances 
against PD.
    Pediatric-Onset Epilepsies Network.--The Committee is aware 
of the enormous economic cost and toll in human suffering 
resulting from epilepsies and considers research in this area a 
high priority. While there are approximately 470,000 children 
currently living with epilepsy, as well as three million 
adults, many of whom were diagnosed as children. A number of 
these types of epilepsy do not respond to existing medications. 
To develop and test more effective therapies, studies must 
precisely classify children with the same epilepsy for clinical 
trials. Creating an infrastructure with a goal of understanding 
pediatric epilepsies diagnoses by cause and coordinating 
research across institutions may increase the potential for 
scientific progress in the era of precision medicine. This 
network could include efforts to unite key assets and support a 
collaborative, multidisciplinary research model to enroll 
patients from many settings to accelerate therapy development 
and expedite translation of research findings into standard 
clinical care. Therefore, the Committee urges NINDS, in 
collaboration with the epilepsies stakeholder community and the 
Curing the Epilepsies conference, to establish the Pediatric-
Onset Epilepsies Network. Such a network could enable 
cooperative research studies, accelerate the development of 
knowledge about epilepsies, and rapidly advance therapeutic 
options, including genetic therapies, and their implementation 
to improve treatments and healthcare outcomes. The Committee 
directs the NIH Director to provide a report on key findings 
and planned actions within 1 year of enactment and annually 
thereafter.
    Preventive and Early-Treatment Cognitive and Brain Health 
Research.--The Committee encourages NIH to give greater 
attention to the study of the pre-symptomatic or preclinical 
stages of neurological disorders, that is, alterations in 
cognitive and brain health before the first clinical symptoms 
of neurological disease when persons typically encounter 
medical professionals. Learning what happens during these 
stages may guide the development of measures for detection and 
monitoring earlier in the course of disease, including 
sensitive neuropsychological measure and biomarkers, which 
could improve early interventions development and testing for 
neurological disease before it becomes disabling and, 
ultimately, prevent diseases like Alzheimer's disease, 
Parkinson's disease, multiple sclerosis, stroke, and epilepsy. 
Mounting evidence suggests that significant pathologies have 
already accumulated by the time symptoms appear and early, pre-
symptomatic intervention may improve outcomes and may reduce 
the costs that neurological disease pose on our health system.
    Spinal Muscular Atrophy [SMA].--The Committee commends NIH 
for its continued support of research in SMA, a rare 
neuromuscular disease. The Committee is aware that past NINDS 
research has led to greater understanding of the nervous system 
and contributed toward approved SMA treatments that slow or 
stop future nerve damage. The Committee also recognizes that 
current treatments do not cure the disease or reverse its 
debilitating symptoms. Without additional SMA research, the 
Committee is concerned that adults and children with SMA who 
were born after treatments and early diagnosis were available 
will continue to face chronic health challenges and significant 
barriers to independence. Furthermore, we do not fully know the 
extent of need among children treated prior to symptom onset. 
As such, the Committee encourages NINDS to expand its research 
in SMA to address fatigue, muscle weakness, motor function 
loss, and other unmet needs that are pervasive among the 
largest segment of the SMA community. Additional research into 
these common needs may also benefit individuals with other 
neuromuscular and rare diseases who face similar challenges.
    Stroke.--Despite notable progress in the stroke mortality 
rate, it remains the fifth leading cause of death and a leading 
cause of severe long-term disability. The Committee supports 
continued research to improve the scientific understanding of 
the brain and stroke, and the translation of that science 
exploring new treatments and improved approaches to stroke 
recovery and rehabilitation through the NIH funded clinical 
trials network StrokeNet. The Committee also supports continued 
stroke-related research conducted through the BRAIN Initiative. 
This initiative is revolutionizing our understanding of the 
brain and offering hope for the millions of individuals 
impacted by brain diseases, disorders, and injuries including 
stroke. African Americans have a disproportionately higher 
prevalence of stroke and the highest death rate from stroke 
compared to any other racial group. The Committee encourages 
continued investment in research to understand and eliminate 
health inequities across neurological disorders and stroke, 
including the Community-Engaged Health Equity Research in 
Neuroscience [HERN] Initiative.
    Tuberous Sclerosis.--The Committee understands the 
importance of continuing to fund research on Tuberous Sclerosis 
Complex in order to support ongoing progress for finding 
cutting-edge treatments and potential cures for Tuberous 
Sclerosis Complex.
    Undiagnosed Diseases Network [UDN].--The Committee provides 
$18,000,000, an increase of $16,000,000, to fund UDN and 
directs the continuation of the coordinating center, all 
clinical sites, DNA sequencing core, central biorepository, 
model organisms screening center, and other necessary testing 
in the pursuit of diagnoses, including but not limited to: 
metabolomics, infectious and toxic exposures, and immune 
abnormalities.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2024....................................  $6,562,279,000
Budget estimate, 2025...................................   6,581,291,000
Committee recommendation................................   6,692,279,000

    The Committee recommendation includes $6,692,279,000, an 
increase of $130,000,000, for the National Institute of Allergy 
and Infectious Diseases [NIAID].
    Antiviral Drug Discovery Centers [AViDDs].--The Committee 
recognizes the importance of research and development of new 
antivirals and their ability to combat new viral outbreaks and 
prevent them from becoming pandemics, and includes $80,000,000 
to continue to support this effort. The Committee supports the 
AViDDs and their mission to develop antiviral drugs to serve as 
our first line of defense against forthcoming viral outbreaks. 
The Committee is concerned that NIH reported to the Comptroller 
General of the United States that future funding for the 
program has been eliminated, leaving them funded for only three 
out of the intended 5 years. The Committee directs NIH to 
continue supporting antiviral drug discovery to mitigate the 
risk of future viral outbreaks.
    Celiac Disease.--The Committee commends NIH for issuing a 
Notice of Special Interest to spur additional research on the 
study of celiac disease. Today, the only known treatment is a 
gluten-free diet; however, recent public and private sector 
research confirms that such a ``treatment'' is insufficient for 
many who suffer from celiac disease. The Committee encourages 
NIH to devote focused research on the study of celiac disease 
and continues to urge the newly created NIH Office of 
Autoimmune Disease Research [OADR] to work with NIAID and other 
NIH Institutes to: support new research on celiac disease; 
better coordinate existing research; and focus new research 
efforts toward causation, diagnosis, management, treatment, 
and, ultimately, a cure of this disease. The Committee directs 
NIH to include updates on research, projects, and programs for 
celiac disease in the fiscal year 2026 CJ.
    Centers for Research on Emerging Infectious Diseases 
[CREID].--The Committee recognizes the importance of detecting 
emerging infectious diseases as early as possible and applauds 
NIAID for creating CREID, a global network of centers dedicated 
to this purpose. The network investigates how and where viruses 
and other pathogens emerge from wildlife and spread diseases to 
people-information that is critical to waging rapid responses 
to such outbreaks. The Committee urges NIAID to provide 
continued funding for the network.
    Diagnostics for Primary Immunodeficiency Disease/Inborn 
Errors of Immunity [PID/IEI].--The Committee recognizes the 
multiple challenges that impede access to a timely and accurate 
diagnosis of PID/IEI. These include needing to improve the 
interpretation of genetic tests and the need for identification 
of biomarkers and other diagnostic tools to both identify forms 
of PID/IEI and to direct/inform targeted treatments. The 
Committee encourages NIAID to prioritize research aimed at 
shortening the time to accurate diagnosis of primary 
immunodeficiency diseases, which will have a significant impact 
on patient outcomes and help lower healthcare costs.
    Equipping NIH Research Programs to Target HIV/AIDS 
Hotspots.--The Committee directs the NIH Office of AIDS 
Research to coordinate NIH-wide resources to focus on areas 
with the highest prevalence of HIV/AIDS, for example, utilizing 
Centers for AIDS Research [CFARs] to develop targeted 
interventions that increase the use of pre-exposure prophylaxis 
[PrEP] and better protect those communities from HIV 
transmission and its consequences.
    Food Allergies.--The Committee recognizes the serious issue 
of food allergies which affect approximately 8 percent of 
children and 10 percent of adults in the United States. The 
Committee commends the ongoing work of NIAID in advancing FDA 
approved treatment options for people with food allergies and 
increasing support for clinical investigation to a total of 24 
clinical sites for this critical research, including 10 sites 
as part of the Consortium for Food Allergy Research [CoFAR]. 
The Committee includes $17,100,000, an increase of $5,000,000, 
for CoFAR to expand its clinical research network to add new 
centers of excellence in food allergy clinical care and to 
select such centers from those with a proven expertise in food 
allergy research.
    Gonorrhea.--The Committee continues to be concerned with 
recent CDC reports that half of all gonorrhea infections in the 
U.S. are resistant to at least one antibiotic and that only one 
treatment option remains. The Committee commends NIAID for 
their efforts to develop new antibiotics and vaccines for the 
multi-drug resistant bacterium and encourages NIAID to 
accelerate work to find new diagnostic tools and treatments for 
these new strains of the disease.
    Hepatitis B.--The Committee applauds NIAID for leading the 
effort to update the Strategic Plan for Trans-NIH Research to 
Cure Hepatitis B, so it remains a robust roadmap to find a 
cure. The Committee is aware of the widely held view in the 
scientific community that finding a cure for hepatitis B, as 
has now been achieved for hepatitis C, is a winnable goal and 
is within reach in the near-term. For these reasons, the 
Committee urges that research, based on the needs as identified 
in the updated Plan, be funded in fiscal year 2025 and beyond. 
The Committee urges NIAID to expand the use of Program 
Projects, R01 and U01 Cooperative Research Agreements, and 
other contract mechanisms to discover and develop new therapies 
for chronic hepatitis B and D. The Committee applauds the 
success of the point of Care Technologies Research Network 
[POCTRN] and Rapid Acceleration of Diagnostics [RADX] programs 
and encourages more use of these programs for development of 
point-of-care tests for HBV, HDV and the cancers caused by 
these viruses. Efforts for establishment of biologically 
relevant animal models, particularly, the immune competent 
small animal models supporting persistent HBV infection, to 
support the development of immune modulators for the functional 
cure of chronic hepatitis B should be supported.
    HIV Self-Testing.--The Committee strongly supports 
advancement of technologies that enable rapid self-testing for 
HIV, particularly those technologies that detect HIV in people 
on current or future therapeutics and vaccines. The Committee 
notes the critical importance of having such self-testing 
technologies available before new options for therapeutic 
control and HIV vaccines become widely available. Self-testing 
technologies are necessary for individuals to know their HIV 
status and seek care to initiate treatment, thereby supporting 
ongoing HIV prevention efforts. Thus, the Committee urges NIH 
to fund as many meritorious proposals as possible to bring 
these important tests to market.
    National Biocontainment Laboratories [NBLs].--The Committee 
provides $33,000,000, an increase of $10,000,000, to the two 
NBLs to support core and shared resources for BSL-4 
containment, enabling them to develop and maintain the research 
resources, facilities and personnel needed to meet the National 
biodefense and emerging infectious diseases research needs in 
the event of a deliberate act of bioterrorism or naturally 
occurring public health emergency. The Committee notes that 
research on high consequence zoonotic viruses requires high-
containment BSL-4 labs. High-containment BSL-4 labs enable 
researchers to diagnose and investigate these types of 
pathogens, and develop rapid and reliable diagnostics, novel 
antiviral therapeutics, and vaccines, without endangering the 
staff or population at large. Additional investments in BSL-4 
infrastructure for research in highly pathogenic zoonotic 
viruses is critical. The Committee directs that this funding be 
used by the NBLs to support (1) maintaining the research 
resources for biodefense, emerging infectious disease agents, 
and other infectious disease threats to global health; (2) 
training new researchers in biosafety level 4 practices; (3) 
maintaining a workforce skilled in BSL-4 research; and (4) 
establishing best practices for the safe, effective, and 
efficient conduct of research in BSL-4 facilities.
    Neglected Disease Research.--The Committee strongly 
supports NIAID's neglected disease research programs. NIH is 
the world's single largest funder of neglected disease research 
and has supported the development of high-impact technologies 
for health areas that receive little attention from industry. 
Many innovation gaps persist, and so these programs should 
remain a priority for NIAID leadership.
    Regional Biocontainment Laboratories [RBLs].--The Committee 
is pleased NIAID competitively awarded UC7 awards to the RBLs. 
The Committee encourages NIAID to allow grantees to carry over 
unused funds into fiscal year 2026 to support this vital work 
of the RBLs. The Committee provides $62,000,000, an increase of 
$10,000,000, to the 12 RBLs to support core and shared 
resources for BSL-3 containment and related activities within 
the RBL facility in its entirety. To the extent possible, of 
this amount, no less than $3,000,000 shall be provided to each 
of the 12 RBLs to support training and maintaining a capable 
research workforce with broad, relevant biomedical, 
technological, veterinary, and regulatory expertise, supporting 
operations, facilities, and equipment purchase costs, and 
supporting research utilizing the capabilities of the RBLs. The 
remaining funding shall go to the 12 RBLs to support: (1) 
research on biodefense, emerging infectious disease agents, and 
other infectious disease threats to global health; (2) training 
new researchers, including in biosafety level 3 practices; (3) 
maintaining a workforce skilled in BSL-3 research; and (4) 
establishing best practices for the safe, effective, and 
efficient conduct of research in BSL-3 facilities. All funding 
shall be used to support the aforementioned activities 
conducted within the RBL, and should not be limited to just the 
BSL-3 space.
    Research on Antimicrobial Resistance [AMR].--The Committee 
provides no less than $565,000,000 to fund NIAID research to 
combat AMR and the training of new investigators to improve AMR 
research capacity as outlined in the 2020-2025 National Action 
Plan to Combat Antibiotic Resistant Bacteria. In the 2020 
National Action Plan for Combating Antibiotic-Resistant 
Bacteria [CARB], 2020-2025, one of the five goals was to 
Accelerate Basic and Applied Research and Development for New 
Antibiotics, Other Therapeutics, and Vaccines in order to 
improve understanding of the many factors that contribute to 
the emergence, spread, and persistence of antibiotic resistance 
and to support new strategies for preventing and mitigating 
infections. NIH has supported research to understand mechanisms 
of AMR spread and to mitigate inappropriate usage of 
antibiotics.
    Syphilis.--The Committee continues to be concerned with the 
rising syphilis rates, and correlation with the syphilis 
increase in women of childbearing age, which often leads to 
congenital syphilis. The Committee commends NIAID for their 
continued work in developing new diagnostic tests for both 
adults and newborns and encourages acceleration of vaccine 
development and new treatment options.
    Tuberculosis [TB].--According to the World Health 
Organization, a total of 1.3 million people died from TB in 
2022 (including 167,000 people with HIV). Worldwide, TB is the 
second leading infectious killer after COVID-19 (above HIV and 
AIDS). Critical scientific research into the development of new 
TB diagnostic, treatment and prevention tools was delayed 
during the COVID-19 pandemic. The Committee commends NIAID on 
the publication of the 2024 update to the Strategic Plan for 
Tuberculosis Research and encourages NIAID to continue its 
implementation.
    Universal Flu Vaccine.--The Committee includes $270,000,000 
to support efforts to develop universal influenza vaccines that 
provides long-lasting protection against numerous flu strains, 
rather than a select few. The Committee urges NIAID to 
prioritize research needed to develop a universal influenza 
vaccine.
    Valley Fever.--The Committee is pleased that NIAID is 
moving forward on execution of its Strategic Plan For Research 
To Develop A Valley Fever Vaccine. The Committee includes 
$4,000,000 for NIAID to continue funding such activities and 
encourages NIAID to continue development of promising vaccine 
candidates, including the canine vaccine, for human use.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2024....................................  $3,244,679,000
Budget estimate, 2025...................................   3,249,375,000
Committee recommendation................................   3,269,679,000

    The Committee recommendation includes $3,269,679,000, an 
increase of $25,000,000, for the National Institute of General 
Medical Sciences [NIGMS], which includes $1,412,482,000 in 
transfers available under 241 of the PHS Act (Public Law 104-73 
as amended).
    Biomedical Research Workforce Training.--Training programs 
at the NIH provide a quality standard of training for graduate 
students and postdoctoral fellows in biomedical research. The 
training grants that support these programs at research 
institutions across the country play a vital role in 
establishing a biomedical research ecosystem and train the next 
generation of researchers for health-related research needs. 
Despite the success of training programs, the number of 
students and postdoctoral scholars supported on training grants 
has remained constant over the years. The Committee applauds 
NIH efforts to increase funding for IDeA States and urges NIH 
to also emphasize the importance of supporting training grants 
in IDeA States. The Committee directs NIH Institutes and 
Centers to conduct and provide to the Committees, a portfolio 
analysis within 120 days of enactment. The analysis will assess 
the distribution of T32 training grants among States, including 
number of applicants and success rates per State to ensure NIH 
is supporting capacity building and a diverse workforce for the 
future biomedical research enterprise. In addition to the 
portfolio analysis, in the fiscal year 2026 CJ, NIH is directed 
to provide an update on specific actions NIH will take to 
identify and remove barriers for applying for training grants 
in IDeA States.
    Expand and Improve Bridge Programs.--The Committee strongly 
supports opportunities for students with limited access to 
STEMM [Science, Technology, Engineering, Mathematics, and 
Medicine] education and research. The Committee recognizes the 
effectiveness and importance of NIGMS bridging programs that 
support historically underserved students and researchers to 
pursue STEMM studies and become the Nation's next generation of 
researchers, including programs such as the Bridges to the 
Baccalaureate Research Training Program, Bridges to the 
Doctorate Research Training Program, Postbaccalaureate Research 
Education Program [PREP], Advancing Research Careers [ARC] 
program, and Maximizing Opportunities for Scientific and 
Academic Independent Careers [MOSAIC] program. The Committee 
urges NIH to expand the size of existing training programs that 
bridge different educational or career stages and establish 
these programs at institutions that have historically received 
low levels of funding support from NIH, including Minority 
Serving Institutions and institutions that are eligible under 
the Department of Education's Strengthening Institutions 
Program. The Committee urges NIH to set clear mentorship and 
support standards for students participating in these programs. 
Finally, the Committee urges NIH to encourage and provide more 
guidance to participating institutions to account for 
sufficient staff and outreach budget and other training-related 
expenses in grant applications.
    Institutional Development Award [IDeA].--The Committee 
recognizes the importance of the IDeA program in enhancing 
geographical representation across NIH's research portfolio, 
and provides no less than $455,956,000, an increase of 
$25,000,000, for the program. In order to ensure that research 
investments from IDeA programs provide maximum benefit, the 
Committee urges NIH to examine ways to increase NIH IDeA State 
participation in major grant programs across NIH's portfolio, 
including those that support biomedical research facilities, 
instrumentation, and training. The Committee notes the 
Biomedical Research Workforce Working Group report and supports 
growing the IDeA funding level to its minimum recommended 
level, which will allow NIH to take advantage of the full 
diversity of the Nation's assets: diversity of individuals, 
diversity of institutions, and diversity of geography. 
Currently eligible States have historically had low aggregate 
success rates for grant applications to NIH and rely on the 
IDeA program to help build a research infrastructure and 
enhance research capacity at institutions in those States. 
Finally, the Committee opposes any efforts within NIH to change 
eligibility for the IDeA program to a system that would be 
based on States' populations.
    IDeA Clinician Researcher Support.--The Committee 
recognizes the NIH's continued efforts to support mentorship 
and career development of clinician researchers through the 
Clinical and Translational Science Awards and other programs. 
However, the Committee is concerned that IDeA-eligible States 
do not have equitable access to funding to support mentored 
career development. The Committee encourages NIH to support 
mentored career development funding for physicians and 
clinicians in IDeA States.
    IDeA Networks for Clinical and Translational Research 
[IDeA-CTR].--The Committee notes the success of the IDeA 
Clinical and Translational Research centers to develop 
infrastructure and human resources to more effectively conduct 
clinical and translational research. Further, the Committee 
notes the potential for further enhancement and progress 
through meaningful collaboration with the Clinical and 
Translational Science Awards [CTSA] program, particularly in 
rural areas. The Committee encourages NIGMS and NCATS to 
provide a general roadmap for collaborative opportunities that 
preserve the autonomy of both programs while removing barriers 
to allow for rapid scientific advancement and improved local 
care and research.
    Increasing Diversity in Biomedical Research.--The Committee 
strongly supports opportunities for the Nation's next 
generation of researchers and efforts to enhance diversity in 
biomedical research. Early-stage researchers, particularly 
those from groups underrepresented in biomedical research, 
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 those groups. Even with these 
obstacles, many early-stage researchers tackle riskier projects 
and have contributed to research that has generated 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 urges 
NIGMS to expand the MOSAIC, ARC program and the Minority Access 
to Research Careers undergraduate 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.
    Minority Serving Institutions.--Congress recognizes the 
importance of highly trained physician-scientists to serve 
diverse communities, decrease health disparities, and enhance 
the biomedical research workforce. The Committee encourages 
NIGMS to support medical scientist training at Minority Serving 
Institutions as defined in title III of the Higher Education 
Act. Such efforts should support dual degree programs that 
train students in medicine and biomedical research.
    Supporting Biomolecular NMR Databanks.--The Committee 
recognizes the essential role that existing, extramural Nuclear 
Magnetic Resonance [NMR] databases located at public academic 
health centers play in fostering medical research and drug 
discovery. As such, the Committee encourages NIGMS to ensure 
that grants which support these valuable scientific community 
assets are of sufficient size to ensure that they can continue 
to add and curate new data, modernize, and support all 
researchers.

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN 
                              DEVELOPMENT

Appropriations, 2024....................................  $1,759,078,000
Budget estimate, 2025...................................   1,766,415,000
Committee recommendation................................   1,779,078,000

    The Committee recommendation includes $1,779,078,000, an 
increase of $20,000,000, for the Eunice Kennedy Shriver 
National Institute of Child Health and Human Development 
[NICHD].
    Andrological Health.--The Committee strongly supports 
translational and clinical research into andrological health, 
and urges NICHD to prioritize and expand these research 
programs.
    Congenital Syphilis [CS].--The Committee continues to be 
concerned with the continued rise in the rates of congenital 
syphilis. CS can lead to life-long deformities and 
disabilities, but with preventative care and treatment, these 
outcomes can be avoided. The Committee encourages NICHD to 
coordinate efforts with NIAID on new testing, diagnosis, and 
treatment efforts.
    Endometriosis.--The Committee urges NICHD to continue 
expanding basic, clinical, and translational research into the 
mechanisms of endometriosis, including root causes of the 
disease and new treatment methods. The Committee encourages 
research on the genetic and immune system components of 
endometriosis. The Committee further encourages NIH to devote 
more resources to support targeted research of endocrine 
disrupting chemicals in endometriosis, the relationship of 
endometriosis and cancer, prenatal and epigenetic influences on 
the risk for endometriosis. The Committee also encourages 
research on non-invasive diagnostics of endometriosis to reduce 
diagnosis delay and improve treatment. The Committee encourages 
research on the growth of endometriosis and endometriosis 
recurrence post-surgical procedures or medical therapeutics.
    Implementing a Maternal Health and Pregnancy Outcomes 
Vision for Everyone [IMPROVE] Initiative.--The Committee 
provides no less than $73,400,000 for this activity, an 
increase of $20,000,000. The Committee is aware that NICHD's 
current Maternal Health Research Centers of Excellence provide 
a platform to further both research and clinical care in 
reducing maternal morbidity and mortality. The Committee 
appreciates NIH's commitment to supporting Centers in areas of 
the country that see the highest rate of both. The Committee 
encourages NICHD to continue to expand its current Centers of 
Excellence with a particular emphasis on increasing support for 
existing centers and establishing new ones in regions of 
greatest need, eliminating racial and ethnic disparities in 
maternal morbidity, and training a diverse group of early-stage 
scientists in maternal health equity research.
    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. 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.
    Maternal Fetal Medicine Units.--The Committee continues to 
support the work of NICHD's Maternal-Fetal Medicine Units 
Network [MFMU]. Since 1986, the MFMU Network has been 
performing multi-site clinical research focused on gathering 
data needed to ensure obstetric patients across the country and 
the world are receiving evidence-based and cost-effective care. 
In fiscal year 2024, Congress requested an update from NICHD on 
its historical investment in the MFMU and plans to sustain and 
enhance that investment going forward. The Committee remains 
concerned that the new network structure introduced in 2022, 
which requires clinical trial proposals for the MFMU Network to 
be considered through the broader NIH grant application 
process, will limit the number of clinical trials performed 
within the MFMU. The Committee requests an update within the 
fiscal year 2026 CJ on the total funding for MFMU Network 
supported clinical trials awarded in each of fiscal years 2010-
2022. This update should detail amounts spent on clinical 
trials and separately account for base funding for the MFMU 
Network clinical sites and data coordinating center. Further, 
NICHD should provide an update on plans to ensure that NIH will 
continue to fund clinical research conducted by the MFMU at the 
same or greater funding levels in the upcoming grant cycle 
compared with prior cycles.
    Maternal Morbidity and Mortality.--The Committee is 
concerned about recent closures of obstetrics and gynecology 
units in rural hospitals across the country and their impact on 
patient access to care. The Committee encourages NICHD to 
support research on this issue, including examining how these 
closures are affecting maternal morbidity and mortality.
    Pelvic Organ Prolapse.--Pelvic organ prolapse [POP] occurs 
when the pelvic floor muscles and connective tissue supporting 
the pelvic organs fail, causing one or more of the pelvic 
organs to fall downward, protruding out of the body. POP is a 
common problem, with 1 out of 8 women undergoing surgery for 
prolapse at some point in their life. Symptomatic POP is 
associated with urinary incontinence, depression, anxiety, 
sleep disturbance, deteriorating physical function and 
diminished socialization. Therefore, the Committee urges the 
NICHD to support prospective studies that can be added on to 
existing maternal-morbidity research, including research 
studies being conducted in underserved areas, to assess 
preventative strategies for POP including ways to decrease 
pelvic floor trauma/denervation during delivery, with the goal 
of reducing the risk of subsequent POP and its complications. 
The Committee requests an update on research activities to 
advance POP prevention and treatment in the fiscal year 2026 
CJ.
    Population Research.--The Committee commends NICHD for 
supporting prospective, population representative longitudinal 
studies, including the Panel Study of Income Dynamics Child 
Development Supplement, Future of Families and Child Wellbeing 
Study, and National Longitudinal Survey of Youth. Data from 
these studies are public goods used widely to inform research 
and training activities conducted by thousands of scientists at 
universities nationwide, including underserved institutions, 
and are heavily used by new and early-stage investigators. In 
addition, these studies are the only nationally representative 
data scientists may use to analyze, for example, how parental 
and grandparental characteristics affect children's outcomes 
and the impact of adverse childhood experiences over the life 
course. NICHD is encouraged to continue supporting this type of 
research.
    Severe Maternal Morbidity.--The Committee is concerned that 
despite the high rate of severe maternal morbidity in the 
United States, there is not a uniform definition of severe 
maternal morbidity. Having a uniform definition would help 
Federal, State and local agencies and research institutions 
establish standardized and interoperable processes for billing 
surveillance, data collection and research. The collected data 
could then inform the development and deployment of targeted, 
evidence-based prevention and treatment programs to reduce the 
incidence of severe maternal morbidity. The Committee 
encourages NICHD to hold a formal convening of subject matter 
experts and organizational representatives, including 
representatives from the CDC, HRSA, NICHD, the Office of the 
National Coordinator for Health Information Technology, FDA, 
and public stakeholders, to determine a uniform definition of 
severe maternal morbidity. The Committee directs NICHD to 
provide a report in the fiscal year 2026 CJ on the proceedings 
of convening including formal definitions for severe maternal 
morbidity.
    Women's Reproductive Health Research [WRHR] Program.--The 
Committee encourages NICHD to continue to fund WRHR scholars, 
with the goal of increasing the diversity of the scholars, 
sites, and research supported by the program. The Committee 
recognizes the effectiveness of the WRHR program, which 
provides an opportunity for obstetrician/gynecologists who 
recently completed postgraduate clinical training to further 
their training in basic, translational and clinical research.

                         NATIONAL EYE INSTITUTE

Appropriations, 2024....................................    $896,549,000
Budget estimate, 2025...................................     898,818,000
Committee recommendation................................     896,549,000

    The Committee recommendation includes $896,549,000 for the 
National Eye Institute [NEI].
    Usher Syndrome.--The Committee encourages NIH to enhance 
and prioritize Usher syndrome research at NEI. The Committee 
requests an update in the fiscal year 2026 CJ. The update 
should include efforts to stimulate the field and to accelerate 
viable human treatment options for those with Usher syndrome.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2024....................................    $913,979,000
Budget estimate, 2025...................................     916,791,000
Committee recommendation................................     913,979,000

    The Committee recommendation includes $913,979,000 for the 
National Institute of Environmental Health Sciences [NIEHS].
    Disaster Research Response Program.--The Committee urges 
NIEHS to support research and community engagement activities 
related to the health of individuals affected by the train 
derailment in East Palestine, Ohio, including first responders 
and local residents in both Ohio and Pennsylvania.
    East Palestine.--The Committee directs $2,000,000 to carry 
out section 2 of the East Palestine Health Impact Monitoring 
Act of 2024, with funding to remain available until September 
30, 2029.
    Environmental-related Health Conditions.--The Committee 
provides $40,000,000 for NIEHS to continue research on the 
impacts that changing environmental conditions have on human 
health.
    Heated Oil Fumes Health Impact.--The Committee is concerned 
that aircraft crews and some frequent fliers can be exposed to 
low concentrations of oil fumes routinely and to higher 
concentrations during a documented event. The Committee 
encourages NIEHS to investigate the health effects of 
inhalation exposure to heated oil fumes in aircraft flight 
decks and cabins.
    Indoor Air.--The Committee urges NIEHS to continue 
researching indoor pollutants, including from combustion 
indoors, to better understand the indoor air landscape and its 
impacts. The Committee requests an update on these activities 
in the fiscal year 2026 CJ.
    Wildfire Smoke.--The Committee recognizes that exposure to 
smoke from wildfires is no longer a rare occurrence and is a 
reality for millions of Americans. The Committee is concerned 
that public health experts do not yet fully understand the risk 
posed by exposure to wildland fire smoke--particularly acute 
and chronic smoke exposure to patients with existing pulmonary 
and cardiac disease. The Committee encourages NIEHS to support 
research to understand the health risks associated with 
wildfire smoke exposure and any interventions that can be 
implemented to mitigate adverse health effects.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 2024....................................  $4,507,623,000
Budget estimate, 2025...................................   4,425,295,000
Committee recommendation................................   4,645,123,000

    The Committee recommendation includes $4,645,123,000, an 
increase of $137,500,000, for the National Institute on Aging 
[NIA].
    Alzheimer's Disease/Alzheimer's Disease-Related Dementias 
[AD/ADRD].--Since fiscal year 2015, Congress has increased 
research funding for AD/ADRD by more than 500 percent, making 
it the largest expenditure of its kind in NIH. By 2050, the 
cost to treat and care for those suffering from Alzheimer's 
disease is expected to rise to as high as $1,100,000,000,000 a 
year. Without a medical breakthrough to prevent, slow, or stop 
the disease, Medicare- and Medicaid-related costs could rise 
more than four-fold. NIH-funded research offers hope for 
finding solutions to manage this disease successfully in the 
future. Therefore, the Committee continues to support 
Alzheimer's disease research, including multi-disciplinary 
approaches into the basic science and pathology of the disease, 
which builds upon the funding goals needed to prevent and 
effectively treat Alzheimer's by 2025 identified in the 
National Plan required by the National Alzheimer's Project Act 
(Public Law 111-375). The Committee includes an increase of 
$275,000,000 across NIH for AD/ADRD research, including an 
increase of $137,500,000 in NINDS and $137,500,000 in NIA. The 
NIA is encouraged to continue addressing the research targets 
outlined in the fiscal year 2025 Professional Judgment Budget. 
In addition, NIA is directed to provide an update on activities 
related to this research in the fiscal year 2026 CJ.
    Clinical Trials.--Although Alzheimer's disease and other 
dementias disproportionately affect Black Americans, Hispanic 
Americans, Asian American and Pacific Islanders, and Native 
Americans, they continue to be underrepresented in AD/ADRD 
clinical trials. The Committee directs NIA to work with the 
Alzheimer's Disease Research Centers and other organizations to 
promote participation in clinical trials within 
underrepresented populations and, to the maximum 
scientifically-feasible extent, reduce the burden of 
participating. These efforts should include expanding community 
engagement and outreach to these populations, incentivizing 
trial locations in areas of unmet need, encouraging the 
diversity of clinical trial staff, allowing appropriate 
flexibility in trial design and inclusion and exclusion 
criteria, and utilizing technology like remote patient 
monitoring, where appropriate, to facilitate clinical trial 
participation and retention. Further, NIA recently provided an 
assessment of the data and metrics it collects related to the 
planning, recruitment, and retention of clinical trial 
participants from underrepresented communities and how those 
data have been or plan to be used in grant-making decisions. 
The assessment also addressed how NIA plans to provide more 
timely data to the Committees and greater transparency to the 
public about the planning, engagement, and recruitment efforts 
of its extramural grantees, including a focus on addressing 
barriers to inclusive and representative enrollment such as 
eligibility criteria, language accessibility, and adequate 
planning for diverse enrollment among grantees. The Committee 
directs NIA to provide an update on activities related to this 
assessment in the fiscal year 2026 CJ. In addition, with 
various treatments for Alzheimer's disease in the pipeline, the 
Committee encourages NIA to support a wide range of trials, 
including those with a patient-based national registry of 
regulatory grade, longitudinal evidence for patients receiving 
any FDA-approved disease modifying therapies for Alzheimer's 
disease in real-world clinical practice.
    Digital Innovation for Aging in Place.--Recent 
technological developments have allowed aging Americans to stay 
in their homes and maintain their independence for as long as 
possible. The Committee strongly encourages NIA to fund 
research that designs and develops digital innovations that 
improve health and medical treatment. These efforts could 
include establishing a smart living environment leveraging 
technologies to improve health and medical treatment, equipping 
homes to enable varying levels of remote care and improved 
diagnosis and treatment, and encouraging medical facilities to 
adopt health technologies, including AI and machine learning, 
to expand to the home space enabling older adults to age in 
place.
    Female Reproductive Aging.--The Committee acknowledges the 
NIA for its pioneering efforts in geroscience and underscores 
the importance of investigating female reproductive aging, a 
critical yet understudied aspect of women's health and 
longevity. For example, aging of the female ovary occurs at a 
more accelerated pace compared to other tissues and organs, 
posing significant implications for fertility, reproductive 
health, and overall well-being. This distinct aging process 
highlights the need for a deeper understanding of the cellular, 
molecular, genetic and epigenetic factors driving early onset 
of female reproductive aging. To ensure progress in this 
pivotal research area, the Committee encourages NIA to convene 
a workshop with experts from NIH, other relevant Federal 
agencies, academic institutions, and the private sector to 
explore the mechanisms that influence female reproductive 
aging, its impact on women's health including and beyond 
reproductive capacity, and the development of strategies and 
interventions to mitigate its effects. The Committee requests 
an update in the fiscal year 2026 CJ.
    Palliative Care Research.--The Committee provides 
$12,500,000 for NIA to coordinate the work of a multi-institute 
and multi-Center initiative for palliative care research, 
including extramural-based research infrastructure, by 
developing early and mid-stage researchers, and engaging 
various healthcare systems, providers, and community partners. 
The Committee recognizes that palliative care is a critical 
area of research and informs supportive care for patients of 
all ages with serious illness and their families focused on 
relief of symptoms and suffering, communication of prognosis 
and treatment options in the context of patient goals, and 
coordination of care within and across healthcare settings.
    Population Research.--The Committee commends NIA for 
supporting a robust population aging research portfolio that 
includes research grants, centers, networks, training programs, 
and population representative surveys studying how demographic, 
social, and economic factors impact the health and well-being 
of older people. In fiscal year 2025, the Committee is pleased 
to learn that NIA plans to renew funding for its Centers on 
Demography and Economics of Aging program. The current 15 
centers provide essential infrastructure and data, stimulating 
aging research and training activities on topics such as 
physical and cognitive functioning, disability, health 
disparities, and Alzheimer's disease, nationwide. The Committee 
urges NIA to encourage enhanced collaboration among its 
centers, including the Centers on Demography and Economics of 
Aging, Alzheimer's Disease Research Centers, and Roybal Centers 
for Translational Research in the Behavioral and Social 
Sciences of Aging.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 2024....................................    $685,465,000
Budget estimate, 2025...................................     689,697,000
Committee recommendation................................     685,465,000

    The Committee recommendation includes $685,465,000 for the 
National Institute of Arthritis and Musculoskeletal and Skin 
Diseases [NIAMS].
    Alopecia Areata.--The Committee notes the disproportionate 
effect of alopecia areata on people of color, specifically 
women. NIAMS research has uncovered genetic factors that are 
associated with alopecia areata, many of which have been 
implicated in other autoimmune diseases. The Committee 
encourages NIAMS to explore collaborative opportunities with 
key stakeholders to advance critical research projects into 
causes and treatments. The Committee requests an update on 
collaborative efforts with relevant Institutes and Centers and 
stakeholders in identifying key research areas of concern in 
the fiscal year 2026 CJ.
    Atopic Dermatitis.--The Committee recognizes NIAMS ongoing 
efforts to incorporate community feedback and otherwise craft a 
new Strategic Plan for Fiscal Year 2025--2029. The Committee 
notes the tremendous opportunity for cross-NIH 
multidisciplinary research into atopic dermatitis and other 
forms of eczema and encourages further efforts to coordinate 
with other institutes and centers to complement emerging NIAMS 
activities and to effectively coordinate the overall research 
portfolio in atopic dermatitis.

    NATIONAL INSTITUTE OF DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 2024....................................    $534,333,000
Budget estimate, 2025...................................     535,929,000
Committee recommendation................................     534,333,000

    The Committee recommendation includes $534,333,000 for the 
National Institute of Deafness and Other Communication 
Disorders [NIDCD].

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2024....................................    $197,693,000
Budget estimate, 2025...................................     198,263,000
Committee recommendation................................     197,693,000

    The Committee recommendation includes $197,693,000 for the 
National Institute of Nursing Research [NINR].
    Health Disparities Research.--The Committee continues to 
provide $10,000,000 for NINR to support research related to 
identifying and reducing health disparities.

           NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2024....................................    $595,318,000
Budget estimate, 2025...................................     598,903,000
Committee recommendation................................     595,318,000

    The Committee recommendation includes $595,318,000 for the 
National Institute on Alcohol Abuse and Alcoholism [NIAAA].
    Fetal Alcohol Spectrum Disorders [FASD].--The Committee 
supports NIAAA efforts to accelerate FASD basic, prevention, 
diagnosis, and treatment research. The Committee encourages 
NIAAA to continue efforts to support innovative research and to 
disseminate research findings to States, Tribes, and provider 
and non-profit organizations in increasing FASD diagnostic 
capacity, enhancing FASD prevention programs, developing 
resources for systems of care, training service providers and 
professionals, and responding to the needs of individuals.
    Reducing Alcohol Related Mortality.--The Committee is 
concerned by the high rates of alcohol misuse and alcohol-
related morbidity and mortality in the United States. The 
Committee urges NIAAA to continue supporting research on 
prevention programs that focus on populations most affected by 
alcohol misuse and alcohol-related mortality. This research can 
include the development, testing, and implementation of 
prevention interventions to reduce alcohol misuse.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2024....................................  $1,662,695,000
Budget estimate, 2025...................................   1,668,343,000
Committee recommendation................................   1,667,695,000

    The Committee recommendation includes $1,667,695,000, an 
increase of $5,000,000, for the National Institute on Drug 
Abuse [NIDA].
    Barriers to Research.--The Committee is concerned that 
restrictions associated with Schedule I of the Controlled 
Substances Act effectively limits the amount and type of 
research that can be conducted on certain Schedule I drugs, 
especially opioids, psychedelics, marijuana or its component 
chemicals, and new synthetic drugs and analogs. At a time when 
we need as much information as possible about these drugs and 
antidotes for their harmful effects, we should be addressing 
regulatory and other barriers to conducting this research. The 
Committee appreciates NIDA's completion of a report on the 
barriers to research that result from the classification of 
drugs and compounds as Schedule I substances including the 
challenges researchers face as a result of limited access to 
sources of marijuana, including dispensary products.
    Cocaine Overdose Treatment.--The Committee remains 
concerned about the drug overdose epidemic and the surge in 
overdose deaths involving stimulants, including cocaine. The 
Committee recognizes that NIDA is prioritizing research and 
development of treatments which can rapidly reverse cocaine 
toxicity and reduce mortality rates, addressing the severe gap 
in this unmet medical need. Due to the unavailability of an 
FDA-approved cocaine overdose reversal medication, the 
Committee encourages NIDA to continue prioritization of 
additional research and development to advance a life-saving 
treatment for overdoses caused by cocaine.
    Alternative Clinical Trial Endpoints for Substance Use 
Disorders.--Although there are effective medications for 
treating opioid, tobacco, and alcohol use disorders, these 
treatments do not work for everyone--and to date, no 
medications have been approved by FDA to treat stimulant use 
disorders. The Committee therefore encourages FDA and NIDA to 
collaborate on the establishment of endpoints other than 
abstinence for use in clinical trials of medications to treat 
substance use disorders. Such alternative endpoints may include 
reduced craving (defined as a strong desire or urge to use 
drugs), reduced drug use, or reduced substance use disorder 
severity. The Committee appreciates NIDA-funded research on 
using alternative endpoints in clinical research on substance 
use disorders, such as the recent finding that reduced drug use 
is associated with meaningful clinical improvements for people 
with stimulant use disorders. The Committee urges FDA and NIDA 
to build upon such research and work together toward 
incorporating alternative endpoints into clinical trials for 
substance use disorders.
    Investments in Basic Research.--The Committee is aware that 
basic research is the foundation for clinical research, both of 
which pave the way to new or improved treatments for substance 
use disorders. Basic research can focus on the causal 
mechanisms underlying the functioning of the human body and 
provides a critical understanding of the short- and long-term 
impacts of drug use. The discoveries that are made through 
basic research can often be translated directly into improved 
patient care, including novel medications, fewer drug-related 
fatalities, and science-based methods for preventing substance 
use and substance use disorders. The Committee encourages 
NIDA's continued investments in investigator-initiated grants 
in basic research and support for training of young 
investigators to ensure a healthy and growing population of 
researchers.
    Methamphetamine and Other Stimulants.--The Committee is 
concerned that, according to predicted provisional data 
released by CDC, overdose deaths involving drugs in the 
categories that include methamphetamine and cocaine increased 
by 38 and 43 percent respectively, in just 2 years. This sharp 
increase has led some to refer to stimulant overdoses as the 
``fourth wave'' of the current drug overdose epidemic in 
America following the rise of opioid-related deaths involving 
prescription opioids, heroin, and fentanyl-related substances. 
No FDA-approved medications are available for treating 
methamphetamine, cocaine, and other stimulant use disorders. 
While there are currently approved medication assisted 
treatments [MATs] for alcohol and opioid addiction there 
remains no approved MAT for methamphetamine addiction. The 
Committee urges NIDA to continue its ongoing trials in order to 
expeditiously find and approve a MAT for methamphetamines. 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 disorders 
and related deaths.
    Opioid Initiative.--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 increases in opioid overdose deaths since 2020, with the 
primary driver being the increased overdose deaths involving 
synthetic opioids, primarily fentanyl. Approximately 295 people 
die each day in this country from drug overdose (over 224 of 
those are directly from opioids), making it one of the most 
common causes of non-disease-related deaths for adolescents and 
young adults. To combat this crisis, the Committee has provided 
within NIDA's budget no less than $370,295,000, an increase of 
$5,000,000, for the Institute's share of the HEAL Initiative 
and in response to rising rates of stimulant use and overdose. 
The Committee encourages NIDA to continue research on the 
development of safe and effective medications and new 
formulations and combinations to treat substance use disorders 
and prevent or reverse overdose, and to continue research on 
comprehensive care models in communities nationwide to prevent 
and treat opioid misuse and opioid use disorder, expand 
treatment capacity, enhance access to overdose reversal 
medications for opioid use disorder, and enhance prescriber 
practice; test interventions in justice system settings to 
expand the uptake of medication treatment and methods to scale 
up these interventions; and develop evidence-based strategies 
to integrate screening and treatment for opioid use disorders 
in emergency department and primary care settings. The 
Committee has included language expanding the allowable use of 
these funds to include research related to stimulant use and 
addiction.
    Overdose Reversal Drugs.--Recognizing the increasing 
severity of the National opioid crisis and the need to better 
our options for responding to, treating, and preventing 
overdoses, the Committee encourages NIDA to prioritize research 
to expedite treatments for and prevention of overdose from 
fentanyl, fentanyl analogs, and other emerging substances. 
Grant recipients should be able to develop and advance 
additional treatment and overdose prevention options such as a 
human IgG1 monoclonal antibody specific for fentanyl and 
structurally related fentanyl analogs to be delivered by 
intravenous, subcutaneous, and/or intramuscular (i.e., auto-
injection) routes of administration.
    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 healthcare providers (doctors, nurses, dentists, and 
pharmacists), patients, and families. Medical professionals 
must be in the forefront of efforts to curb the opioid crisis. 
The Committee continues to be pleased with the NIDAMED 
initiative, targeting physicians-in-training, including medical 
students and resident physicians in primary care specialties 
(e.g., internal medicine, family practice, emergency medicine, 
and pediatrics). The Committee encourages NIDA to continue to 
provide clinical resources to providers to help identify and 
treat patients with substance use disorder.
    Youth E-Cigarette Use.--The Committee is aware of alarming 
trends in youth e-cigarette use and recent survey data from CDC 
indicating that more than 10 percent of high school students 
and 4.6 percent of middle school students reported using e-
cigarettes in the previous 30 days in 2023. The Committee 
understands that electronic cigarettes (e-cigarettes) and other 
vaporizing equipment remain popular among adolescents, and 
requests that NIDA continue to fund research on the use and 
consequences of using these devices. The Committee is pleased 
that NIDA continues to support the Monitoring the Future survey 
and Population Assessment of Tobacco and Health studies, which 
provide timely data on tobacco products and other drug use. 
Finally, with more than 4 million young people using e-
cigarettes, there is a greater need for research into 
therapeutic options for nicotine cessation among youth who have 
developed addiction to nicotine. The Committee encourages NIDA 
to continue supporting research to develop therapies, including 
both pharmacologic and behavioral therapies, to combat nicotine 
addiction in pediatric populations.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2024....................................  $2,187,843,000
Budget estimate, 2025...................................   2,503,162,000
Committee recommendation................................   2,642,343,000

    The Committee recommendation includes $2,642,343,000, an 
increase of $454,500,000, for the National Institute of Mental 
Health [NIMH].
    Autism Spectrum Disorder [ASD].--The Committee encourages 
NIH to support greater investment in research on autism, 
particularly in areas outlined in the Interagency Autism 
Coordinating Committee's [IACC] Strategic Plan for ASD. The 
Committee urges NIMH to work in close partnership with the 
other Institutes that serve on the IACC to provide an update on 
the level of research investment for each of the priority areas 
outlined in the IACC Strategic Plan for ASD. While significant 
progress has been made in the understanding of autism, large 
gaps remain in the ability to improve outcomes and access to 
services for autistic individuals across their life span. 
Research has shown that autistic individuals have higher rates 
of some co-occurring physical and mental health conditions, 
impacting quality of life and increasing medical utilization 
and costs. Additionally, there are significant unaddressed 
racial, ethnic, and socioeconomic health equity challenges 
experienced by autistic individuals across their life span and 
by their families. As such, the Committee encourages NIMH to 
work collaboratively with NIMHD to support research on the 
socioeconomic, racial, and ethnic health disparities associated 
with ASD, and to work collaboratively with other institutes 
including NIA, NIEHS, and NINDS to support research on the 
impact of neurological, social, and environmental factors 
leading to co-occurring health conditions.
    Computational Resources.--The Committee is aware of and 
concerned about the neural basis of complex mental disorders 
for pediatric and adolescent children. The Committee 
understands these neuroimaging data are among the most 
challenging for university researchers to analyze. The 
Committee encourages NIMH to consider funding programs and 
projects that would increase the capacity for computational 
hardware and resources for analysis and training to identify 
neural patterns that are protective against mental illnesses. 
The Committee also encourages NIMH to prioritize research 
related to the development of new algorithmic approaches to 
integrate complex data sources to improve diagnosis, treatment, 
and protection of mental illnesses.
    Mental Health Research.--In recognition of the country's 
unprecedented mental health crisis, the Committee provides a 
$275,000,000 increase for mental health research. This funding 
is provided to support research focused on developing targeted 
prevention of and treatment for mental illness. The Committee 
expects this funding will be used to accelerate better 
diagnostics, improved therapeutics and behavioral treatments, 
and enhanced precision of mental healthcare; continue to 
develop a new Precision Psychiatry Initiative; and support 
studies of social media's impact on mental health. The 
Committee supports NIMH efforts to launch a new depression 
biomarker development effort to guide treatment decisions for 
major depression and identify research gaps and opportunities 
for understanding relationships among social media behavior, 
social media engagement, and youth mental health. These 
initiatives will combine innovative physiological and 
behavioral methods to better predict patient prognosis and 
optimize treatment. In addition, the Committee continues to be 
concerned about the effects of the COVID-19 pandemic on mental 
and behavioral health and encourages NIMH to support research 
into the impacts of the pandemic on mental health.
    Peer Support for Youth.--The Committee understands that 
many youth who are struggling with their mental health seek out 
peer support services, often because they are not ready to 
engage or do not have access to clinical healthcare. But while 
numerous studies have shown that peer support increases help-
seeking behavior and reduces social isolation in adults, 
research on youth peer support services and peer-to-peer 
counseling programs is limited. Therefore, the Committee 
encourages NIMH to prioritize research in these areas, 
including how to scale up such services and programs 
effectively. In addition, the Committee encourages NIMH to 
continue to regularly hear from young people to inform its 
future research priorities through its Advisory Council, 
strategic planning process, focus groups or similar leadership 
methods. The Committee supports the agency's existing youth-
informed activities and encourages additional efforts to grow 
youth engagement in setting its research priorities and 
carrying out participatory research.
    Suicide Prevention.--The Committee recognizes that suicide 
a complex, and serious public health problem with multiple 
contributing factors, including biological, psychological, 
social, and environmental. The Committee encourages NIMH to 
direct additional attention to suicide prevention research 
across all of these areas, as well as the application of novel 
measurement techniques, statistical analysis, digital 
initiatives and information systems. The Committee also 
encourages NIMH to promote greater collaboration with other NIH 
Institutes and Centers with expertise in research areas that 
can contribute to suicide prevention, especially NIA, NICHD, 
NHGRI, NIAAA and NIDA. The Committee requests an update on 
these activities in the fiscal year 2026 CJ.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2024....................................    $663,200,000
Budget estimate, 2025...................................     663,660,000
Committee recommendation................................     663,200,000

    The Committee recommendation includes $663,200,000 for the 
National Human Genome Research Institute [NHGRI].
    Pharmacogenomic Research.--The Committee notes that an 
individual's genome influences responses to medications, 
including side effects, metabolization of medications, and 
effectiveness of medications, and therefore recognizes that 
additional research is needed to support the advancement of 
pharmacogenomics.
    Proteomics.--The Committee recognizes the promise of 
research into the proteome in the study of biological systems. 
The ability to effectively and efficiently analyze protein 
patterns and their changes over time has potential to provide 
valuable insights into a person's real-time state of health 
including identifying existing disease, understanding the 
biological drivers of that disease, predicting near-term health 
events, and guiding effective therapeutic interventions. The 
Committee urges NHGRI to utilize existing resources to engage 
with academia and domestic industry partners to expand its 
research into this cutting-edge field.

      NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2024....................................    $440,627,000
Budget estimate, 2025...................................     441,944,000
Committee recommendation................................     440,627,000

    The Committee recommendation includes $440,627,000 for the 
National Institute of Biomedical Imaging and Bioengineering 
[NIBIB].
    Biomedical Technology Development.--The Committee is 
pleased with the success of the Rapid Acceleration of 
Diagnostics Tech program in accelerating the innovation and 
commercialization of COVID-19 diagnostic technologies. The 
Committee appreciates NIBIB's efforts to expand the innovation 
funnel model beyond COVID-19 testing to address other critical 
unmet needs in diagnostic testing and other biomedical 
technologies and encourages NIBIB to continue these efforts in 
fiscal year 2025 in consultation with other institutes and 
centers, including but not limited to NHLBI, NIAID, NICHD, NIA, 
NINDS, and NIMH. The Committee further directs NIBIB to provide 
an update in the fiscal year 2026 CJ on progress of these 
efforts.

        NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH

Appropriations, 2024....................................    $170,384,000
Budget estimate, 2025...................................     170,894,000
Committee recommendation................................     170,384,000

    The Committee recommendation includes $170,384,000 for the 
National Center for Complementary and Integrative Health 
[NCCIH].
    Pain Management.--The Committee includes $5,000,000 to 
support research into non-pharmacological treatments for pain 
management and urges NCCIH, along with DOD and VA, to continue 
to support research, including comorbidities such as opioid 
misuse, abuse, and disorder among military personnel, veterans, 
and their families. The Committee urges NIH, VA, and DOD to 
expand research on non-pharmacological treatments for veterans 
and service members.

      NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2024....................................    $534,395,000
Budget estimate, 2025...................................     526,710,000
Committee recommendation................................     539,395,000

    The Committee recommendation includes $539,395,000, an 
increase of $5,000,000, for the National Institute on Minority 
Health and Health Disparities [NIMHD].
    Improving Native American Cancer Outcomes.--The Committee 
notes that Native Americans experience overall cancer incidence 
and mortality rates that are strikingly higher than non-Native 
populations. The Committee includes $8,000,000, an increase of 
$2,000,000, for the Initiative for Improving Native American 
Cancer Outcomes to support efforts including research, 
education, outreach, and clinical access related to cancer in 
Native American populations. The Committee further directs 
NIMHD to work with NCI to locate this Initiative at an NCI-
designated cancer center demonstrating partnerships with Indian 
Tribes, Tribal organizations, and urban Indian organizations to 
improve the screening, diagnosis, and treatment of cancers 
among Native Americans, particularly those living in rural 
communities.
    Native Hawaiian/Pacific Islander Health Research Office.--
The Committee includes $7,000,000, an increase of $3,000,000, 
for a Native Hawaiian/Pacific Islander Health Research Office. 
This office should focus on both addressing Native Hawaiian and 
Pacific Islander [NHPI] health disparities as well as 
supporting the pathway and research of NHPI investigators. The 
office should develop partnerships with academic institutions 
with a proven track record of working closely with NHPI 
communities and NHPI-serving organizations and located in 
States with significant NHPI populations to support the 
development of future researchers from these same communities.
    Research Centers at Minority Institutions [RCMI] Program.--
The Committee encourages NIMHD to continue investing in this 
program to provide more opportunities for health professions 
institutions with historical missions and precedence of serving 
minorities and building research infrastructure to conduct 
minority health and health disparities research.
    Research Endowment Program.--The Committee is pleased with 
NIMHD's reinvigoration of the Research Endowment Program and 
recent investments in the program. The Committee urges NIMHD to 
increase funding available to existing grantees and continue to 
expand and assist eligible institutions receiving grants with 
this additional funding through a competitive process.

 JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH 
                                SCIENCES

Appropriations, 2024....................................     $95,162,000
Budget estimate, 2025...................................      95,415,000
Committee recommendation................................      95,162,000

    The Committee recommendation includes $95,162,000 for the 
Fogarty International Center [FIC].
    Fogarty International Center [FIC].--The Committee 
recognizes the need to support resources for FIC for its work 
in strengthening health research systems, training infectious 
disease researchers, and improving pandemic preparedness in 
low- and middle-income countries [LMICs]. FIC supports cross-
cutting research and research training programs that apply to a 
broad range of health threats, enabling grantees and trainees 
to anticipate and respond effectively to new global challenges. 
Programs within FIC support training for researchers in the 
development and use of powerful tools such as data science, 
mobile health, and bioinformatics, which are applied to 
anticipating and controlling a wide range of global health 
threats that could impact the United States. The Committee 
encourages FIC to continue to expand training and research 
partnerships with schools and programs of public health and 
related academic institutions in support of this core mission. 
In addition, the Committee supports expanding FIC's role in 
pandemic preparedness and research capacity building, including 
by strengthening international coordination, increasing 
capacity for computational modeling and outbreak analytics, and 
supporting research to reduce health disparities and improve 
implementation of health interventions in low-resource 
settings.
    Global Infectious Disease Research Training Program.--The 
Committee recognizes that building a critical mass of 
researchers in developing countries is essential to controlling 
infectious diseases. Such researchers are key to generating new 
strategies for disease prevention and treatment. Therefore, the 
Committee urges FIC to prioritize funding for the Global 
Infectious Disease Research Training Program.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 2024....................................    $497,548,000
Budget estimate, 2025...................................     526,796,000
Committee recommendation................................     597,548,000

    The Committee recommendation includes $597,548,000, an 
increase of $100,000,000, for the National Library of Medicine 
[NLM].
    Data Initiative.--The Committee supports the transformation 
of NLM from its traditional role as a repository of data and 
research results to one where it serves as an active hub 
coordinating the use of ever-expanding data resources and 
facilitates researcher access to advanced analytics, including 
artificial intelligence and machine learning techniques. The 
Committee provides $100,000,000 to begin to expand NLM's data 
storage capabilities and develop the tools, computational 
resources, and datasets necessary to establish a federated 
biomedical research data sharing infrastructure that features a 
centralized catalog of data holdings and use models. Such a 
platform will be integrated with existing HHS infrastructure to 
obtain data from the clinical care environment. It will 
integrate data collected from NIH intramural and extramural 
research programs, including existing platforms focused on 
genomic and biomolecular structure; image processing; systems 
biology networks, gene regulation; health information 
standards; natural language processing; and statistical 
methods, among others. Examples of data access models to be 
considered for integration in the platform include but are not 
limited to: the Genomic Data Science Analysis, Visualization, 
and Informatics Lab-space [AnVIL], Health Equity Action Network 
[HEAN], Medical Imaging and Data Resource Center [MIDRC], 
National COVID Cohort Collaborative [N3C], NCI Clinical Trials 
Data, and NCI Cancer Research Data Commons. A new data 
initiative under development across HHS agencies, led by NIH in 
collaboration with the Office of the National Coordinator for 
Health Information Technology, will also enable comprehensive 
data collection from the clinical care environment, i.e. ``real 
world'' data. This initiative will drive development and 
implementation of data standards, increase data quality and 
speed time to data access for use in clinical decision-making 
and ultimately lead to better health outcomes. NLM will provide 
the infrastructure required to achieve the data catalogue, 
collection, security, and use management required for this new 
``real world'' data platform. Finally, NLM is directed to 
leverage this dynamic research environment to serve as an 
educational platform to train and support a diverse data 
science workforce. The Committee expects that this 
restructuring will elevate NLM to serve as an epicenter for 
NIH-funded research to advance information science, analytics, 
and data science, and support the application of artificial 
intelligence in biomedical research. NLM is directed to provide 
an update on these efforts within 120 days of enactment.
    Epitranscriptomics Database Standards.--The Committee 
recognizes the recent release of the National Academies of 
Sciences, Engineering, and Medicine [NASEM] report ``Charting a 
Future for Sequencing RNA and Its Modifications'' in March 
2024. The Committee notes the report's recommendation that 
clear and consistent standards for data and databases need to 
be established to facilitate data access and sharing. Given 
that NLM's National Center for Biotechnology Information [NCBI] 
collaborates with the scientific community to support 
development of standards for databases and biological 
nomenclature, among other responsibilities, the Committee urges 
NCBI to support the establishment of data and database 
standards for epitranscriptomics in collaboration with the 
scientific community consistent with the NASEM report 
recommendation, and include an update on this effort in the 
fiscal year 2026 CJ.

          NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2024....................................    $928,323,000
Budget estimate, 2025...................................     926,086,000
Committee recommendation................................     933,323,000

    The Committee recommendation includes $933,323,000, an 
increase of $5,000,000, for the National Center for Advancing 
Translational Sciences [NCATS].
    Clinical and Translational Science Awards [CTSA] Program.--
The Committee provides $629,560,000 for the CTSA program, the 
same as the fiscal year 2024 enacted level. Well-resourced and 
fully supported U-awards form the backbone of the CTSA program 
and any ongoing changes to grants and awards mechanism for 
CTSAs should maintain this focus to ensure hubs continue to 
have flexibility and stability, as well as thrive and provide 
an effective core that drives this critical national network 
forward, including developing localized partnerships, and 
effectively training the next generation of researchers while 
enhancing research capacity. The Committee reiterates that 
NCATS should continue to support at least 60 sites and that any 
hub that successfully recompetes for funding should continue to 
receive at least 95 percent of its previous level of support, 
if such an amount is requested. U-awards should continue to 
form the primary base of support so that hubs have flexibility 
and stability, can continue to develop localized partnerships, 
and can effectively train the next generation of researchers 
while enhancing research capacity. While the Committee 
recognizes optional funding opportunities which were previously 
incorporated into the prior single application offer a higher 
level of institutional funding support, NCATS must ensure these 
opportunities do not diffuse the focus of CTSAs and create 
challenges to ongoing national collaborative. The Committee 
also notes the work of the IDeA Clinical and Translational 
Research centers and urges increased collaboration between 
these programs.
    Collaboration with Business Incubators.--The Committee 
urges NCATS to continue proactive outreach to redouble its 
efforts to leverage its mission by exploring opportunities or 
potential collaborations with business incubators that host 
small to midsize science, research and pharmaceutical companies 
that use service-based approaches to nurture and guide their 
member companies to success. The Committee encourages NCATS to 
continue to use Administrative Supplements to existing CTSA 
contracts to fulfill this objective.
    Cures Acceleration Network [CAN].--The Committee continues 
to provide $75,000,000 for the CAN to reduce barriers between 
research discovery and clinical trials.
    National Clinical Cohort Collaborative [N3C].--The 
Committee provides an increase of $5,000,000 to support N3C's 
open-science, privacy-preserving data-sharing platform to 
accelerate biomedical research and discovery. Supported by the 
CTSA Program, N3C links de-identified electronic health record 
data with other types of data such as imaging, mortality, and 
Medicare and Medicaid data from CMS to answer key research 
questions on a variety of diseases, with two diseases being 
piloted. The Committee supports the continuation of N3C and 
encourages NCATS to continue coordinating with other HHS 
agencies to make N3C available as an underlying common real-
world data platform to drive faster discovery across a range of 
diseases and maximize the Federal research investment by 
creating a reusable data infrastructure. Within 1 year of 
enactment, the Committee requests NCATS provide a 5-year 
strategic plan and recommendations for expanding the N3C 
platform.
    Rare Disease Research.--The Committee encourages NCATS to 
leverage the investments made in NCATS rare disease research to 
accelerate the development of new treatments for the 95 percent 
of rare diseases with no approved treatment, to strengthen the 
innovation of diagnostics to shorten the average 6.3 year-long 
diagnostic odyssey, and to lower the nearly $1,000,000,000,000 
annual economic burden of rare diseases. The Committee urges 
NCATS to increase funding for rare disease research, helping to 
grow the newly created Division of Rare Diseases Research 
Innovation.
    Translational Science.--The Committee recognizes the 
important work of NCATS-funded CTSAs in supporting innovation 
and job creation. The Committee also understands that many 
commercially promising and potentially lifesaving inventions 
from CTSAs are often translated into FDA-approved and 
commercially available products. The Committee understands that 
there can be limitations in commercialization knowledge and 
resources available. The Committee therefore urges NCATS to 
continue to work with CTSAs to provide opportunities to 
translate research.

                         OFFICE OF THE DIRECTOR

Appropriations, 2024....................................  $2,605,514,000
Budget estimate, 2025...................................   3,013,455,000
Committee recommendation................................   3,109,514,000

    The Committee recommendation includes $3,109,514,000 for 
the Office of the Director [OD]. Within this total, 
$692,401,000 is provided for the Common Fund, and $12,600,000 
is included for the Gabriella Miller Kids First Research Act 
(Public Law 113-94).
    ADRD Clinical Trial Diversity/Health Equity.--The Committee 
recommends that NIH fund or conduct Black/African American-, 
Latino/Hispanic- and women- only research studies to better 
understand the underlying etiology of cognitive impairment and 
dementia in these groups that have disproportionately higher 
prevalence of disease.
    Advancing Novel Alternative Methods Research.--The 
Committee is encouraged by many of the insights and 
recommendations of the Advisory Committee to the Director [ACD] 
Working Group on Catalyzing the Development and Use of Novel 
Alternative Methods [NAMs] to Advance Biomedical Research, 
detailed in the December 2023 Report to the ACD and accepted by 
the NIH in February 2024. The Committee acknowledges that NAMs 
complement understanding of human biology and advance human 
health. Within 18 months of enactment of this act, the 
Committee directs the NIH to publish a publicly available 
Strategic Plan for NAMs Research to aid in implementing the 
Working Group recommendations. The Strategic Plan is encouraged 
to include timelines for reaching identified goals, including 
benchmarks where available, and strategies for measuring 
progress toward advancing NAMs across NIH Institutes and 
Centers. The Committee encourages NIH to provide Congress with 
a report on progress toward the development of the Strategic 
Plan, including a plan for public input, within 180 days of 
enactment of this act. Following the Strategic Plan's 
publication, the Committee expects NIH to provide publicly 
available updates on the progress of implementing the Strategic 
Plan annually. NIH is encouraged to update the Strategic Plan 
at least every 5 years following its publication.
    Alcohol and Polysubstance Misuse Research.--The Committee 
is pleased to see NIH supporting research on alcohol and 
polysubstance use, and urges the Director to continue to 
support research in this area across the United States. Given 
the increasing prevalence of polysubstance-involved overdose 
deaths, particularly among rural and minority communities, the 
Committee also encourages the Director to support studies in 
rural and minority communities with high rates of mortality 
involving alcohol and polysubstance use.
    All of Us Research Program.--The Committee provides 
$383,000,000 for the All of Us Research Program, fully 
restoring it to the fiscal year 2023 enacted level.
    ALS Research, Treatments, and Expanded Access.--The 
Committee continues to provide funding for ALS research to 
reduce the burdens of people with ALS as quickly as possible. 
It is crucial for people living with ALS and people diagnosed 
with ALS in the future, that NIH dramatically grows its ALS 
portfolio and the research workforce with additional grant 
funding and increases its focus on research that will lead to 
measurable changes in the lives of people living with ALS. The 
Committee directs NIH to handle funding of expanded access 
grants as authorized by the Accelerating Access to Critical 
Therapies [ACT] for ALS (Public Law 117-79) as separate, not 
competitive with, funding for other research on ALS and 
includes $75,000,000 for this purpose. Expanded Access Grants 
support scientific research utilizing data from expanded access 
to investigational drugs for people with ALS who are not 
eligible for clinical trials. The Committee requests NINDS 
include ALS clinics across the country in an ALS Clinical 
Research Network to increase capacity for research utilizing 
data from expanded access and other clinical research at 
geographically distributed sites. The Committee continues to 
direct NINDS and OD to brief the Committees prior to any 
execution of expanded access grants or programmatic funding. 
Once awards are announced, the Committee directs NINDS and OD 
to provide the Committees with an explanation of the funded 
grants, including a clear breakdown of what the funding is to 
be used for. Furthermore, after the review and awards of 
meritorious applications under Section 2, the Committee directs 
NIH to apply any unused funds to programs authorized under ACT 
for ALS including Section 3 public-private research 
partnership. Finally, if sufficient eligible applications are 
not received, or NINDS and OD have any reason to believe any 
funding should lapse, the ICs are directed to notify the 
Committees prior to notifications of awards. This notification 
shall include: (1) a detailed explanation as to why 
applications cannot be funded; (2) the technical assistance 
provided to applicants to assist them in submitting eligible 
grant applications; and (3) a proposed plan to award funding 
for other ALS research identified by the NIH ALS Strategic 
Priorities prior to the end of the fiscal year.
    Amyloidosis.--The Committee urges NIH to expand its 
research efforts in amyloidosis, a group of rare and often 
fatal diseases. Amyloidosis is characterized by abnormally 
folded protein deposits in tissues. Federal and foundation 
support over the past years has given hope for successful new 
treatments. However more efforts are needed to accelerate 
research and awareness of the disease and to help patients with 
amyloidosis related multi-organ dysfunction.
    Artificial Intelligence/Machine Learning [AI/ML].--The 
Committee provides $155,000,000, an increase of $20,000,000, 
for the Office of Data Science Strategy to support NIH's 
efforts to build capacity to leverage AI, ML and data science 
to accelerate the pace of biomedical innovation. The Committee 
encourages NIH to continue expanding the application of AI, ML, 
and data science across its research portfolio. The application 
of AI methods in biomedicine offer promising new approaches to 
screen for, detect, and diagnose health conditions, predict 
disease risk and progression, improve drug discovery, and 
optimize precision care for patients. However, the AI/ML 
research field lacks diversity in its researchers as well as in 
the data sets that it uses. Furthermore, new techniques are 
needed to incorporate ethics and trustworthiness into the 
design of new models. These gaps pose a risk of creating and 
continuing harmful biases in how AI/ML is used, how algorithms 
are developed and trained, and how findings are interpreted, 
ultimately leading to continued health disparities and 
inequities. The Committee notes Executive Order 14110 and 
supports efforts to increase diversity in AI/ML, including 
accelerating grants awarded through NIH's AI/ML Consortium to 
Advance Health Equity and Researcher Diversity [AIM-AHEAD] 
program. In addition, the Committee supports the enhancement of 
biosecurity oversight in order to keep pace with scientific 
advances, including E.O. 14110's requirement to develop a 
framework for synthetic nucleic acid screening. The Committee 
supports these activities and directs NIH to engage with 
intergovernmental partners to ensure their proper 
implementation. The Committee supports the memorandum of 
understanding [MOU] between NIH and the Department of Energy 
[DOE] focused on using advanced computing, quantum, and AI/ML 
for biomedical research and data sourcing. The Committee 
encourages NIH to continue coordinating with DOE to accelerate 
advances in precision oncology and scientific computing as part 
of the Cancer Moonshot program. The Committee continues to 
support collaboration between NIH and DOE to bring together 
biomedical scientists with computer scientists and other data 
science experts. The Committee also supports NIH's 
contributions to the National AI Research Resource [NAIRR] and 
the creation of AI ready datasets for the research community. 
The Committee encourages NIH to develop effective AI education 
and training pathways for the health research workforce, 
including trainees and senior scientists, to ensure the U.S. 
biomedical research workforce remains at the forefront of 
scientific discovery. These training resources should support 
biomedical researchers from diverse populations and backgrounds 
in the use of AI technologies to efficiently, accurately, and 
meaningfully process data for their research, as well as to 
participate in multi-disciplinary teams to develop new 
capabilities that advance biomedical AI. The Committee urges 
NIH to establish infrastructure capabilities around data, 
computing, and software across the agency and within the 
research community. The Committee also urges NIH to coordinate 
with relevant intergovernmental partners to support this long-
term mission.
    Biomedical Research Facilities.--The Committee continues to 
provide $80,000,000 for grants to public and nonprofit entities 
to expand, remodel, renovate, or alter existing research 
facilities or construct new research facilities as authorized 
under section 404I of the Public Health Service Act (42 U.S.C. 
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. The Committee also 
encourages NIH to allocate no less than 25 percent of funding 
for this program to institutions of emerging excellence, that 
could include those in IDeA States, to ensure geographic and 
institutional diversity.
    Biosecurity in Synthetic Nucleic Acid Synthesis.--The 
Committee commends the multiple Federal efforts to advance the 
adoption of strong biosecurity standards for synthetic biology 
technologies. NIH and other agencies that fund life-sciences 
research are required to establish that, as a requirement of 
funding, synthetic nucleic acid procurement is conducted 
through providers or manufacturers that adhere to the Framework 
for Nucleic Acid Synthesis Screening. Moreover, NIH should also 
explore approaches to encourage the purchase of domestically 
produced synthetic genetic materials and tools to protect U.S. 
intellectual property. The Committee requests an update within 
90 days of enactment on NIH's ongoing work to advance the 
adoption of strong biosecurity standards for synthetic biology 
technologies.
    Brain Research through Advancing Innovative 
Neurotechnologies [BRAIN] Initiative.--The Committee continues 
to support the BRAIN Initiative which is revolutionizing our 
understanding of the brain and fostering discoveries, 
collaborations, and partnerships that will lead to treatments 
and cures for brain diseases, disorders and injuries. The 
Committee provides $359,000,000 for the BRAIN Initiative, fully 
restoring the program to its fiscal year 2023 enacted amount. 
The Committee requests the BRAIN Initiative to communicate 
about the progress and achievements of the key projects and 
studies it is supporting with these funds by reporting on their 
objectives and anticipated/actual outcomes within 90 days of 
enactment.
    Cannabis Research.--The Committee is concerned that 
marijuana policies on the Federal level and in the States 
(medical marijuana, recreational use, etc.) are being changed 
without the benefit of scientific research to help guide those 
decisions. The Committee recognizes the increased interest and 
need to study cannabis and its constituent cannabinoids. The 
Committee encourages NIH to continue supporting its current 
research agenda across its Institutes and Centers, including 
research on higher potency THC, alternative cannabis 
formulations and extracts, and minor cannabinoids. The 
Committee also encourages NIH to continue supporting research 
on the potential medical uses of cannabis, such as for chronic 
pain, appetite stimulation, immune diseases, cancer, metabolic 
and digestive disorders, epilepsy, glaucoma, MS, sleep 
disorders, and a variety of mental health conditions such as 
anxiety and PTSD. The Committee encourages NIH to continue to 
take an integrated approach to cannabis research across its 
Institutes and Centers. Finally, 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.
    Cell and Gene Therapies.--Newly approved cell and gene 
therapies provide enormous promise for patients with conditions 
ranging from various cancers such as lymphoma and multiple 
myeloma to inherited blood disorders like hemophilia, sickle 
cell disease and beta thalassemia. Long-term data from clinical 
trials and real world experience are needed for researchers, 
practitioners, and patients to understand the long-term effects 
and potential toxicities associated with these therapies. The 
Committee encourages NIH to explore these issues by holding a 
workshop with the relevant Federal agency representatives, 
including FDA and NIH, and expert stakeholders on this topic 
and requests an update in the fiscal year 2026 CJ.
    Cephalopod Research.--The Committee recognizes that there 
are no federally required welfare standards for the use of 
cephalopods in federally-funded research because all 
invertebrate animals are excluded from the Public Health 
Service [PHS] Policy on the Humane Care and Use of Laboratory 
Animals, which provides certain welfare standards for 
vertebrate animals. The Committee recognizes that implementing 
and complying with the PHS Policy requires reference to 
guidelines in the Guide for the Care and Use of Laboratory 
Animals (the Guide), which does not currently include 
cephalopod-specific welfare guidelines, and updates to which 
are overseen by the National Academies of Sciences, 
Engineering, and Medicine [NASEM]. The Committee appreciates 
NIH's efforts to consolidate resources and possibly develop 
guidance for the humane care and use of laboratory cephalopods; 
however, this guidance will not be a sufficient substitution 
for the PHS Policy in establishing welfare standards for 
cephalopods, and will be temporary until cephalopod guidelines 
are included in the Guide and until the PHS Policy definition 
of ``animal'' is updated to include cephalopods. The Committee 
urges NIH to continue working with NASEM on this issue and 
urges NIH to consider expanding the definition of ``animal'' in 
the PHS Policy to include cephalopods if the Guide is updated 
and permanent guidelines are in place.
    Childhood Post-Infectious Neuroimmune Disorders/PANS/
PANDAS.--The Committee is concerned that although NIH supports 
research on Pediatric Acute-Onset Neuropsychiatric Syndrome 
[PANS] and Pediatric Autoimmune Neuropsychiatric Disorders 
Associated with Streptococcus [PANDAS], significantly more 
needs to be done. Understanding the causes, diagnosis, and 
treatment of these life-threatening diseases is essential to 
expedite early identification and intervention, thereby 
reducing the risk of chronic illness and associated costs to 
families, school systems, healthcare systems, and insurers. 
PANS/PANDAS research also would further the understanding of 
the critical link between neuropsychiatric illness and COVID-19 
and other infections. The Committee encourages NIH to continue 
to prioritize research on PANS/PANDAS and related to autoimmune 
encephalitic conditions, and requests an update in the fiscal 
year 2026 CJ on the progress being made on mechanisms of 
disease, the identification of biomarkers to aid in diagnosis, 
the evidence base for new and existing treatments, and the role 
of genetic susceptibility.
    Chimera Research.--The Committee supports NIH's funding 
limitation regarding the introduction of human pluripotent 
cells into non-human vertebrate animal pre-gastrulation stage 
embryos. The Committee takes seriously the bioethical 
considerations regarding the creation of human-animal chimeras 
and the continuation of research using these cells.
    Chimpanzees.--The Committee is concerned that NIH has not 
moved chimps from Holloman Air Force Base in Alamogordo, New 
Mexico, despite Federal law and court orders directing the 
agency to do so. The Committee strongly urges the NIH to 
relocate the chimps from Holloman Airforce Base to Chimp Haven 
if their health conditions allow for their safe transport. 
Within 30 days of enactment, NIH is directed to provide a 
report to the Committee on progress toward relocating chimps 
from Holloman Air Force Base to Chimp Haven, and monthly 
thereafter until all chimps have been successfully relocated.
    Common Data Elements [CDEs].--The Committee applauds the 
Office of Data Science Strategy for issuing a request for 
information [RFI] to stakeholders focused on developing CDEs 
and for convening a workshop on this topic. The Committee 
recognizes the importance of CDEs in facilitating research 
activities and fostering collaboration amongst the research and 
healthcare communities. CDEs are instrumental in standardizing 
data collection, enhancing data quality, and enabling more 
effective data sharing and analysis, particularly in complex 
areas such as autoimmune and immune-mediated diseases. The 
Committee encourages NIH to build upon the RFI and workshop and 
to develop a plan to work with stakeholders, particularly in 
the autoimmune and immune-mediate communities, to develop and 
advance the use of CDEs.
    Common Data Elements for Women's Health.--The Committee 
recognizes the continued need to develop common data elements 
[CDEs] related to women's health that will help researchers 
share and combine datasets, promote interoperability, and 
improve the accuracy of datasets when it comes to women's 
health. The Committee encourages the Office of Data Science 
Strategy [ODSS] to collaborate with the Office of Research on 
Women's Health [ORWH] and Institutes and Centers to prepare a 
roadmap for developing new NIH-endorsed CDEs to capture more 
data about women's health in both research and clinical 
settings. In addition, the Committee urges NIH to launch a data 
resource to better coordinate and integrate investments in 
women's health research across NIH. The Committee encourages 
ODSS and ORWH to engage outside stakeholders, including 
professional societies and patient organizations, in this work, 
as appropriate. NIH is directed to provide an update on 
relevant activities within 90 days of enactment.
    Common Fund.--The Committee includes an increase of 
$20,000,000 for the Common Fund and acknowledges the role of 
the NIH Common Fund in advancing biomedical research and 
fostering innovative research collaborations across various NIH 
Institutes, Centers, and Offices to catalyze discovery across 
all biomedical research, and to create a space where 
investigators and multiple NIH Institutes, Centers, and Offices 
collaborate to address scientific challenges and opportunities 
that are high-priority for NIH as a whole. The Committee 
encourages the Common Fund to consider establishing an RNA 
Project ["RNOME"] to support this work. The Committee requests 
an update on Common Fund projects in the fiscal year 2026 CJ.
    Compensation for Trainees and Early Career Researchers.--
The Committee appreciates that the future of U.S. economic 
competitiveness and our Nation's ability to address national, 
economic, and health security threats depends on sustaining a 
robust STEM workforce. Ensuring individuals from communities 
that are under-represented in the STEM field can enter and 
sustain a career as part of the STEM workforce is essential to 
strengthening the research workforce going forward. The 
Committee is deeply concerned that entrenched financial 
barriers are increasingly deterring graduate and postdoctoral 
students, particularly those from underrepresented communities, 
from pursuing STEM careers. The lack of Cost-of-Living 
Adjustments [COLAs] can make it financially unrealistic for 
postdoctoral scholars to accept positions, particularly in 
high-cost areas; areas in which academic medical centers are 
located. The Committee commends NIH for proposing meaningful 
increases in stipends for postdoctoral scholars. These 
increases take a significant step towards returning National 
Research Service Awards [NRSA] to their inflation-adjusted pre-
pandemic levels and brings the agency closer to offering real 
dollar increases in the stipend of early career researchers 
that are needed to ensure a strong STEM workforce. The 
Committee looks forward to NIH's continued efforts to meet its 
goal of $70,000 stipends for NRSA postdoctoral scholars as soon 
as possible. The Committee directs NIH to consider alternatives 
for faster implementation of this goal and looks forward to 
receiving NIH's report on the adequacy of compensation for 
trainees as required by the Consolidated Appropriations Act, 
2024 (Public Law 118-122).
    Create and Implement a Comprehensive Research Agenda on 
Menopause.--Consistent with the Executive Order on Advancing 
Women's Health Research and Innovation, NIH will launch a 
comprehensive research agenda that will guide future 
investments in menopause-related research and advance the 
treatment of menopausal symptoms. The Committee continues to 
support NIH's work to expand data collection efforts related to 
women's midlife health, identify ways to improve management of 
menopause-related issues and the clinical care that women 
receive, and develop new resources to help women better 
understand their options for menopause-related symptoms, 
prevention, and treatment. The Committee encourages NIH to 
support research that will inform the development of safe and 
effective treatments for perimenopause- and menopause-related 
symptoms. In addition, the Committee requests a report on data 
and knowledge gaps, or other barriers, related to research, 
diagnostic testing, and treatments with respect to the 
menopausal transition. The Committee encourages NIH to convene 
a stakeholder workshop to discuss research needs. Finally, the 
Committee encourages NIH to consider expanding research on non-
hormonal management options for menopause to establish a more 
comprehensive and consistent scientific evidence base regarding 
their efficacy, safety, and long-term effects. NIH is directed 
to provide an update on menopause-related research activities 
within 120 days of enactment.
    Denying Foreign Access to Americans' Sensitive Health 
Data.--The Committee is concerned that NIH does not have proper 
protocols to restrict the ability of foreign adversaries from 
accessing sensitive data within NIH databases. Therefore, the 
Committee directs the Director, within 30 days of enactment, to 
report on its processes to maintain, update, publish and 
implement user authentication protocols to restrict the ability 
for foreign adversary entities, as defined in 15 CFR section 
7.4, to access the databases.
    Developmental Delays.--The Committee continues to provide 
$10,000,000 for research on developmental delays, including 
speech and language delays in infants and toddlers, 
characterizing speech and language development and outcomes in 
infants and toddlers through early adolescence. The Committee 
urges NIH to support research which may include longitudinal 
studies, translation of research into clinical practice, and 
novel approaches to study children with speech and language 
delays to provide parents, teachers, pediatricians, and other 
caregivers with the information they need to help late talking 
children grow and thrive in school and other social 
environments.
    Diet and Chronic Disease Research.--The Committee applauds 
NIH, including the Office of Nutrition Research and NIAID, for 
moving ahead with a scientific workshop focused on the role 
food and diet play in developing mucosal immunity for 
conditions such as Crohn's disease, ulcerative colitis, and 
other digestive and autoimmune or immune-mediated diseases. 
This workshop is anticipated to provide crucial insights to 
inform future Inflammatory Bowel Disease and larger diet and 
nutrition research and public health activities. The Committee 
urges NIH to promptly disseminate the proceedings of this 
workshop, particularly recommendations to inform future 
research funding priorities.
    Emerging Technologies.--The Committee commends NIH for 
seeking new mechanisms to partner with other Federal agencies, 
such as its partnership with the National Science Foundation on 
emerging technologies such as quantum information sciences and 
quantum technologies, bioengineering and synthetic biology, 
artificial intelligence, and digital twins. As these programs 
are developed, the agencies are encouraged to find mechanisms 
to continue activities at the intersections of robotics, 
biomechanics, disabilities, and chronic pain. The National 
Robotics Initiative supported these efforts and now that it has 
sunsetted the agencies should ensure new mechanisms to foster 
collaboration between biomedical researchers and engineers, 
computer and physical scientists, and other disciplines to 
ensure progress on critical health challenges are considered.
    Environmental Influences on Child Health Outcomes [ECHO].--
The Committee includes $180,000,000, for the ECHO program. ECHO 
currently funds the Navajo Birth Cohort Study. The Committee 
encourages expanding the study to include a larger 
representation of Navajo children in the cohort to allow for a 
better understanding of the impacts of environmental exposure 
in the Navajo Nation.
    Expanding Support for Young Investigators.--NIH has been 
criticized for funding too many late career scientists while 
funding too few early career scientists with new ideas. The 
Committee is concerned that the average age of first-time R01 
funded investigators remains 42 years old. More than twice as 
many R01 grants are awarded to investigators over 65 than to 
those under 36 years old. The Committee appreciates NIH's 
efforts to provide support for early-career researchers through 
several dedicated initiatives, including the NIH Director's New 
Innovator Award, Next Generation Researchers Initiative, 
Stephen Katz award, and the NIH Pathway to Independence Award. 
The Committee encourages NIH to continue supporting these 
important initiatives and to expand support for early career 
researchers by increasing the number of award recipients for 
these programs in future years. The Consolidated Appropriations 
Act, 2024 (Public Law 118-122) directed NIH to provide a 
``professional judgement'' budget to the Committee to grow and 
retain the early career investigator pool, accelerate earlier 
research independence, and ensure the long term sustainability 
of the biomedical research enterprise. Building off of these 
efforts, the Committee directs NIH to develop a strategic plan 
for increasing its investments in early-career researchers and 
to provide a report on this activity within 1 year of 
enactment.
    Firearm Injury and Mortality Prevention.--The Committee 
provides $12,500,000 to conduct research on firearm injury and 
mortality prevention. Given violence and suicide have a number 
of causes, the Committee recommends NIH take a comprehensive 
approach to studying these underlying causes and evidence-based 
methods of prevention of injury, including crime prevention. 
All grantees under this section will be required to fulfill 
requirements around open data, open code, pre-registration of 
research projects, and open access to research articles 
consistent with the National Science Foundation's open science 
principles. The Director is to report to the Committees within 
30 days of enactment of this act on implementation schedules 
and procedures for grant awards, which strive to ensure that 
such awards support ideologically and politically unbiased 
research projects.
    Focused Ultrasound.--The Committee understands focused 
ultrasound is a non-invasive, non-pharmacological, relatively 
safe, and cost-effective alternative or complement to 
conventional surgery, radiation, or drug-based treatments. The 
Committee encourages NIH continue to engage with the focused 
ultrasound stakeholder community and requests an update on 
focused ultrasound in the fiscal year 2026 CJ.
    Food as Medicine.--The Committee is aware of the strategic 
goal within the Strategic Plan for NIH Nutrition Research 
focused on improving the use of food as medicine and is 
interested in how certain foods, which are prescribed to 
support management of a specific condition and administered 
under physician supervision, impact the lives of patients, for 
example those with digestive diseases including Crohn's disease 
and ulcerative colitis. The Committee urges NIH to support 
research on the efficacy of `food as medicine' strategies to 
treat various diseases and conditions.
    Foreign Adversaries.--The Committee is concerned about 
funding for research at any laboratory owned or controlled by 
the governments of the People's Republic of China, the Republic 
of Cuba, the Islamic Republic of Iran, the Democratic People's 
Republic of Korea, the Russian Federation, the Bolivarian 
Republic of Venezuela under the regime of Nicolas Maduro Moros, 
or any other country determined by the Secretary of State to be 
a foreign adversary. The Committee requests a report on any 
such research within 30 days of enactment.
    Foreign Influence.--To support NIH's efforts to 
expeditiously complete grant compliance reviews, the Committee 
continues to include $2,500,000 for this activity within the 
Office of Extramural Research. The Committee directs NIH to 
provide biannual briefings on compliance, oversight, and 
monitoring reviews where non-compliance related to foreign 
interference has been identified.
    Full Spectrum of Medical Research.--The Committee 
recognizes the growing importance of supporting the full 
spectrum of medical research at NIH, to ensure breakthroughs in 
basic science are translated into innovative therapies, 
diagnostic tools, and health information with a tangible 
benefit to the patient and professional communities. The 
Committee encourages NIH to support the flagship CTSA program 
and to catalyze emerging opportunities in AI, big data, and 
other areas, while maintaining the commitment to critical 
activities, such as training the next generation of cutting-
edge physician-scientists.
    Fund the Person, Not the Project.--While many labs are 
funded by R01-equivalent grants, the R35 mechanism arguably 
allows scientists more flexibility and freedom to pursue the 
most meritorious science. The Committee looks forward to 
reviewing NIH's plans for expanding the R35 along with its 
plans for evaluating the impact on scientific progress, as 
directed in the Consolidated Appropriations Act, 2024 (Public 
Law 118-122).
    Funding Replication Experiments and/or Fraud Detection.--
The Committee recognizes that many biomedical research studies 
have turned out to be irreproducible or even outright 
fraudulent. The Reproducibility Project in Cancer Biology 
showed that cancer biology studies in top journals often failed 
to be replicable, and a prominent line of Alzheimer's studies 
was found to be based on an allegedly fraudulent study funded 
by NIH in the early 2000s. Given the importance of detecting 
both reproducibility and fraud, the Committee provides 
$10,000,000 to establish a program to fund replication 
experiments on significant lines of research, as well as 
attempts to proactively look for signs of academic fraud. The 
Committee directs NIH to brief the Committee within 180 days of 
enactment on the establishment, staffing and plans for this 
effort in fiscal years 2025 and 2026.
    Genomic Testing and Research.--The Committee encourages 
NHGRI and NICHD to work together to support research on genetic 
and genomic testing, including whole genome sequencing, whole 
exome sequencing, and gene panels, as effective tools in 
rapidly identifying diagnoses in pediatric populations.
    Global Cohort for Alzheimer's Treatment.--More than 55 
million people worldwide are living with dementia, including 
more than 6.9 million Americans with Alzheimer's disease. The 
disease does not affect everyone equally: in the United States 
two-thirds of people living with Alzheimer's disease are women. 
Black people are twice as likely and Latino people are one and 
one-half times as likely to develop Alzheimer's than White 
people. It is believed that there are disparities in 
Alzheimer's disease both between and within nations around the 
world, including between men and women and members of different 
ethnic groups. In order to ensure that treatments work for all 
people, the Committee urges the National Institutes of Health 
to provide an update in the fiscal year 2026 Congressional 
Justification on activities related to global cohort studies or 
networks with high-quality data on a well-characterized, 
diverse population, readily available to researchers. The 
Committee expects such a cohort or network of global cohorts 
would increase discovery of targets for drug development and 
associated biomarkers.
    Harassment Policies.--NIH has taken major steps over the 
last several years to address harassment in biomedical research 
settings. However, the Committee remains frustrated by 
statutory loopholes that fail to protect victims of harassment 
and prevent perpetrators from transferring grants between 
institutions. In 2020, NIH clarified the longstanding 
requirement for institutions to seek prior approval when 
changing personnel on a grant or moving the grant to a new 
institution. The request for approval was expected to mention 
whether the change was related to concerns about safety or work 
environments (e.g. due to concerns about harassment, bullying, 
retaliation, or hostile working conditions). These 
notifications allow NIH to make informed decisions about any 
changes to awards including requests to transfer awards to a 
new institution. Additionally, new authority provided by the 
Consolidated Appropriations Act, 2022 (Public Law 117-35) made 
it mandatory for institutions to inform NIH of disciplinary 
actions taken against senior or key personnel, regardless of 
whether they prompted changes including transferring a grant 
between institutions. If an ongoing investigation is incomplete 
and the individual under investigation leaves their current 
position, however, NIH lacks the authority to require recipient 
organizations to complete the report or share its findings with 
the agency. To address this issue, the Committee has included a 
new general provision to require institutions that receive NIH 
funding to complete any investigation undertaken due to 
concerns about harassment, bullying retaliation, or hostile 
working conditions, even if during the course of the 
investigation the individual under investigation leaves their 
current position and is no longer employed by the institution. 
NIH is directed to continue to provide annual updates to the 
Committees on holding both NIH-funded institutions and 
researchers accountable for such incidents, including through 
the loss of Federal funding.
    Health Impacts on Children of Technology and Social Media 
Use.--The Committee remains concerned about the impacts of 
technology use and media consumption on infant, children, and 
adolescent development. The Committee appreciates NIH's ongoing 
engagement on this important topic and encourages NIH to 
prioritize research into the cognitive, physical, and 
socioemotional impacts of young people's use of technologies as 
well as long-term developmental effects on children's social, 
communication, and creative skills. The Committee also 
encourages NIH to study potential correlations between 
increased use of digital media and technologies and 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. The Committee 
encourages collaboration between NIMH and NICHD for these 
activities. The Committee requests an update on these 
activities within 120 days of enactment.
    The HEALthy Brain and Child Development [HBCD] Study.--The 
Committee recognizes and supports the NIH HBCD Study, which 
will establish a large cohort of pregnant individuals and 
follow them and their children up to age 10 to characterize the 
influence of a variety of factors on neurodevelopment and long-
term outcomes. The study aims to enroll over 7,000 participants 
through 27 sites across the United States, including regions of 
the country significantly affected by the opioid crisis. The 
study cohort will be comprised of participants who reflect the 
U.S. population but will oversample for individuals who have 
used substances sometime during their pregnancy. The study will 
also include a matching cohort with similar characteristics but 
no substance use during the pregnancy. Multimodal data 
collection will include neuroimaging, behavioral and cognitive 
assessments as well as collection of biospecimens and brain 
activity measurements [EEG]. Knowledge gained will be critical 
to help understand and prevent some of the known impacts of 
pre- and postnatal exposure to drugs and environmental 
influences, including risks for future illicit substance use, 
mental illness, and other behavioral and developmental 
problems, as well as identify factors that contribute to 
resilience and opportunities for intervention. The Committee 
recognizes that the HBCD Study is supported in part by the NIH 
HEAL Initiative, and NIH Institutes, Centers, and Offices 
[ICOs], including OBSSR, ORWH, NEI, NIMHD, NIBIB, NIEHS, NICHD, 
NINDS, NIAAA, NIMH, NCI, and NIDA, and encourages additional 
NIH support for this important study.
    Hypermobile Ehlers-Danlos Syndrome [hEDS].--The Committee 
is aware that researchers recently identified the first disease 
gene for hEDS and have developed the first hEDS animal model. 
In order to continue strides forward and expedite translational 
discoveries of cures, treatments and diagnosis, the Committee 
encourages NIGMS to increase support for hEDS related research 
at academic medical centers where hEDS patients are being 
treated. This investment may help lead to diagnostic markers of 
disease and provide the basis for long-term sustainable 
research programs. In addition, the Committee encourages NIH to 
evaluate the best approach to support research that would spur 
earlier diagnosis and improved treatment, care, education and 
mechanistic understanding of hEDS.
    Improving Clinical Trials.--The Committee reiterates its 
directive outlined in the Consolidated Appropriations Act, 2024 
(Public Law 118-122) and looks forward to reviewing the report 
produced by the independent panel's findings.
    INCLUDE Initiative.--The Committee includes no less than 
$95,000,000, an increase of $5,000,000, within OD for the 
INCLUDE Initiative. The Committee encourages NIH to continue to 
make further investments in health equity-focused research and 
care for Black Americans and other underrepresented groups with 
Down syndrome, and in promising studies of the mechanisms 
driving delayed growth, altered metabolism, and organ 
dysfunction, and other emerging areas. The Committee remains 
pleased with a focus on large cohort studies across the 
lifespan, novel clinical trials, and multi-year, NIH-wide 
research driving important advances in understanding immune 
system dysregulation, Alzheimer's disease, and leukemia that is 
contributing to improvements in the health outcomes and quality 
of life of individuals with Down syndrome as well as millions 
of typical individuals. The Committee requests that NIH provide 
an updated plan within 60 days of enactment of this act that 
includes a timeline and description of potential grant 
opportunities and deadlines for all expected funding 
opportunities so that young investigators and new research 
institutions may be further encouraged to explore research in 
this space. This plan should also incorporate an increase in 
pipeline research initiatives specific to Down syndrome.
    Long COVID Treatments.--The Committee remains concerned 
about the economic and overall health impact that Long COVID 
inflicts on the Nation. It is currently estimated that between 
6 percent and 19 percent of those infected with SARS-CoV-2 go 
on to develop Long COVID, resulting in up to 20 million 
Americans suffering from this set of debilitating chronic 
symptoms. Long COVID is characterized by a wide range of 
symptoms including severe fatigue, non-restorative sleep, 
cognitive dysfunction, and widespread pain. Further, it 
resembles other post-acute infection syndromes [PAISs], such as 
fibromyalgia, myalgic encephalomyelitis/chronic fatigue 
syndrome [ME/CFS] and related conditions, known as chronic 
overlapping pain conditions [COPCs] or nociplastic syndromes. 
While the Committee is pleased that NIH's HEAL and RECOVER 
initiatives plan to target some specific symptoms of Long 
COVID, the Committee is concerned that NIH has not expanded the 
evaluation of treatments to address many common symptoms 
associated with Long COVID either individually or that present 
as syndromes which are combinations of symptoms. Furthermore, 
NIH's research program has defined Long COVID narrowly, 
excluding many of the common symptoms plaguing Long COVID 
sufferers. In June 2024, NASEM released the 2024 NASEM Long 
COVID Definition, which encompasses extensive lists of the 
symptoms and diagnosable conditions that current science 
attributes to Long COVID. The Committee urges NIH to rebalance 
its research program to prioritize clinical trials in pursuit 
of effective treatments and to use the NASEM Long COVID 
definition to guide its choice of symptoms and conditions to be 
address by the candidate treatments. Such trials should target 
key symptoms and symptom complexes associated with Long COVID 
including widespread pain, fatigue, non-restorative sleep, 
brain fog, dizziness, post-exertional malaise [PEM], postural 
orthostatic tachycardia syndrome [POTS] and loss of taste and 
smell. Further, the Committee urges NIH to prioritize the 
support of clinical trials evaluating therapies for Long COVID 
including therapies that have demonstrated efficacy in treating 
COPCs or nociplastic syndromes that overlap with Long COVID.
    Lung Health Disparities.--The Committee is concerned about 
the disproportionate impact of lung conditions, such as asthma, 
COPD, and lung cancer on populations experiencing health 
disparities, and encourages NHLBI collaborate with NIMHD to 
advance research in this area. The Committee requests an update 
from both NHLBI and NIMHD in their fiscal year 2026 CJ.
    Lyme Disease and Related Tick-Borne Illnesses.--The 
Committee includes not less than $125,000,000, an increase of 
$25,000,000, for research into Lyme and other Tick-Borne 
diseases. The Committee urges NIH to develop new tools that can 
more effectively prevent, diagnose, and treat Lyme disease, 
including its long-term effects, and other tick-borne diseases. 
The Committee encourages the promotion and development of 
potential vaccine candidates for Lyme disease and other tick-
borne diseases. The Committee urges NIH to conduct research to 
better understand modes of transmission for Lyme and other 
tick-borne diseases. The Committee encourages NIH to 
incentivize new investigators to enter the field of Lyme 
disease and other tick-borne disease research. The Committee 
encourages NIH to coordinate with CDC on publishing reports 
that assess diagnostic advancements, methods for prevention, 
the state of treatment, and links between tick-borne disease 
and other illnesses.
    Measuring Biological Age.--The Committee understands that 
aging is a primary risk factor for a wide range of chronic 
diseases and conditions, including cancer, Alzheimer's disease, 
frailty, cardiovascular disease, and many others. The Committee 
also recognizes that modifying fundamental molecular pathways 
of aging could enhance a person's healthspan by delaying or 
mitigating these diseases and conditions. The ability to 
measure biological age, as distinct from chronological age, is 
critical to this effort. Therefore, the Committee encourages 
NIH to explore opportunities to advance research aiming to 
develop and validate precise measurements of biological age 
that are reliable across individuals of different races and 
socio-economic status. The Committee encourages NIH to take a 
collaborative, transdisciplinary and trans-NIH approach, 
integrating epidemiology, genomics, multi-omics, organismal 
physiology, biology and computational biology, and precision 
therapeutics. The Committee requests an update on this request 
within 180 days of enactment.
    Mental Health, Addiction and Resilience Research Network.--
Diseases of the mind and brain can develop early in life, 
contribute to the burden of overall health and daily life 
function, and contribute to the persistent and rising rates of 
deaths of despair--those from overdoses, suicide, and liver 
disease from alcoholism. The Committee encourages NIH to 
support collaborative research efforts to uncover the root 
causes, risk and resilience/protective factors of mental health 
and addiction. These efforts could include leveraging existing 
longitudinal research to examine the biological, psychological, 
and social factors and their interactions across multiple 
layers of analysis that put people at risk for addiction and 
mental illness including patterns of intergenerational 
transmission of mental illness, discover ways to better prepare 
and respond to stress, trauma and adversity, and inform and 
guide new strategies for prevention, recovery, and resilience.
    Mitochondrial Disease Research.--The Committee encourages 
NIH to prioritize research on primary and secondary 
mitochondrial disease. A constellation of rare diseases linked 
to impaired mitochondrial function needs further research while 
potentially promising interventions work through the FDA 
approval process. At the same time, research continues to 
validate the substantial connections between mitochondrial 
function and major conditions such as Alzheimer's, Parkinson's, 
ALS, Muscular Dystrophy, heart failure, and Long-COVID. The 
Committee strongly encourages NIH to advance primary 
mitochondrial disease research, continue its ongoing outreach 
and collaboration with the FDA related to research that may 
lead to future mitochondrial disease-related drug approvals, 
ensure that support for Long-COVID research includes 
opportunities for studies to explore the role of mitochondrial 
impairment, and ensure that opportunities remain available to 
support collaborative research on mitochondrial disease to 
centralize a critical mass of research, clinical care, and 
provider education.
    Multi-Purpose Prevention Technologies.--The Committee 
encourages NIH, and particularly NICHD and NIAID, to work with 
the U.S. Agency for International Development and other 
Federal, public, and private sector partners to accelerate 
research, development and implementation of multipurpose 
prevention technologies that are effective, affordable, 
acceptable, and easy to deliver.
    National Security.--The Committee believes that NIH should 
consider relevant national security issues when developing and 
executing the NIH-Wide Strategic Plan.
    Neurofibromatosis [NF].--The Committee supports efforts to 
increase funding and resources for NF research and treatment at 
multiple Institutes, including NCI, NINDS, NIDCD, NHLBI, NICHD, 
NIMH, NCATS, and NEI. Children and adults with NF are at 
elevated risk for the development of many forms of cancer, 
deafness, blindness, developmental delays and autism. The 
Committee encourages NCI to 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 support preclinical research and clinical trials. Because NF 
can cause blindness, pain, and hearing loss, the Committee 
urges NEI, NINDS, and NIDCD to continue to support fundamental 
basic science research on NF relevant to restoring normal nerve 
function. Based on emerging findings from numerous researchers 
worldwide demonstrating that children with NF have a higher 
chance of developing autism, learning disabilities, motor 
delays, and attention deficits, the Committee encourages NINDS, 
NIMH, and NICHD to continue their support of research 
investigations in these areas. Since NF2 accounts for some 
genetic forms of deafness, the Committee encourages NIDCD to 
expand its investment in NF2-related research. NF1 can cause 
vision loss due to optic gliomas. The Committee encourages NIH 
to expand its investment in NF1-focused research on optic 
gliomas and vision restoration.
    New Approach Methodologies.--The Committee supports the NIH 
Common Fund's Complement Animal Research In Experimentation 
[Complement-ARIE] Program, intended to spur the development, 
standardization and use of new approach methodologies [NAMs] 
intend to more accurately model human biology. The Committee 
also encourages NIH, in new Announcements and other indications 
of funding opportunities, to continue consideration of NAMs as 
an option for areas of preclinical research when it is not 
appropriate to use human participants and where the use of NAMs 
has been demonstrated to support biomedical discoveries. The 
Committee further encourages NIH to collect and make publicly 
available a report that outlines how the use of vertebrate 
animal models in agency research contributes to the mission of 
NIH as well as efforts by the agency to encourage the use of 
new approach methods or strategies. This report should include 
examples of how other methods have been used in NIH research to 
reduce, replace, and refine the number of animals used in 
research.
    NIH-Wide Effort on Women's Health Research.--The Committee 
commends NIH for its launch of a cross-cutting effort to 
transform women's health across the lifespan, which will 
initially be supported by $200,000,000 from NIH. This NIH-wide 
effort--a first step to transform the way we approach and fund 
women's health research--will allow NIH to catalyze the 
ambitious, multi-faceted, interdisciplinary research projects 
that women need, such as research on the impact of 
perimenopause and menopause on heart health, brain health, and 
bone health. This coordinated, NIH-wide effort will be led by 
OD, ORWH, NIA, NHLBI, NIDA, NICHD, NIAMS, and any other 
Institutes and Centers deemed relevant by the NIH Director. The 
Committee urges NIH to continue to expand basic, clinical, and 
translational research into women's health, including the 
mechanisms of endometriosis and other gynecological conditions, 
to identify early diagnostic markers, and develop new treatment 
methods. The Committee strongly encourages OD and all 
Institutes and Centers to dedicate additional funds and 
participate in this cross-cutting effort in fiscal year 2025, 
with a focus on grant opportunities to support research and 
education to improve women's health in diverse settings across 
the United States. NIH is directed to provide an update on the 
progress and achievements of the key projects and studies 
supported by this NIH-wide effort by reporting on their 
objectives and anticipated/actual outcomes within 90 days of 
enactment.
    Office of the Chief Officer for Scientific Workforce 
Diversity [COSWD].--The Committee continues to provide 
$22,415,000 to the Office of COSWD.
    Office of Nutrition Research [ONR].--The Committee supports 
ONR's plan to establish Centers of Excellence in Food Is 
Medicine to advance research, education, patient care, and 
community outreach on the role of nutrition in preventing and 
treating diet-related chronic diseases. The Committee 
recognizes that food is medicine services, such as medically 
tailored meals and produce prescriptions, may improve health 
outcomes, reduce healthcare costs, and address health 
disparities among vulnerable populations. The Committee 
encourages NIH to collaborate with existing Food Is Medicine 
stakeholders in academia, healthcare, and the nonprofit sector 
to leverage their expertise and experience in this field.
    Office of Research on Women's Health [ORWH].--The Committee 
notes bill language that was included in the Consolidated 
Appropriations Act, 2022 (Public Law 117-103) that funding for 
ORWH be made available for direct grant making to address 
women's health research needs that are not being addressed by 
Institutes and Centers. The Committee provides $152,480,000 in 
base funding for the Office of Research on Women's Health, an 
increase of $76,000,000. The role of ORWH is to improve women's 
health research and research on sex and gender influences in 
health and disease within the NIH scientific framework to 
achieve equity in women's health across the lifespan. Congress 
is committed to prioritizing this research portfolio and 
ensuring ORWH has the resources it needs to help fulfill its 
mission. Within this amount, the Committee allocates 
$14,000,000 to the Building Interdisciplinary Research Careers 
in Women's Health [BIRCWH] program with the goal of 
strengthening the workforce pipeline through mentorship of 
early career scientists engaged in women's health research. 
Recognizing the impact of the BIRCWH program, the Committee 
urges NIH to use these funds to support additional researchers 
focused on women's health and sex differences, including 
research focused on cancer, maternal health, endometriosis, 
fibroids and pelvic floor disorders. The Committee expects NIH 
to use these funds to enhance the BIRCWH program through 
research on health of women and female-specific diseases or 
conditions.
    Osteopathic Medical Schools.--Colleges of Osteopathic 
Medicine educate 25 percent of all the Nation's medical 
students and prioritize research and training in primary care 
and rural and underserved healthcare. The Committee understands 
osteopathic medical schools and their principal investigators 
are welcome to review and apply for any NIH funding 
opportunities in the same way other organizations seeking NIH 
support do and that the same is true for Doctors of Osteopathy 
[D.O.s] on NIH National Advisory Councils and study sections. 
Further, the Committee recognizes the historic relationship 
between osteopathic medicine and the research priorities of 
NCCIH but that D.O.s have been designated on applications 
submitted to and awarded from other NIH Institutes and Centers. 
The Committee encourages NIH continue engaging with researchers 
from Colleges of Osteopathic Medicine, encouraging them to 
apply for available funding opportunities across NIH Institutes 
and Centers, and requests an update in the fiscal year 2026 CJ 
of how Institutes and Centers are expanding research and 
representation opportunities for Colleges of Osteopathic 
Medicine.
    Pain and Addiction.--The Committee commends NIH, NIDA, and 
NINDS for their focus on addressing addiction and developing 
alternatives to opioids for safe and effective pain management 
strategies that reduce reliance on opioids. In particular, NIDA 
and NINDS' commitment to research on improved pain management 
and prevention, treatment, and recovery from substance use 
disorders as part of NIH's HEAL Initiative continues to help 
fuel the next generation of scientists and clinicians focused 
on mitigating chronic pain with nonaddictive therapies and 
prevention and treatment of drug addiction. The Committee 
encourages NIH, NIDA, and NINDS to continue their efforts 
through the HEAL Initiative in fiscal year 2024, with a focus 
on grant opportunities to support research and education to 
improve outcomes for people with both chronic pain and 
addiction in diverse settings across the United States, 
particularly those located in areas with high incidence of 
people at risk for chronic pain, substance use, and overdose.
    Pediatric Recruitment Within the All of Us Research 
Program.--The Committee remains concerned about the lack of 
active recruitment of children into the All of Us Research 
Program but is encouraged by ongoing activities to finalize 
child recruitment protocols and other steps necessary to 
implement a multi-phase child recruitment program. Ensuring 
children are enrolled in the program is essential to achieving 
the program's overall scientific goals and objectives. The 
Committee strongly supports actively enrolling children into 
the program and encourages the NIH to build within the All of 
Us Research Program a diverse pediatric dataset with depth and 
breadth to accelerate healthcare discovery and innovation for 
children and their families. The Committee also encourages that 
enrollment, retention, and follow-up of children continues 
until this goal is met, even if adult recruiting objectives are 
met, and provides sufficient funding for this purpose.
    Pelvic Floor Disorders [PFDs].--PFDs are common conditions 
that can significantly affect a woman's quality of life. 
Approximately 25 percent of women experience at least one PFD 
and this condition becomes more common with age. Unfortunately, 
health disparities in the care of PFDs is a prevalent issue, 
especially impacting patients in underserved areas, areas with 
limited access to healthcare, barriers to healthcare and care-
seeking behaviors regarding the treatment/management of PFDs. 
Therefore, the Committee urges NIH to support research to 
better understand disparities in care for diverse patients, 
which may include identifying risk factor clusters in 
geographic regions and within these diverse populations that 
suffer from PFDs. The Committee requests an update on this 
effort in the fiscal year 2026 CJ.
    Primate Research Centers.--The Committee includes 
$30,000,000 in funding to remodel, renovate, or alter existing 
research facilities or construct new research facilities for 
non-human primate resource infrastructure, as authorized under 
42 U.S.C. section 283k.
    Psychedelic Research.--The Committee recognizes the 
increased interest and need to study psychedelics, including 
MDMA, ketamine, and psilocybin, and their potential therapeutic 
effects. The Committee encourages NIH to expand its current 
research agenda across its Institutes and Centers, potentially 
by forming a cross-Institute research group, and to encourage 
psychedelic research at the NIH Clinical Center. The Committee 
also encourages NIH to work with FDA in developing and 
supporting public-private collaborations to advance all forms 
of psychedelic research for therapeutic purposes.
    Real World Clinical Data.--The Committee recognizes our 
healthcare system is quickly becoming more digitalized, 
providing more data and information to better inform clinicians 
and researchers and enhance clinical decisions that may lead to 
improved health outcomes for patients. However, today that data 
is stored in fragmented and complex systems limiting its 
interoperability and usability to improve human health. Data 
privacy and reliability are critical components to balance in 
data access including use of these data in biomedical research. 
Technologies such as privacy-preserving record linking [PPRL] 
are now available, enabling access to individual level data of 
de-identified healthcare data across disparate data sources 
such as clinical trials, real-world data sources like 
electronic health records, payor claims, and mortality data, 
while considering confidentiality and privacy. Such 
technologies provide the ability to efficiently extend 
longitudinal data access for efficient observation of 
additional clinical safety and efficacy insights without 
compromising patient privacy. The Committee urges NIH to 
prioritize and standardize across its guidance documents, 
specifications for use of encryption tools and privacy-
preserving record locators to optimize comprehensive linking of 
real-world clinical data alongside traditional prospective data 
collection including but not limited to, those that will go for 
review by the FDA.
    Reducing the Administrative Burden on Researchers.--The 
Committee remains concerned about the status of NIH's 
implementation plans following a 2019 final report on 
administrative burden. The Committee reiterates the directives 
described in the Consolidated Appropriations Act, 2024 (Public 
Law 118-122).
    Reforming the SBIR/STTR Programs at NIH.--At Congress' 
behest the National Academies released a major evaluation of 
NIH's SBIR/STTR programs in 2022. The National Academies' 
report found the time scale and scope of the NIH SBIR/STTR 
review process was out of alignment with the needs of 
innovative small business, and moreover a majority of the peer 
reviewers are academic scholars and a small number of program 
managers have commercial experience. The Committee encourages 
NIH to provide an update on recommendations regarding the 
business and/or commercialization experience of program manager 
and peer reviewers and efforts to implement a review process 
that is more appropriate for industry. NIH is directed to 
report back to the Committee annually over the next 2 years as 
to the progress towards such a plan.
    Reorienting Biomedical Academia Away from Soft Money.--
Across biomedical academia, many professors are expected by 
their universities to raise a substantial portion (sometimes 
even 100 percent) of their own salary via grants. Even a long-
time tenured professor can be at jeopardy of losing part or all 
of their salary if they fail to bring in enough grants. It is 
the sense of Congress that the soft money system can discourage 
the best and most innovative science, because it incentivizes 
individual scientists to stick with the most risk-averse idea 
that can get funded by NIH. As Bruce Alberts has proposed, 
``the maximum amount of money that the NIH contributes to the 
salary of research faculty (its salary cap) could be sharply 
reduced over time, and/or an overhead cost penalty could be 
introduced in proportion to an institution's fraction of soft-
money positions (replacing the overhead cost bonus that 
currently exists).'' NIH is directed to conduct a prospective 
study of academia's use of soft money requirements over the 
next five to 10 years, seek public input as appropriate, 
recommend possible solutions, and provide an update on its 
efforts within 1 year of enactment.
    Research on Enhanced Potential Pandemic Pathogens 
[ePPPs].--The Committee supports the USG Policy for Oversight 
of Dual Use Research of Concern and Pathogens with Enhanced 
Pandemic Potential issued in May 2024. Per Section 5.3 
Responsibilities of Federal Agencies, NIH is directed to 
require all research institutions it supports to fully follow 
this policy as a condition of funding. NIH is also directed to 
provide guidance to research institutions regarding its policy 
through an implementation office, as outlined in the 
Consolidated Appropriations Act, 2024 (Public Law 118-122). The 
Committee continues to provide $1,000,000 for this office to 
serve as a main point of contact for research institutions 
regarding ePPP policy, and develop tools and training guidance 
to strengthen risk-assessment, safety, security, and ethical 
considerations surrounding proposed ePPP research at research 
institutions. NIH shall provide annual reports to the Committee 
on the progress and activities of implementation. In addition, 
NIH is directed to review and, where appropriate, identify 
needed relevant authorities when considering appropriate 
actions for investigators and research institutions that fail 
to follow the research oversight framework under the policy. 
NIH will also consider additional approaches for promoting use 
of these or similar oversight procedures by research 
institutions that conduct life sciences research and do not 
receive Federal funding. NIH is directed to provide a report on 
these activities within 180 days of enactment.
    Research with Non-Human Primates [NHP].--The Committee 
recognizes the critical role of NHP research in virtually all 
areas of biomedical research. Research with unique animal 
models makes irreplaceable contributions to understanding the 
biological processes that cause disease, which is necessary for 
the development, safety and efficacy testing of new 
therapeutics before clinical trials. NHP research will be vital 
to studying both the underlying mechanisms and potential cures 
for existing and emergent diseases. NHP research remains 
critical to understand the causes of degenerative and brain 
diseases and to improve the effectiveness of new compounds and 
non-pharmaceutical treatments such as deep brain stimulation 
and neuromodulation. The Committee urges NIH to award funding 
to meritorious research proposals to study these 
neurodegenerative disorders, including studies that utilize 
NHPs. NIH is also encouraged to continue the development and 
validation of new approach methodologies as promising 
technological advancements that enhance the utility of NHP 
models and may reduce the need for models in the future.
    Research Transparency.--As demonstrated over the past 
several years, the Committee remains committed to funding NIH 
research and ensuring that our Nation's researchers, 
particularly our early career scientists, have the support to 
make the scientific breakthroughs that may transform 
healthcare. However, it is critical that NIH can ensure funds 
are used for the best possible research that fulfill the core 
research mission of NIH. The Committee appreciates that in 
response to prior language, NIH continues to provide, in 
writing made available on a publicly accessible website, that 
each grant or agreement promotes efforts to seek fundamental 
knowledge about the nature and behavior of living systems and/
or the application of that knowledge to enhance health, 
lengthen life, and reduce illness and disability.
    Scientific Management Review Board.--The Committee 
reiterates the directives described in the Consolidated 
Appropriations Act, 2024 (Public Law 118-122). NIH is directed 
to reconvene the SMRB to review the overall research portfolio 
of the agency and advise on the use of organizational 
authorities, including abolishing Institutes or Centers, 
creating new ones, and reorganizing existing structures. The 
Committee directs NIH to provide an annual report on SMRB 
activities.
    Stopping Tax Dollars from Funding Chinese Military 
Research.--The Committee is concerned about research awards 
funded by NIH that are associated with Chinese defense 
entities. Therefore, the Committee directs NIH to submit a 
report to the Committee within 180 days of enactment and 
annually thereafter until September 30, 2026 on all NIH-funded 
research awards that involved persons from the People's 
Republic of China [PRC].
    Study on the Impact of Screen Time on Learning Outcomes.--
Screen time for children rose throughout the COVID-19 pandemic 
and has continued to remain high. One study showed that in 2021 
teens spent an average of 8.5 hours on screens per day, and 
children from ages 8-12 spent 5.5 hours on screens per day. The 
Committee is concerned over the implications of high screen 
time on children's ability to learn and process information in 
schools and urges NIH to study the impact of increased screen 
time on children's learning outcomes.
    Support Innovation in Women's Health.--NIH's SBIR and STTR 
programs are directed to increase investments in supporting 
innovators and early-stage small businesses engaged in research 
and development on women's health. NIH is directed to provide 
an update on these activities within 120 days of enactment.
    Temporomandibular Disorder [TMD].--The Committee notes the 
issuance of the TMD Collaborative for Improving Patient-
Centered Translational Research [TMD IMPACT] by NIDCR and the 
first step in the implementation of a national consortium for 
TMD research. The Committee recognizes that TMD is a complex, 
multisystem condition and therefore encourages the NIH Director 
to work closely with the NIDCR Director to ensure that other 
Institutes, Centers, and Offices with the appropriate 
scientific expertise participate and support NIDCR as it 
implements and manages this project. NIH is encouraged to use 
the recommendations from the recent National Academies of 
Sciences, Engineering and Medicine report on TMDs, from the TMJ 
Patient-led RoundTable efforts, and from patients themselves as 
guidelines in the development of this consortium. The Committee 
is encouraged that TMD, a long neglected, misunderstood and 
underfunded condition is now receiving the attention and 
support needed to improve the understanding of TMD and develop 
evidence-based treatments and care for this complex condition. 
The Committee requests an update within 120 days of enactment 
on the development and implementation of this large-scale 
Collaborative to ensure the full participation of the many 
government and private entities necessary to successfully 
launch the Collaborative.
    Term Limits.--The Committee continues to provide $500,000 
and directs NIH to implement Recommendation 10 from the 2003 
Institute of Medicine report Enhancing the Vitality of the 
National Institutes of Health: Organizational Change to Meet 
New Challenges. NIH is directed to provide an annual report on 
these efforts, including a timeline and any barriers to 
implementation.
    Von Hippel-Lindau [VHL] Disease.--The Committee appreciates 
NIH's support for research on VHL disease, which has led to the 
development of new treatments for not only VHL but also more 
prevalent cancers. While significant research has focused on 
the role between the VHL Gene and Hypoxia-Inducible Factor 2 
Alpha, more research is needed to identify additional molecular 
targets. The Committee requests an update on these activities 
in the fiscal year 2026 CJ.
    Wastewater Surveillance R&D.--The Committee recognizes the 
potential and importance of wastewater surveillance in public 
health surveillance. Building on the prior NIH-supported 
efforts, the Committee encourages NIH to continue efforts 
supporting innovation through developing and improving 
wastewater surveillance capabilities including in rural 
communities.
    Women's Health Research Initiative and NIH-Wide SABV 
Policy.--The Executive Order on Advancing Women's Health 
Research and Innovation directs agencies to develop and 
strengthen research and data standards to improve women's 
health. The Committee supports greater investment in research 
on conditions unique to or that occur predominantly in women or 
manifest themselves differently in women than in men. The 
Committee directs NIH to further integrate and prioritize 
funding for women's health across its research portfolio and to 
study ways to leverage AI to advance women's health research. 
In addition to NIH efforts to dedicate additional funds for 
research on women's health needs, the NIH's sex as a biological 
variable [SABV] policy has helped ensure that research that NIH 
funds considers women's health in the development of study 
design and in data collection and analysis. The Committee 
encourages NIH to track and analyze progress in integrating 
SABV into biomedical research, where appropriate, across its 
Institutes and Centers and to adopt NIH-wide standards 
regarding how applicants, reviewers, and grantees should 
consider SABV in funding opportunities, research designs, 
analyses, and reporting. NIH is directed to provide an update 
on relevant activities within 90 days of enactment.
    Youth Tobacco Cessation Research.--The Committee recognizes 
that despite two million youth using at least one tobacco 
product, there are no FDA-approved tobacco cessation therapies 
for people under 17 and few well-studied, evidence-based 
behavioral interventions for youth tobacco use. The Committee 
encourages NIH to continue to support research on effective 
tobacco cessation modalities for youth under age 18, including 
pediatric studies of the safety and effectiveness of cessation 
treatments currently approved for adults. Studies should 
account for the broad range of tobacco products used by youth, 
including cessation options for individuals interested in 
quitting cigarettes, e-cigarettes, smokeless tobacco, and 
cigars. The Committee urges NIH to consider research gaps 
identified by the U.S. Preventive Services Task Force.

                        BUILDINGS AND FACILITIES

Appropriations, 2024....................................    $350,000,000
Budget estimate, 2025...................................     350,000,000
Committee recommendation................................     350,000,000

    The Committee includes $350,000,000, the same as the fiscal 
year 2024 enacted level, for Buildings and Facilities. For the 
fifth time in as many years, the recommendation does not 
include authority for NIH to transfer up to 1 percent of its 
research funding to the Buildings and Facilities account. This 
is extraordinary authority for a Federal agency and NIH has yet 
to provide an explanation for why this mechanism would be 
appropriate. Funding provided for research should not be 
unilaterally transferred without a sound explanation and robust 
justification of need. The Committee commends the agency for 
continuing to develop a sound capital planning process and for 
keeping the Committee informed on such activities. These 
efforts have been supported by the Committee with modifications 
of section 216 of this act which permit NIH to use up to 
$100,000,000 of research funding for alterations and repairs. 
The Committee directs NIH to continue to provide biannual 
updates of its efforts to develop best practices and its 
maintenance and construction plans for projects whose cost 
exceeds $5,000,000, including any changes to those plans and 
the original baseline estimates for individual projects. 
Finally, the Committee also directs NIH to describe in its 
fiscal year 2026 and future CJs how the projects requested in 
its budgets tie to its capital planning process, including the 
Research Facilities Advisory Committee's role in determining 
which projects are selected for inclusion in the budget.

                   NIH INNOVATION ACCOUNT, CURES ACT

Appropriations, 2024....................................    $407,000,000
Budget estimate, 2025...................................     127,000,000
Committee recommendation................................     127,000,000

    The Committee recommendation includes $127,000,000 to be 
spent from the NIH Innovation Account for the All of Us 
precision medicine initiative. The Committee expects NIH to 
transfer funding shortly after enactment of this act.

              ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH

Appropriations, 2024....................................  $1,500,000,000
Budget estimate, 2025...................................   1,500,000,000
Committee recommendation................................   1,500,000,000

    The Committee includes $1,500,000,000 for the Advanced 
Research Projects Agency for Health [ARPA-H], the same level as 
fiscal year 2024. The Committee continues to believe ARPA-H 
requires a different culture and mission than NIH's other 27 
Institutes and Centers. The Committee continues to direct ARPA-
H to provide quarterly briefings to the Committee on its 
establishment process, hiring, and scientific priorities and 
progress. The Committee expects such briefings to address how 
ARPA-H's activities are designed to advance biomedical research 
and development and the mission to create breakthrough 
technologies, as well as how to balance long-term trans-
disciplinary scientific challenges with short-term research 
goals.
    Amyotrophic Lateral Sclerosis [ALS].--The Committee urges 
ARPA-H to support R&D programs and projects to develop 
therapies, targeted therapies, and treatments for ALS and 
related neurodegenerative disorders.
    Commercialization Network.--Speeding the translation of 
innovative health technologies to market is essential for the 
success of ARPA-H. This acceleration depends on meaningful 
collaboration between researchers, entrepreneurs, and investors 
across sectors and geographic areas. The Committee applauds the 
establishment of the Investor Catalyst Hub in the ARPANET-H hub 
and spoke network and appreciates its initial efforts to build 
a diverse, wide-ranging network of experts to advance 
innovation and commercialization of medical technologies. The 
Committee urges ARPA-H to provide continued funding for the 
Investor Catalyst Hub in fiscal year 2025.
    Emerging Health Threats.--The Committee recognizes that 
ARPA-H plays a unique role in the U.S. science and technology 
enterprise. Modeled after the Defense Advanced Research Agency 
[DARPA] and the Biomedical Advanced Research and Development 
Authority [BARDA] but more broadly focused on improving health 
outcomes for all Americans, ARPA-H is expected to pursue 
transformative advances in health research beyond the scope of 
other public or private efforts. U.S. citizens and interests 
can be threatened by endemic and emerging diseases in any part 
of the world. The Committee urges ARPA-H to contribute in 
unique ways to combating existing and emerging health threats 
here and abroad, and to strengthen U.S. science and technology 
capacity, competitiveness, and leadership.
    Long COVID Research.--ARPA-H is urged to invest in Long 
COVID research to ensure its high-risk, high-reward research is 
focused on drug trials, development of biomarkers, and research 
that includes Long COVID associated conditions, such as 
dysautonomia, postural orthostatic tachycardia syndrome [POTS], 
and myalgic encephalomyelitis/chronic fatigue syndrome [ME/
CFS]. The Committee urges ARPA-H to coordinate with NIH on 
these efforts to augment NIH's Long COVID research portfolio. 
ARPA-H is also urged to prioritize the support of R&D programs 
and projects that can enable clinical trials evaluating 
therapies which target key symptoms and symptom complexes 
associated with Long COVID including widespread pain, fatigue, 
non-restorative sleep, brain fog, dizziness, post-exertional 
malaise [PEM], POTS and loss of taste and smell.
    Novel Alternative Methods.--The Committee is aware that 
ARPA-H's programs, many of which encompass a wide range of 
biomedical research, utilize both animal and non-animal 
research methodologies. Each program is led by a Program 
Manager [PM] who oversees multiple groups of performers who aim 
to solve the same problem through unique approaches. 
Acknowledging ARPA-H's operational model, the Committee urges 
ARPA-H to require performers to specify expected use of animals 
and novel alternative methods [NAMs] in their proposals, if 
known. ARPA-H shall aggregate this data for anticipated awards 
and information from the Vertebrate Animal Section submissions 
(required by the Office of Laboratory Animal Welfare) into a 
comprehensive annual report that reflects the methodologies 
used across their programs, including descriptions and 
rationale for animal models and NAMs used. This report shall be 
submitted to the Committee and made publicly available within 
90 days following the conclusion of each project year. This 
activity will ensure accountability and transparency across 
ARPA-H, fostering ethical research practices while advancing 
biomedical innovation.
    Public Health Interventions.--The Committee urges the 
agency to consider a new program focused on a data system to 
aid proactive public health interventions.
    Women's Health.--The Committee was encouraged by ARPA-H's 
announcement of the Sprint for Women's Health, a $100,000,000 
commitment in response to the White House Initiative for 
Women's Health Research to fund transformative research and 
development in women's health. The Committee urges ARPA-H to 
continue this important work to address women's health and 
accelerate and scale tools, products, and platforms to improve 
women's health outcomes.

       Substance Abuse And Mental Health Services Administration

    The Committee recommends $7,554,306,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA]. The 
recommendation includes $133,667,000 in transfers available 
under section 241 of the PHS Act (Public Law 78-410 as amended) 
and $12,000,000 in transfers from the PPH Fund.
    SAMHSA is the public health agency responsible for 
supporting mental health programs and behavioral healthcare, 
treatment, and prevention services throughout the country.
    The Committee recommendation continues bill language that 
instructs the Assistant Secretary of SAMHSA and the Secretary 
to exempt the Mental Health Block Grant, the Substance Use 
Prevention Treatment, and Recovery Services Block Grant, and 
the State Opioid Response grant from being used as a source for 
the PHS evaluation set-aside in fiscal year 2025.

                             MENTAL HEALTH

Appropriations, 2024....................................  $2,808,546,000
Budget estimate, 2025...................................   3,112,046,000
Committee recommendation................................   2,902,546,000

    The Committee recommends $2,902,546,000 for mental health 
services. The recommendation includes $21,039,000 in transfers 
available under section 241 of the PHS Act (Public Law 78-410 
as amended) and $12,000,000 in transfers from the PPH Fund. 
Included in the recommendation is funding for Mental Health 
Programs of Regional and National Significance [PRNS], the 
MHBG, children's mental health services, Projects for 
Assistance in Transition from Homelessness [PATH], Protection 
and Advocacy for Individuals with Mental Illness [PAIMI], and 
the National Child Traumatic Stress Initiative.

Programs of Regional and National Significance

    The Committee recommends $1,119,453,000 for PRNS within the 
Center for Mental Health Services. The Committee recommendation 
includes $12,000,000 in transfers to PRNS from the PPH Fund. 
These programs address priority mental health needs by 
developing and applying evidence-based practices, offering 
training and technical assistance, providing targeted capacity 
expansion grants, and changing the delivery system through 
family, client-oriented, and consumer-run activities.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

 
------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
CAPACITY:
    Seclusion & Restraint...........        $1,147,000        $1,147,000
    Project AWARE...................       140,001,000       146,001,000
    Mental Health Awareness Training        27,963,000        27,963,000
    Healthy Transitions.............        28,451,000        28,451,000
    Infant and Early Childhood              15,000,000        15,000,000
     Mental Health..................
    Interagency Task Force on Trauma         2,000,000         2,000,000
     Informed Care..................
    Children and Family Programs....         7,229,000         7,229,000
    Consumer and Family Network              4,954,000         4,954,000
     Grants.........................
    Project Launch..................        23,605,000        23,605,000
    Mental Health System                     3,779,000         3,779,000
     Transformation.................
    Primary and Behavioral Health           55,877,000        55,877,000
     Care Integration...............
    National Strategy for Suicide           28,200,000        30,200,000
     Prevention.....................
        Zero Suicide................        26,200,000        26,200,000
            American Indian and              3,400,000         3,400,000
             Alaska Native Set-Aside
            Older Adult Suicide       ................         2,000,000
             Prevention Pilot.......
    Mental Health Crisis Response           20,000,000        30,000,000
     Grants.........................
    988 Lifeline....................       519,618,000       539,618,000
    Garrett Lee Smith-Youth Suicide
     Prevention
        State Grants................        43,806,000        43,806,000
        Campus Grants...............         8,488,000         8,488,000
    American Indian and Alaska               3,931,000         4,931,000
     Native Suicide Prevention......
    Tribal Behavioral Grants........        22,750,000        22,750,000
    Homeless Prevention Programs....        33,696,000        33,696,000
    Minority AIDS...................         9,224,000         9,224,000
    Criminal and Juvenile Justice           11,269,000        11,269,000
     Programs.......................
    Assisted Outpatient Treatment...        21,420,000        21,420,000
    Assertive Community Treatment            9,000,000         9,000,000
     for Individuals with Serious
     Mental Illness.................
Science and Service:
    Garrett Lee Smith-Suicide               11,000,000        11,000,000
     Prevention Resource Center.....
    Practice Improvement and                 7,828,000         7,828,000
     Training.......................
    Consumer and Consumer Support            1,918,000         1,918,000
     Technical Assistance Centers...
    Primary and Behavioral Health            2,991,000         2,991,000
     Care Integration Technical
     Assistance.....................
    Minority Fellowship Program.....        11,059,000        11,059,000
    Disaster Response...............         1,953,000         1,953,000
    Homelessness....................         2,296,000         2,296,000
------------------------------------------------------------------------

    988 Suicide and Crisis Lifeline [988 Lifeline].--Suicide is 
a leading cause of death in the United States, claiming over 
49,000 lives in 2022. The Committee provides $539,618,000 for 
the 988 Lifeline and Behavioral Health Crisis Services. This 
amount includes funding to continue to strengthen the 988 
Lifeline and enable the program to continue to respond in a 
timely manner to an increasing number of contacts. The 988 
Lifeline coordinates a network of independently operated crisis 
centers across the United States by providing suicide 
prevention and crisis intervention services for individuals 
seeking help. The Committee requests a briefing within 90 days 
of enactment on the 988 Lifeline spend plan and related 
activities.
    Behavioral Health Crisis and 988 Coordinating Office.--
Within the total for the 988 Lifeline, the Committee 
recommendation again includes $7,000,000 to continue the office 
dedicated to the implementation of the 988 Lifeline and the 
coordination of efforts related to behavioral health crisis 
care across HHS operating divisions as well as with external 
stakeholders. The Committee requests that the Secretary include 
a multi-year, crisis care system roadmap in the fiscal year 
2026 CJ.
    988 Program Integrity.--The Committee remains concerned 
about the suicide rates among youth and young adults. The 
Committee recognizes the vital services provided through the 
988 Lifeline and the important role of State partners in 
suicide prevention and behavioral health. The Committee 
requests SAMHSA include information on 988 program integrity 
activities, including with respect to safeguarding 988 user 
data and privacy, and a review of work with States and other 
988 program partners in the 988 Lifeline spend plan briefing.
    988 Lifeline Text and Chat-Based Capabilities.--The 
Committee encourages SAMHSA to continue to make funding 
competitively available to chat and text backup centers to 
provide the capacity and infrastructure to handle vulnerable 
youth callers, chats, and texts. Within the total for the 988 
Lifeline, the Committee continues $10,000,000 for specialized 
services for Spanish speakers seeking access to 988 services 
through texts or chats. SAMHSA shall make this funding 
available to one or more organizations with the capacity and 
experience to offer culturally competent, Spanish language text 
and chat services for mental health support and crisis 
intervention.
    Specialized Services for LGBTQ+ Youth.--The Committee 
understands that LGBTQ+ youth are four times more likely to 
attempt suicide than their peers. Within the total for the 988 
Lifeline, the Committee includes $34,100,000 which shall be 
used to provide specialized services for LGBTQ+ youth, 
including training for existing counselors in LGBTQ+ youth 
cultural competency and the establishment and operation of an 
Integrated Voice Response [IVR] to transfer LGBTQ+ youth to a 
specialty organization. This funding shall be awarded through a 
competitive process to an organization with experience working 
with LGBTQ+ youth and with the capacity and infrastructure to 
handle calls, chats, and texts from LGBTQ+ youth through IVR 
technology and other technology solutions where appropriate.
    Unified 988 Lifeline Technology.--The Committee is aware 
that 988 Lifeline crisis contact centers have not all 
implemented the unified technology that has been developed by 
SAMHSA's 988 Lifeline Network Administrator. The Committee 
encourages SAMHSA to inform crisis contact centers within the 
network about the availability of the Unified Platform and to 
urge these same crisis contact centers to use this technology 
if there is not a State-approved unified technology platform.
    Youth-to-Youth Peer Support.--The Committee recognizes that 
young people are uniquely situated to provide peer support for 
teens and young adults who are struggling with their mental 
health. The Committee is also aware that youth-to-youth 
engagement, when conducted by youth with professional support 
and training, has proven effective at reaching young people in 
crisis but is currently underused across the Nation. The 
Committee recommends the inclusion and expansion of peer 
services as a component of the 988 Lifeline, which may include 
integrating training on youth peer services across contact 
centers within the 988 Lifeline network, along with highly 
coordinated referrals and connections for youth peer-run 
support lines that are not formally embedded within the 988 
Lifeline.
    Eating Disorders.--The Committee continues to direct SAMHSA 
to coordinate with HRSA to create a pediatric training model 
for pediatric providers for prevention, early intervention, 
treatment, and ongoing support protocols for youth with or at-
risk of developing an eating disorder.
    Garrett Lee Smith Youth Suicide Prevention.--The Committee 
recommends $43,806,000 for Garrett Lee Smith Youth Suicide 
Prevention programs, which will support the development and 
implementation of early intervention programs and youth suicide 
prevention strategies. Additionally, the Committee recommends 
$11,000,000 for the Garrett Lee Smith Youth Suicide Prevention 
Resource Center.
    Garrett Lee Smith Campus Suicide Prevention Grant 
Program.--The Committee recognizes the importance of addressing 
mental health and suicide prevention on college campuses, 
including at institutions of higher education that are 
traditionally under-resourced. The Committee supports SAMHSA's 
waiver of matching funds for minority-serving institutions and 
community colleges included in the 2024 funding notice and as 
directed in Public Law 118-47. The Committee directs the 
Assistant Secretary to continue to waive the requirement of 
matching funds for minority-serving institutions and community 
colleges as defined by the Higher Education Act of 1965 to help 
meet these growing needs and address disparities in access to 
mental health services. The Secretary may continue to waive 
such requirement with respect to an institution of higher 
education not covered by those definitions, if the Secretary 
determines that extraordinary need at the institution justifies 
the waiver.
    Healthy Transitions.--The Committee includes $28,451,000 
for the Healthy Transitions program, which provides grants to 
States and tribes to improve access to mental healthcare 
treatment and related support services for young people aged 16 
to 25 who either have, or are at risk of developing, a serious 
mental health condition.
    Infant and Early Childhood Mental Health.--The Committee 
provides $15,000,000 for grants to entities such as State 
agencies, Tribal communities, universities, 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. Additionally, the Committee recognizes the 
importance of early intervention strategies to prevent the 
onset of mental disorders, particularly among children. Recent 
research has shown that half of those who will develop mental 
health disorders show symptoms by age 14. The Committee 
encourages SAMHSA to work with States to support services and 
activities related to infants and toddlers, such as expanding 
the infant and early childhood mental health workforce; 
increasing knowledge of infant and early childhood mental 
health among professionals most connected with young children 
to promote positive early mental health and early 
identification; strengthening systems and networks for 
referral; and improving access to quality services for children 
and families who are in need of support.
    Interagency Task Force on Trauma Informed Care.--The 
Committee recommends $2,000,000 to continue the Interagency 
Task Force on Trauma-Informed Care as authorized by the SUPPORT 
Act (Public Law 115-271). The Committee supports the Task 
Force's authorized activities, including the dissemination of 
trauma-informed best practices and the promotion of such models 
and training strategies through all relevant grant programs and 
the Task Force is encouraged to collaborate with the National 
Child Traumatic Stress Network.
    Mental Health Awareness Training.--The Committee provides 
$27,963,000 to continue existing activities, including Mental 
Health First Aid. Mental Health Awareness Training and Mental 
Health First Aid have allowed Americans as well as first 
responders to recognize the signs and symptoms of common mental 
disorders. In addition to the funding made available in this 
bill, the Bipartisan Safer Communities Act included 
$120,000,000 for Mental Health Awareness Training over 4 fiscal 
years, with $30,000,000 made available each fiscal year through 
September 30, 2025, to support mental health awareness 
training. In continuing competitive funding opportunities, 
SAMHSA is directed to include as eligible grantees local law 
enforcement agencies, fire departments, and emergency medical 
units with a special emphasis on training for crisis de-
escalation techniques. SAMHSA is also encouraged to allow 
training for college students, veterans, armed services 
personnel, and their family members and broaden applicable 
settings for trainings to include non-educational and non-
healthcare settings where appropriate within the Mental Health 
Awareness Training program. Additionally, SAMHSA is encouraged 
to prioritize grants to eligible entities that will serve 
within States where there is a high prevalence of adverse 
childhood experiences and youth substance use disorders.
    Mental Health Crisis Response Grants.--The Committee 
understands the significant need for crisis services in order 
to divert people experiencing a mental health crisis away from 
the criminal justice system and into mental health treatment. 
The Committee includes $30,000,000 for communities to create or 
enhance existing crisis response programs that may include 
teams of mental health professionals, law enforcement, 
emergency medical technicians, and crisis workers to provide 
immediate support and stabilization to those in crisis.
    Minority Fellowship Program.--The Committee includes 
$11,059,000 to support grants that will increase the number of 
culturally competent behavioral health professionals who teach, 
administer, conduct services research, and provide direct 
mental illness services for underserved minority populations. 
The Committee understands the importance of increasing the pool 
of culturally competent pediatric mental health professionals, 
including child and adolescent psychiatrists, to address the 
Nation's youth mental health crisis. The Committee encourages 
SAMHSA to prioritize and increase the number of pediatric 
behavioral health treatment providers, including child and 
adolescent psychiatrists, selected to participate in the 
minority fellowship program. The Committee looks forward to the 
report requested in Public Law 118-47 that will outline the 
number and type of healthcare providers, by occupation, 
participating in the program.
    National Strategy for Suicide Prevention.--The Committee 
includes $30,200,000 for suicide prevention programs. Of the 
total, $26,200,000 is for the implementation of the Zero 
Suicide model, which is a comprehensive, multi-setting approach 
to suicide prevention within health systems.
    Additionally, suicide is often more prevalent in highly 
rural areas and among the American Indian and Alaskan Native 
populations. According to the CDC, American Indian/Alaska 
Natives [AI/AN] have the highest rates of suicide of any racial 
or ethnic group in the United States. In order to combat the 
rise in suicide rates among this population, the Committee 
recommends $3,400,000 for AI/AN within Zero Suicide.
    Older Adult Suicide Prevention Program.--The Committee 
notes that deaths by suicide among adults 65 and older 
increased by over 8 percent in 2022 compared to 2021. Older 
adults comprise 16.4 percent of the U.S. population but 
represent 22 percent of all suicides. The Committee includes 
$2,000,000 within the National Strategy of Suicide Prevention 
for an older adult suicide prevention grant program, to be 
implemented in conjunction with the Administration for 
Community Living. The grants will support community efforts to 
reduce suicide among this population through increased 
screening, intervention, and referrals to treatment.
    Primary and Behavioral Health Care Integration Grants and 
Technical Assistance.--The Committee notes that one of the 
goals of the Primary and Behavioral Health Care Integration 
Grant program is to improve patient access to bidirectional 
integrated care services. The Committee provides $55,877,000 
for the program to promote full integration and collaboration 
in clinical practice between behavioral healthcare and primary/
physical healthcare, and $2,991,000 for technical assistance 
and directs SAMHSA to fund the psychiatric collaborative care 
model implemented by primary care physician practices as 
authorized under section 1301(i)(2) of division FF of Public 
Law 117-328. Pursuant to such law, these technical assistance 
centers may be funded through cooperative agreements.
    Project AWARE.--The Committee provides $146,001,000 for 
Project AWARE. This program increases awareness of mental 
health issues and connects young people who have behavioral 
health concerns and their families with needed services. The 
Committee encourages SAMHSA to continue using funds to provide 
mental health services in schools and for school-aged youth, 
and provide an update on these efforts in the fiscal year 2026 
CJ.
    In addition to the funding made available in this bill, the 
Bipartisan Safer Communities Act included $240,000,000 for 
Project AWARE over 4 fiscal years, with $60,000,000 made 
available each fiscal year through September 30, 2025, to 
support mental health services for youth.
    Of the amount provided for Project AWARE, the Committee 
directs SAMHSA to use $17,500,000 for discretionary grants to 
support efforts in high-crime, high-poverty areas and, in 
particular, communities that are seeking to address relevant 
impacts and root causes of civil unrest, community violence, 
and collective trauma. These grants should maintain the same 
focus as fiscal year 2024 grants. SAMHSA is encouraged to 
continue consultation with the Department of Education in 
administration of these grants. The Committee requests a report 
on progress of grantees in the fiscal year 2026 CJ.
    The Committee recognizes the increased need for school and 
community-based trauma services for children, youth, young 
adults, and their families and the need to support school staff 
with training in trauma-informed practices. Within the total 
for Project AWARE, the Committee directs $14,000,000 for 
student access to evidence-based, culturally relevant, trauma 
support services and mental healthcare through established 
partnerships with community organizations as authorized by 
section 7134 of the SUPPORT Act (Public Law 115-271).
    Psychosocial Rehabilitation Model.--The Committee 
encourages SAMHSA to explore the expansion of accredited 
clubhouses to reach a broader subset of the people with serious 
mental illness [SMI]. Specifically, the Committee requests a 
briefing, within 180 days of enactment of this act, with 
recommendations on how SAMHSA will address loneliness and 
social isolation and other social drivers of health through 
community-based models like accredited clubhouses and how 
SAMHSA programs may promote the expansion of accredited 
clubhouses for people with SMI.

Community Mental Health Services Block Grant

    The Committee recommends $1,042,571,000 for the Mental 
Health Block Grant [MHBG]. The recommendation includes 
$21,039,000 in transfers available under section 241 of the PHS 
Act (Public Law 78-410 as amended). In addition to the funding 
made available in this bill, the Bipartisan Safer Communities 
Act included $250,000,000 over 4 fiscal years, with $62,500,000 
made available each fiscal year through September 30, 2025, to 
support the MHBG.
    The MHBG distributes funds to 59 eligible States and 
territories through a formula based on specified economic and 
demographic factors. Grant applications must include an annual 
plan for providing comprehensive community mental health 
services to adults with a serious mental illness and children 
with a serious emotional disturbance.
    The Committee recommendation continues bill language 
requiring that at least 10 percent of the funds for the MHBG 
program be set-aside for evidence-based programs that address 
the needs of individuals with early serious mental illness, 
including psychotic disorders. The Committee continues to 
direct SAMHSA to include in budget justifications a detailed 
table showing at a minimum each State's allotment, name of the 
program being implemented, and a short description of the 
program.
    Crisis Set-Aside.--The Committee continues the 5 percent 
set-aside within the MHBG for States to implement evidence-
based, crisis care programs to address the needs of individuals 
in crisis including those with serious mental illnesses and 
children with serious mental and emotional distress. The 
Committee directs SAMHSA to continue 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 24/
7 mobile crisis units, local and Statewide call centers with 
the capacity to respond to distressed or suicidal individuals, 
and other programs that allow the development of systems where 
individuals can always receive assistance during a crisis.

Children's Mental Health Services

    The Committee recommends $130,000,000 for the Children's 
Mental Health Services program. This program provides grants 
and technical assistance to support comprehensive, community-
based systems of care for children and adolescents with serious 
emotional, behavioral, or mental disorders. Grantees must 
provide matching funds and services must be coordinated with 
the educational, juvenile justice, child welfare, and primary 
healthcare systems. The Committee continues to include a 10 
percent set-aside for an early intervention demonstration 
program with persons not more than 25 years of age at clinical 
high risk of developing a first-episode psychosis.

Projects for Assistance in Transition from Homelessness [PATH]

    The Committee recommends $66,635,000 for PATH, which 
addresses the needs of individuals with serious mental illness 
who are experiencing homelessness or are at risk of 
homelessness. Funds are used to provide an array of services, 
such as screening and diagnostic services, emergency 
assistance, case management, and referrals to the most 
appropriate housing environment.

Protection and Advocacy for Individuals with Mental Illness [PAIMI]

    The Committee recommends $40,000,000 for PAIMI. This 
program helps ensure that the rights of mentally ill 
individuals are protected while they are patients in all public 
and private facilities or while they are living in the 
community, including in their own homes. Funds are allocated to 
States according to a formula based on population and relative 
per capita incomes.

National Child Traumatic Stress Initiative

    The Committee recommends $103,887,000 for the National 
Child Traumatic Stress Initiative, which develops and promotes 
effective treatment and services for children and adolescents 
exposed to a wide array of traumatic events. In addition to the 
funding made available in this bill, the Bipartisan Safer 
Communities Act included $40,000,000 for the National Child 
Traumatic Stress Network [NCTSN] over 4 fiscal years, with 
$10,000,000 made available each fiscal year through September 
30, 2025, for trauma services for youth.
    The Committee supports the NCTSN for building, evaluating, 
disseminating, and delivering evidence-based 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 the network maintains its focus on 
collaboration, data collection, and the provision of direct 
services, and that the NCTSN mission or grant opportunities not 
be limited to training only.

Certified Community Behavioral Health Clinics [CCBHC]

    The Committee includes $400,000,000 for the CCBHC expansion 
program, which allows communities to improve access to mental 
health and substance use disorder treatment services.
    The Committee continues to direct SAMHSA to prioritize 
resources to entities within States that are able to quickly 
stand-up a CCBHC, including those part of the demonstration 
authorized by section 223(a) of the Protecting Access to 
Medicare Act of 2014 [PAMA] (Public Law 113-93).
    Accreditation.--The Committee urges SAMHSA to examine and 
approve accreditation products that certify CCBHCs in having 
met requirements as established by SAMHSA. CCBHC grantees 
should receive independent accreditation from an approved 
entity as part of participation under this program. Funding 
included under this program is permitted for grantees' use to 
obtain any such required independent accreditation in lieu of 
self-attestation for meeting the CCBHC requirements as a part 
of reducing paperwork and administrative burden, and SAMHSA 
shall consider the costs of accreditation when establishing 
funding levels for clinics under this grant. The Committee 
further permits SAMHSA to use funds under this program to 
establish the accreditation process and expand the audiences 
eligible to receive training and technical assistance, to 
include (but not limited to) demonstration CCBHCs and CCBHCs 
participating in a State-led implementation effort under a 
Medicaid State Plan Amendment, waiver, or other Medicaid 
authority.
    Data Infrastructure.--The Committee provides $2,500,000 for 
SAMHSA to develop a CCBHC data infrastructure and data 
repository program while establishing a data reporting 
partnership with at least one State currently operating a 
Statewide CCBHC network. With more than 500 CCBHCs operating in 
46 States, it is incumbent upon the agency to assure a high 
level of accountability in concert with expanded access to 
intensive community-based services for persons with SMI and 
substance use disorders. The Committee directs SAMHSA to report 
to the Senate and House Appropriations Committees on this 
undertaking within 90 days of enactment of this act.

                       SUBSTANCE ABUSE TREATMENT

Appropriations, 2024....................................  $4,159,298,000
Budget estimate, 2025...................................   4,194,048,000
Committee recommendation................................   4,235,298,000

    The Committee recommends $4,235,298,000 for substance use 
disorder services and treatment programs, including PRNS and 
the substance use prevention and treatment block grant to the 
States. The recommendation includes $81,200,000 in transfers 
available under section 241 of the PHS Act (Public Law 78-410 
as amended).

Programs of Regional and National Significance

    The Committee recommends $587,219,000 for PRNS within the 
Center for Substance Abuse Treatment. The recommendation 
includes $2,000,000 in transfers available under section 241 of 
the PHS Act (Public Law 78-410 as amended).
    PRNS include activities to increase capacity by 
implementing service improvements using proven evidence-based 
approaches, as well as science-to-services activities that 
promote the identification of practices thought to have 
potential for broad service improvement.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

 
------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
CAPACITY:
    Opioid Treatment Programs/             $10,724,000       $10,724,000
     Regulatory Activities..........
    Screening, Brief Intervention,          33,840,000        33,840,000
     and Referral to Treatment
     [SBIRT]........................
        PHS Evaluation Funds........         2,000,000         2,000,000
    Targeted Capacity Expansion-           122,416,000       125,416,000
     General........................
        Medication Assisted                111,000,000       114,000,000
         Treatment..................
            Tribal Set-aside........        14,500,000        14,500,000
    Grants to Prevent Prescription          16,000,000        16,000,000
     Drug/Opioid Overdose...........
    First Responder Training........        57,000,000        59,000,000
        Rural Focus.................        32,000,000        34,000,000
    Pregnant and Postpartum Women...        38,931,000        40,931,000
    Recovery Community Services              4,434,000         4,434,000
     Program........................
    Children and Families...........        30,197,000        30,197,000
    Treatment Systems for Homeless..        37,114,000        37,114,000
    Minority AIDS...................        66,881,000        66,881,000
    Criminal Justice Activities.....        94,000,000        94,000,000
        Drug Courts.................        74,000,000        74,000,000
    Improving Access to Overdose             1,500,000         1,500,000
     Treatment......................
    Building Communities of Recovery        17,000,000        18,000,000
    Peer Support Technical                   2,000,000         2,000,000
     Assistance Center..............
    Comprehensive Opioid Recovery            6,000,000         7,000,000
     Centers........................
    Emergency Department                     8,000,000         8,000,000
     Alternatives to Opioids........
    Treatment, Recovery, and                12,000,000        12,000,000
     Workforce Support..............
    Youth Prevention and Recovery            2,000,000         3,000,000
     Initiative.....................
Science and Service:
    Addiction Technology Transfer            9,046,000        10,046,000
     Centers........................
    Minority Fellowship Program.....         7,136,000         7,136,000
------------------------------------------------------------------------

    Building Communities of Recovery and Peer Support 
Networks.--The Committee appreciates SAMHSA's implementation of 
new funding for community-based networks assisting individuals 
with substance use disorder recovery, and urges SAMHSA to 
promote the expansion of recovery support services and to 
reduce stigma associated with addictions. The Committee 
recognizes the coordinated efforts of this program to connect 
people in recovery to a wide array of community resources, 
including housing services, primary care, employment resources, 
among others, and urges the program to expand its reach to 
others in need of support. To further support these recovery 
community organizations, the Committee continues $2,000,000 for 
the National Peer Run Training and Technical Assistance Center 
to provide addiction recovery support to peer networks and 
recovery communities.
    Comprehensive Opioid Recovery Centers.--The Committee 
includes $7,000,000, to help ensure that people with substance 
use disorders can access proper treatment, as authorized by 
section 7121 of the SUPPORT Act.
    Drug Courts.--The Committee recommends $74,000,000 for Drug 
Courts. The Committee continues to direct SAMHSA to ensure that 
all funding for drug treatment activities is allocated to serve 
people diagnosed with a substance use disorder as their primary 
condition. SAMHSA is further directed to ensure that all drug 
court recipients work with the corresponding State alcohol and 
drug 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 $8,000,000 to award grants to hospitals and 
emergency departments to develop, implement, enhance, or study 
alternatives to opioids for pain management in such settings as 
authorized in section 7091 of the SUPPORT Act.
    First Responder Training.--The Committee provides 
$59,000,000 for First Responder Training grants. Of this 
amount, $34,000,000 is set aside for rural communities with 
high rates of substance use. In addition, $13,500,000 of this 
funding is provided to make new awards to rural public and non-
profit fire and EMS agencies to train and recruit staff, 
provide education, and purchase equipment (including 
medications such as naloxone and protective equipment) as 
authorized in the Supporting and Improving Rural EMS Needs Act, 
included in the Agriculture Improvement Act of 2018 (Public Law 
115-334). The Committee directs SAMHSA to ensure funding is for 
new awardees and allows awards in amounts less than the maximum 
award amount to ensure nationwide funding.
    Grants to Prevent Prescription Drugs/Opioid Overdoses.--The 
Committee recognizes that the number of young Americans dying 
due to opioid overdose is rising. The Committee acknowledges 
the existing Grants for Reducing Overdose Deaths program and 
encourages the Secretary to expand eligibility to provide 
schools access to this program for training and for opioid 
overdose reversal agents, such as naloxone.
    Medication-Assisted Treatment.--The Committee includes 
$114,000,000 for medication-assisted treatment, of which 
$14,500,000 is for grants to Indian Tribes, Tribal 
organizations, or consortia. These grants should target States 
with the highest age adjusted rates of admissions, including 
those that have demonstrated a dramatic age-adjusted increase 
in admissions for the treatment of opioid use disorders. The 
Committee continues to direct the Center for Substance Abuse 
Treatment to ensure that these grants include as an allowable 
use the support of medication-assisted treatment and other 
clinically appropriate services to achieve and maintain 
abstinence from all opioids, including programs that offer low-
barrier or same day treatment options.
    Medications for Opioid Use Disorder.--The Committee urges 
SAMHSA to include as an allowable use of funds all FDA approved 
medications for opioid use disorder and overdose reversal and 
other clinically appropriate services to treat opioid use 
disorder.
    Minority Fellowship Program.--The Committee includes 
$7,136,000 to support grants that will increase the number of 
culturally competent behavioral health professionals who teach, 
administer, conduct services research, and provide direct 
substance use disorder treatment services for minority 
populations that are underserved.
    Opioid Use in Rural Communities.--The Committee is aware 
that response to the opioid use disorder crisis continues to 
pose unique challenges for rural America. Rural areas can 
struggle with limited access to care and there is a lack of 
health professionals necessary for identifying, diagnosing, and 
treating patients with substance use disorders, as well as 
assisting individuals in recovery. As a result, responding to 
the opioid crisis in rural America requires a comprehensive 
approach, which may involve: an integrated approach to care; 
collaboration when appropriate with patients and their 
families; involvement of community partners and institutions; 
advancing competency and skills development for healthcare 
providers treating people with substance use disorders; 
training to provide care in a culturally responsive manner; and 
the use of technologies to ensure improved access to medically 
underserved areas through the use of telehealth and the 
addition of treatment programs where feasible. The Committee 
encourages SAMHSA to support initiatives to advance these 
objectives, specifically focusing on addressing the needs of 
individuals with substance use disorders in rural and 
medically-underserved areas, as well as programs that emphasize 
a comprehensive community-based approach involving academic 
institutions, healthcare providers, and local criminal justice 
systems.
    Opioid Use Disorder Recurrence.--The Committee is concerned 
that relapse following withdrawal management from opioids is a 
contributing factor to the overdose crisis. The Committee 
appreciates SAMHSA's efforts to address this within the Federal 
grant population by emphasizing the potential benefits of 
withdrawal management for opioid use disorder followed by 
medication to prevent recurrence and encourages SAMHSA to 
disseminate and implement this policy in all settings where 
withdrawal management is offered, including opioid treatment 
programs, rehabilitation centers, and criminal justice 
settings.
    Pregnant and Postpartum Women Program.--The Committee 
includes $40,931,00 for the Pregnant and Postpartum Women 
program, which uses a family-centered approach to provide 
comprehensive residential substance use disorder treatment 
services for pregnant and postpartum women, their minor 
children, and other family members. The Committee encourages 
SAMHSA to prioritize States that support best-practice 
collaborative models for the treatment and support of pregnant 
women with opioid use disorders.
    Substance Use Screening, Brief Intervention, and Referral 
to Treatment [SBIRT].--The Committee understands that substance 
use disorders, including opioid use, typically begin in 
adolescence, and that preventing early substance use is an 
effective strategy to prevent problems later in life. The 
Committee is also aware that SBIRT has been shown to be a cost-
effective model for reducing and preventing underage drinking 
and other substance use, but that many health providers, 
especially pediatricians and those in underserved communities, 
have not been trained to use the method effectively. The 
Committee encourages SAMHSA to use funds for the adoption of 
SBIRT protocols in primary care and other appropriate settings 
that serve youth 12 to 21 years of age, as well as for the 
adoption of system-level approaches to facilitate the uptake of 
SBIRT into routine healthcare visits for adults.
    Treatment Assistance for Localities.--The Committee 
recognizes the use of peer recovery specialists and mutual aid 
recovery programs that support medication-assisted treatment 
and directs SAMHSA to support evidence-based, self-empowering, 
mutual aid recovery support programs that expressly support 
medication-assisted treatment in its grant programs.
    Treatment, Recovery, and Workforce Support.--The Committee 
includes $12,000,000 for SAMHSA to continue implementation of 
section 7183 of the SUPPORT Act.
    Women's Addiction Services Leadership Institute.--The 
Committee is aware that CSAT implemented for 10 years an 
important workforce development initiative known as the Women's 
Addiction Services Leadership Institute [WASLI]. The program, 
which ended in 2018 due to insufficient funding, strengthened 
the capacity of emerging leaders to meet the needs of women 
with substance use disorders by developing participants' 
leadership skills and creating a network of the next generation 
of leaders in women's addiction services. A total of 112 
emerging leaders graduated from WASLI and 56 coaches received 
training in executive coaching. The Committee includes 
$1,000,000 within the Addiction Technology Transfer Centers for 
SAMHSA to reinstitute WASLI in order to close a significant gap 
in Federal support to strengthen and retain the women's 
substance use disorder services workforce.

State Opioid Response [SOR] Grants

    The Committee provides $1,600,000,000 for grants to States 
to address the opioid crisis. Bill language provides not less 
than 4 percent for grants to Indian Tribes or Tribal 
organizations. The Committee supports the 15 percent set-aside 
for States with the highest age-adjusted mortality rate related 
to substance use disorders, as authorized in Public Law 117-
328. The Assistant Secretary is encouraged to apply a weighted 
formula within the set-aside based on state ordinal ranking. 
Activities funded with this grant may include treatment, 
prevention, and recovery support services. The Committee 
continues to direct SAMHSA to conduct a yearly evaluation of 
the program to be transmitted to the Committees on 
Appropriations of the House of Representatives and Senate no 
later than 180 days after enactment of this act. SAMHSA is 
directed to make such evaluation publicly available on SAMHSA's 
website. The Committee further directs SAMHSA to continue 
funding technical assistance within the administrative portion 
of the appropriated amounts for the SOR grants, to provide 
locally based technical assistance teams as has been done 
through the Opioid Response Network. The Committee recognizes 
the importance and essential work currently being done by the 
Opioid Response Network in delivering technical assistance to 
State and Territory SOR grantees, sub-recipients and others 
addressing opioid use disorder and stimulant use disorder in 
their communities.
    SOR Formula Data.--The Committee remains concerned that the 
fatal overdose data used in determining the 15 percent set 
aside reflects all drug poisoning deaths, which does not 
accurately identify rates of total overdoses from opioids, 
including fentanyl. The Committee urges the Assistant Secretary 
to consider using data pertaining to opioid-specific drug 
overdoses.
    SOR Funding Cliffs.--The Committee continues to direct 
SAMHSA to avoid significant funding cliffs between States with 
similar opioid mortality data and to prevent unusually large 
changes in a State's SOR allocation when compared to the prior 
year's allocation, and acknowledges SAMHSA's work to avoid 
cliffs in the last funding cycle. In ensuring the formula 
avoids such cliffs, the Assistant Secretary may consider 
options including, but not limited to, expanding the number of 
States that are eligible for the 15 percent set aside and using 
multiple years of data to minimize the effect of temporary 
changes in overdose mortality rates. SAMHSA shall submit to the 
Committees on Appropriations of the House of Representatives 
and the Senate a work plan of the proposed allocation of funds 
not later than 30 days prior to awarding grants.
    Rural Opioid Technical Assistance Regional Centers [ROTA-R] 
Cooperative Agreements.--The Committee is concerned with the 
proposal to consolidate all ROTA-R activities into one program 
award in the fiscal year 2024 notice of funding announcement. 
This decision could dilute the effectiveness of the traditional 
ROTA-R program and jeopardize the ability to effectively 
respond to locally identified needs, and leave behind the rural 
communities that are currently being served. The Committee 
recognizes the need, however, for more collaboration and 
coordination among ROTA-R recipients while also appreciating 
the unique needs of each regional, rural community to address 
the opioid crisis. As such, the Committee directs SAMHSA to 
maintain funding for the 10 cooperative agreements under the 
ROTA-R program at not less than the fiscal year 2023 level 
instead of consolidating the program, and directs not more than 
$1,500,000 to use for a technical assistance center to serve as 
a coordinating body for the ROTA-R recipients.

Substance Use Prevention, Treatment, and Recovery Services [SUPTRS] 
        Block Grant

    The Committee recommends $2,048,079,000 for the SUPTRS 
Block Grant. The recommendation includes $79,200,000 in 
transfers available under section 241 of the PHS Act (Public 
Law 78-410 as amended).
    The Committee recognizes the importance of the block grant 
given its flexibility to allow States to direct resources to 
address the most pressing needs. This funding stream is also 
critical in assisting States to address all substance use 
disorders, including, but not limited to, those related to 
alcohol, cocaine, and methamphetamine. In addition, States may 
use SUPTRS Block Grant funds to support medications and 
recovery support for the treatment of alcohol use and other 
substance use disorders, including to support peer recovery 
housing. The Committee also notes the importance of the block 
grant's 20 percent prevention set-aside, which is a vital 
source of primary prevention funding. The block grant provides 
funds to States to support alcohol and drug use prevention, 
treatment, and rehabilitation services. Funds are allocated to 
States according to a formula.
    The Secretary is encouraged to review and recommend changes 
to the formula used for distributing SUPTRS block grant funds 
to States no later than 1 year prior to the expiration of the 
authorization to ensure that sufficient funds are being 
directed to the hardest hit States, specifically those with the 
highest drug overdose death rates.
    Funding Flexibilities.--To address the growing need for 
substance use disorder prevention and treatment, States, 
Territories and their communities have been developing 
innovative ways to engage the millions of people with substance 
use disorders to access treatment services. The Committee 
encourages SAMHSA to implement funding flexibilities that 
allows States, Territories, and their communities the ability 
to rollover unused SUPTRS dollars allowing for these innovative 
programs to continue after they have been implemented.
    No Cost Extension.--The Committee directs SAMHSA to allow 
States to apply for a one-year, no-cost extension to September 
30, 2026 for the allocation of supplemental funds to the SUPTRS 
Block Grant as provided in Public Law 117-2. States are 
concerned about the impending fiscal cliff. An extension as 
described allows certain States to work with their providers to 
implement spending plans in a more strategic, predictable, and 
efficient manner.

                       SUBSTANCE ABUSE PREVENTION

Appropriations, 2024....................................    $236,879,000
Budget estimate, 2025...................................     236,879,000
Committee recommendation................................     246,879,000

    The Committee recommends $246,879,000 for the Center for 
Substance Abuse Prevention [CSAP], the sole Federal 
organization with responsibility for improving accessibility 
and quality of substance use prevention services.
    The Committee continues to instruct SAMHSA to ensure that 
all the funding provided to CSAP, as well as the 20 percent 
prevention set aside in the Substance Use Prevention, 
Treatment, and Recovery Services Block Grant, be used only for 
evidence-based substance use prevention activities. The 
Committee looks forward to the report requested in Public Law 
118-47 detailing how this guidance is being applied to all CSAP 
programs as well as in the guidance to the States and 
territories regarding the 20 percent prevention set aside in 
the SUPTRS Block Grant.

Programs of Regional and National Significance

    The Committee provides $246,879,000 for PRNS within CSAP. 
These programs support the development of new practice 
knowledge on substance use prevention; identification of proven 
effective models; dissemination of science-based intervention 
information; State and community capacity building for 
implementation of proven, effective substance use prevention 
programs; and programs addressing new needs in the prevention 
system.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

 
------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
CAPACITY:
    Strategic Prevention Framework/       $135,484,000      $145,484,000
     Partnership for Success........
        Strategic Prevention                10,000,000        10,000,000
         Framework Rx...............
    Federal Drug-Free Workplace.....         5,139,000         5,139,000
    Minority AIDS...................        43,205,000        43,205,000
    Sober Truth on Preventing               14,500,000        14,500,000
     Underage Drinking (STOP Act)...
            National Adult-Oriented          2,500,000         2,500,000
             Media Public Services
             Campaign...............
            Community Based                 11,000,000        11,000,000
             Coalition Enhancement
             Grants.................
            Interagency Coordinating         1,000,000         1,000,000
             Committee to Prevent
             Underage Drinking......
        Tribal Behavioral Health            23,665,000        23,665,000
         Grants.....................
Science and Service:
        Center for the Application           9,493,000         9,493,000
         of Prevention Technologies.
        Science and Service Program          4,072,000         4,072,000
         Coordination...............
        Minority Fellowship Program.         1,321,000         1,321,000
------------------------------------------------------------------------

    Interagency Coordinating Committee for the Prevention of 
Underage Drinking [ICCPUD].--The Committee understands ICCPUD 
funding has been used for activities that fall outside its 
authorization as specified in Public Law 109-422. The funding 
provided in this act for ICCPUD shall only be used for the 
purpose of preventing or reducing underage drinking and not for 
any other purpose.
    Minority Fellowship Program Support for Prevention 
Workforce.--The Committee directs SAMHSA to award $1,321,000 in 
Minority Fellowship Program funds, to support a separate 
prevention fellowship program that will increase the number of 
culturally competent prevention specialists to help expand 
prevention programming for underserved minority populations.
    Prevention Technology Transfer Centers [PTTC] Network.--The 
Committee supports the work of the PTTC Network and efforts 
related to certified prevention specialists and the Prevention 
Fellowship program. This program supported 16 early career 
prevention fellows throughout each HHS region where they gained 
hands on experience working in State alcohol and drug agencies. 
Fellows, coached by mentors, developed leadership skills; 
received training in professional development; acquired 
proficiency in core competencies to prepare for certified 
prevention specialist exams; and prepared for employment 
opportunities in the substance use prevention field.
    Strategic Prevention Framework.--The Committee recommends 
$145,484,000 for the Strategic Prevention Framework. Within the 
total provided, $135,484,000 is for the Strategic Prevention 
Framework-Partnerships for Success program, and $10,000,000 is 
for Strategic Prevention Framework-Rx. The Strategic Prevention 
Framework is designed to prevent the onset of substance misuse 
while strengthening prevention capacity and infrastructure at 
the State, community, and Tribal levels. The Committee 
recognizes that substance use prevention is underutilized 
relative to its ability to prevent and delay substance use 
initiation as well as slow the pathways to addiction and 
overdose, and that demand for community-based primary 
prevention resources far outpaces available funding.
    Sober Truth on Preventing [STOP] Underage Drinking Act.--
The Committee provides $14,500,000 for the STOP Act. Of this 
funding, $11,000,000 is for community-based coalition 
enhancement grants, $2,500,000 is for the National media 
campaign, and $1,000,000 is for the Interagency Coordinating 
Committee on the Prevention of Underage Drinking.
    Subawards.--The Committee is concerned about the 
accountability of grants provided under SP-22-001 and directs 
SAMHSA to track and monitor subawards.
    Substance Use Disorder Prevention Workforce Report.--The 
Committee notes that SAMHSA was directed in fiscal year 2022 to 
conduct a comprehensive national study regarding the substance 
use prevention workforce. The study will collect information on 
the existing availability of and access to data on prevention 
workforce size, salaries, and 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 looks forward to a briefing from SAMHSA 
on the study's findings within 60 days of issuing the final 
report.
    Tribal Behavioral Health Grants.--SAMHSA has administered 
Tribal Behavioral Health Grants for mental health and substance 
use prevention and treatment for Tribes and Tribal 
organizations since fiscal year 2014. In light of the continued 
growth of this program, as well as the urgent need among Tribal 
populations, the Committee continues to urge the Assistant 
Secretary for SAMHSA to engage with Tribes on ways to maximize 
participation in this program.

                HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2024....................................    $241,673,000
Budget estimate, 2025...................................     172,583,000
Committee recommendation................................     232,920,000

    The Committee recommends $232,920,000 for Health 
Surveillance and Program Support activities. The recommendation 
includes $31,428,000 in transfers available under section 241 
of the PHS Act (Public Law 78-410 as amended).
    This activity supports Federal staff and the administrative 
functions of the agency. It also provides funding to SAMHSA's 
surveillance and data collection activities, including national 
surveys such as the National Survey on Drug Use and Health.
    Within the total provided for Health Surveillance and 
Program Support, the Committee recommendation includes funding 
for the following activities:

 
------------------------------------------------------------------------
                                      Fiscal year 2024      Committee
           Budget activity              appropriation    recommendation
------------------------------------------------------------------------
Health Surveillance.................       $50,623,000       $50,623,000
    PHS Evaluation Funds............        30,428,000        30,428,000
Program Support.....................        84,500,000        84,500,000
Performance and Quality Information         10,200,000        10,200,000
 Systems............................
Drug Abuse Warning Network..........        10,000,000        10,000,000
Public Awareness and Support........        13,260,000        13,260,000
Behavioral Health Workforce Data....         1,000,000         1,000,000
    PHS Evaluation Funds............         1,000,000         1,000,000
------------------------------------------------------------------------

    Block Grant Reporting Requirements.--The Committee 
acknowledges the important role of the Community Mental Health 
Services and Substance Use Prevention, Treatment, and Recovery 
Services Block Grants in supporting States' efforts to provide 
resources for expanded mental health and substance use disorder 
treatment and prevention services. The Committee reiterates the 
request for a report as included in Public Law 118-47 regarding 
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.
    Congressionally Directed Spending.--Within the funds 
included in this account, $63,337,000 are for the projects, and 
in the amounts, specified in the table titled ``Congressionally 
Directed Spending Items'' at the end of this Committee Report.
    Drug Abuse Warning Network.--The Committee recommends 
$10,000,000 for the Drug Abuse Warning Network [DAWN]. 
Authorized by the 21st Century Cures Act, DAWN is a 
surveillance system to monitor emergency department visits in 
order to help public health workers, policy makers, and other 
stakeholders respond effectively to emerging substance use 
trends.
    Health Information Technology.--The Committee understands 
that adoption of health information technology [health IT] 
among behavioral health providers currently lags behind that of 
other provider types and recognizes the benefits of advancing 
health IT in behavioral healthcare settings. The Committee 
supports the efforts of the Behavioral Health Information 
Technology Initiative to pilot the inclusion of behavioral 
health data elements in health IT within the SUPTRS and Mental 
Health block grants. The Committee encourages SAMHSA to explore 
providing States with flexibility within the block grant 
administrative cap to pursue the additional incorporation of 
health IT.
    National Survey on Drug Use and Health [NSDUH].--Recent 
data from NSDUH indicates that LGBTQ+ adults are more likely to 
experience mental health conditions such as depression and 
suicidality. The Committee encourages SAMHSA to continue to use 
NSDUH to better understand how to support the LGBTQ+ community 
through mental health and substance use programs.
    Program Support.--The Committee recommends $84,500,000 for 
program support, to ensure SAMHSA has the resources and staff 
to further its mission.

               Agency for Healthcare Research and Quality

Appropriations, 2024....................................    $369,000,000
Budget estimate, 2025...................................     387,345,000
Committee recommendation................................     376,000,000

    The Committee provides $376,000,000 for the Agency for 
Healthcare Research and Quality [AHRQ]. This funding is 
combined with $126,000,000 in mandatory funding from the 
Patient-Centered Outcomes Research Trust Fund. AHRQ's mission 
is to enhance the quality, appropriateness, and effectiveness 
of health services, as well as access to such services. AHRQ 
conducts, supports, and disseminates scientific and policy-
relevant research on topics, such as promoting high-quality 
care and patient safety, eliminating healthcare disparities, 
using information technology, and evaluating the effectiveness 
of clinical services.

                  HEALTH COSTS, QUALITY, AND OUTCOMES

    Health costs, quality, and outcomes [HCQO] research 
activity is focused on improving clinical practice, 
strengthening the healthcare system's capacity to deliver 
quality care, and tracking progress toward health goals through 
monitoring and evaluation.
    Within the total provided for HCQO, the Committee 
recommendation includes funding for the following activities:
    Center for Primary Care Research.--The Committee includes 
no less than $2,000,000 for the Center for Primary Care 
Research authorized by 42 U.S.C. 299b-4(b). The center supports 
clinical primary care research as well as strategies to improve 
primary care delivery and advancing the development of primary 
care researchers. The Committee supports efforts to coordinate 
research in areas such as multiple chronic conditions, symptom 
syndromes such as Long COVID, behavioral and social health 
integration, telehealth in primary care, shared decision-
making, and patient experience of care. The areas of focus 
should include, but not be limited to, expanding research on 
persons with multiple co-morbid conditions and improving 
primary care in rural and underserved areas and health equity.
    Improving Maternal Health.--The Committee continues to 
support AHRQ efforts to address the complex challenges of 
ensuring safe and healthy pregnancies and childbirth, 
particularly for underserved women who are at substantially 
higher risk of complication and death.
    Long COVID.--The extensive incidence of individuals 
suffering from Long COVID (post-acute sequelae of SARS CoV-2 
infection [PASC]) presents an ongoing challenge to the 
healthcare system, patients, and their caregivers. The 
Committee recommendation includes $13,500,000 to continue the 
work of the Long COVID Centers of Excellence and the Long COVID 
Care Network. The Committee continues to direct AHRQ to 
coordinate these efforts with other federally funded Long COVID 
research initiatives, and to encourage robust data collection 
and data sharing efforts among agencies and grantees.
    Menopause Research.--The Committee provides $5,000,000 for 
a Menopause Research to Action Network to scale and accelerate 
existing and emerging research evidence and care delivery 
models into routine clinical practice. The Network shall focus 
on improving treatment and management of perimenopause and 
menopausal symptoms, as well as related chronic conditions to 
help improve mid-life health outcomes among women. In doing so, 
the Committee directs AHRQ to: (1) prioritize projects that 
propose scaling up evidence-based interventions that have 
demonstrated potential for improving care delivery and 
outcomes; (2) ensure the Network has the capability to collect 
and disseminate new findings and best practices widely, 
including to rural and underserved areas; and (3) coordinate 
these efforts with other Federal healthcare agencies.
    Opioid Research.--The Committee continues to support the 
research AHRQ has undertaken to better equip practitioners with 
evidence-based interventions to treat opioid and multi-
substance misuse. The Committee is aware that many patients 
with substance use disorders face significant barriers to care 
from siloed medical, behavioral health, and substance use 
treatment systems, new physical disabilities related to 
complications from substance use, and housing insecurity. The 
Committee directs AHRQ to support research that integrates the 
management of substance use disorders in primary care settings. 
The Committee similarly urges AHRQ to prioritize funding 
opportunities for innovative integrated care models that span 
the continuum of hospitalization, transitional care, primary 
care, and community-based interventions.
    Patient Safety.--The Committee continues to support AHRQ's 
research to address failures in the diagnostic process and to 
support Diagnostic Safety Centers of Excellence to develop 
systems, measures, and new technology solutions to improve 
diagnostic safety and quality.

United States Preventive Services Task Force [USPSTF]

    The Committee recommends $11,542,000 for the USPSTF, which 
works to improve the health of people nationwide by making 
evidence-based recommendations about clinical preventive 
services.
    Medical Innovations.--The Committee continues to note 
concern with the USPSTF's ability to keep pace with medical 
innovation. Emerging and innovative screening modalities can 
further public health for all Americans and address health 
inequities by improving timely access to and compliance with 
USPSTF-recommended screenings. The Committee continues to 
encourage the USPSTF to utilize the Early Topic Update process 
described in the USPSTF procedure manual to review a 
recommendation on an enhanced timeframe upon a showing of new 
evidence. The Committee also continues to urge the USPSTF to 
prioritize review of any new screening test or preventive 
medication approved or cleared by the FDA that is a preventive 
strategy or modality pertaining to, but not included in, a 
previous USPSTF recommendation.
    USPSTF Public Engagement.--The Committee continues to 
encourage the USPSTF to advance open processes that help ensure 
meaningful engagement by the public, including underrepresented 
groups.

                   MEDICAL EXPENDITURE PANEL SURVEYS

    The Committee recommends $72,791,000 for Medical 
Expenditure Panel Surveys [MEPS], which collect detailed 
information annually from households, healthcare providers, and 
employers regarding how Americans use and pay for healthcare. 
The data from MEPS are used to develop estimates of healthcare 
utilization, expenditures, sources of payment, and the degree 
of health insurance coverage of the U.S. population.

                            PROGRAM SUPPORT

    The Committee recommends $73,100,000 for program support. 
This activity funds the overall management of AHRQ, including 
salaries, benefits, and overhead costs.

               Centers for Medicare and Medicaid Services


                     GRANTS TO STATES FOR MEDICAID

Appropriations, 2024....................................$406,956,850,000
Budget estimate, 2025................................... 383,609,399,000
Committee recommendation................................ 383,609,399,000

    The Committee recommends $383,609,399,000 in mandatory 
funding for Grants to States for Medicaid.
    The fiscal year 2025 recommendation excludes 
$245,580,414,000 in fiscal year 2024 advance appropriations for 
fiscal year 2025. As requested by the administration, 
$261,063,820,000 is provided for the first quarter of fiscal 
year 2026.
    The Medicaid program provides medical care for eligible 
low-income individuals and families. It is administered by each 
of the 50 States, the District of Columbia, and the U.S. 
territories. Federal funds for medical assistance are made 
available to the States according to a formula that determines 
the appropriate Federal matching rate for State program costs. 
This matching rate is based on the State's average per capita 
income relative to the National average and cannot be less than 
50 percent.

                   PAYMENTS TO HEALTHCARE TRUST FUNDS

Appropriations, 2024....................................$476,725,000,000
Budget estimate, 2025................................... 521,757,000,000
Committee recommendation................................ 521,757,000,000

    The Committee recommends $521,757,000,000 in mandatory 
funding for payments to healthcare trust funds.
    This entitlement account includes the general fund subsidy 
to the Federal Supplementary Medical Insurance Trust Fund for 
Medicare Part B benefits and for Medicare Part D drug benefits 
and administration, plus other reimbursements to the Federal 
Hospital Insurance Trust Fund for Part A benefits and related 
administrative costs that have not been financed by payroll 
taxes or premium contributions.

                           PROGRAM MANAGEMENT

Appropriations, 2024....................................  $3,669,744,000
Budget estimate, 2025...................................   4,329,000,000
Committee recommendation................................   3,669,744,000

    The Committee recommends $3,669,744,000 for CMS program 
management, which includes funding for research and 
evaluations, program operations and demonstrations, survey and 
certification programs, and Federal administration.

Program Operations

    The Committee recommends $2,479,823,000 for the Program 
Operations account, which covers a broad range of activities 
including claims processing and program safeguard activities 
performed by Medicare contractors. These contractors also 
provide information, guidance, and technical support to both 
providers and beneficiaries.
    Affordable Care Act Notifications.--The Committee continues 
bill language requiring the administration to provide detailed 
enrollment figures to the Committees on Appropriations not less 
than two full business days before any public release of the 
information.
    Algorithm-Based Healthcare Services.--Algorithm-based 
health-care services are provided through medical devices 
cleared by the FDA that rely on artificial intelligence [AI], 
machine learning [ML], or other similar software to produce 
clinical information for use in the diagnosis or treatment of a 
patient's condition. The Committee notes the lack of a 
consistent coverage and payment pathway for these services, 
including the absence of coverage criteria, reimbursement 
methodologies, and transparent risk parameters. The Committee 
encourages CMS to consider formalizing payment and coverage 
pathways for algorithm-based healthcare services to improve 
beneficiary access and support the development of safe and 
effective AI/ML-enabled solutions.
    Alzheimer's Disease Diagnostics.--The Committee is 
encouraged by innovations in diagnostic tools and treatments 
for Alzheimer's disease and some of its most serious symptoms. 
The Committee acknowledges that the potential benefits of early 
diagnosis include timely access to treatments and lifestyle 
interventions, enhanced opportunities to participate in 
research studies, lower costs of care, and more time for care 
and quality of life planning. The Committee urges CMS to help 
facilitate timely and equitable beneficiary access to 
diagnostic tools and services, including diagnostic 
radiopharmaceuticals and positron emission tomography [PET]. 
The Committee also urges continued collaboration between CMS 
and other Federal agencies in their collective efforts to shift 
the standard of care towards timely and accurate detection and 
diagnosis.
    Alzheimer's Disease Therapies.--The Committee continues to 
express disappointment with CMS's decision to limit coverage of 
FDA-approved monoclonal antibodies for the treatment of 
Alzheimer's disease. The Committee urges CMS to reconsider the 
National Coverage Determination policy to provide full access 
for Medicare beneficiaries to these FDA-approved Alzheimer's 
treatments.
    Area Wage Index.--The Committee is pleased that CMS 
proposed an extension to its low wage index hospital policy in 
the Fiscal Year 2025 Hospital Inpatient Prospective Payment 
System and Long-Term Care Hospital Prospective Payment System 
Proposed Rule. This policy helps many rural, low-wage hospitals 
attract and maintain a skilled workforce. The Committee 
requests an update on this topic in the fiscal year 2026 CJ.
    Biosimilars.--The Committee notes concerns about the lack 
of access to lower cost biosimilars for Medicare Part D 
enrollees, including the prevalence of formulary exclusions of 
lower priced biosimilars and the application of step therapy by 
some plans to require enrollees to use a higher-priced brand 
product before accessing a biosimilar. The Committee notes the 
potential savings for patients and taxpayers through swift 
inclusion of biosimilars on Medicare Part D formularies. The 
Committee therefore urges CMS to examine existing barriers to 
biosimilar adoption, including Part D plan practices that 
impede access to lower-priced products. CMS should also provide 
beneficiary-focused education on the availability of 
biosimilars on Medicare Plan Finder and real-time benefit 
tools, as well as ensure guidance and regulations for Part D 
formulary development and design appropriately encourage the 
adoption of biosimilars with lower list prices, given that 
beneficiaries often pay coinsurance as a percentage of a 
product's list price under the program.
    Chronic Kidney Disease [CKD].--The Committee notes that 
Medicare spends nearly 25 percent of its annual budget on 
beneficiaries with a kidney disease diagnosis. The Committee 
encourages CMS to work to ensure that Medicare benefit 
guidelines reflect the most recent clinical CKD guidelines and 
promote access to early screening, testing, diagnosis, and 
treatment for individuals at higher risk for CKD.
    Coding Intensity.--The Committee notes that Medicare 
Advantage [MA] payments are risk-adjusted to provide sufficient 
resources to deliver comprehensive care for individuals with 
complex health needs. CMS applies the intensity adjustment 
equally to all MA health plans regardless of the variance in 
coding intensity that exists. The Committee encourages CMS to 
work with Congress and relevant stakeholders to evaluate the 
feasibility of implementing tiers for coding intensity 
adjustments. Such changes could potentially deter outliers, 
reduce aggressive coding behavior, and result in more effective 
care management.
    Cognitive Impairment.--The Committee directs CMS to include 
a report in the fiscal year 2026 CJ identifying actions the 
agency can take, within existing authorities, to improve early 
detection of mild cognitive impairment [MCI] as part of the 
Medicare Annual Wellness Visit [AWV] and the annual Initial 
Preventive Physical Exam [IPPE]. This review should include 
opportunities to improve early detection of MCI during the AWV 
and IPPE by ensuring the use of evidence-based, reliable, 
cognitive impairment detection tools identified by the National 
Institute on Aging.
    Comprehensive Kidney Care.--The Committee urges CMS to 
reevaluate whether to apply the Retrospective Trend Adjustments 
[RTA] within the Comprehensive Kidney Care Contracting model 
for Performance Year 2022 and Performance Year 2023 for the 
End-Stage Renal Disease [ESRD] population for Medicare ESRD 
Beneficiaries, considering in particular the differences 
between the calculated RTA for Medicare ESRD Beneficiaries and 
the calculated RTA for Medicare Parts A and B Beneficiaries for 
each performance year.
    Consumer Operated and Oriented Plan [CO-OP] Program.--The 
Committee recognizes the potential role of CO-OPs in lowering 
costs, stabilizing markets, and providing access to consumer-
centered Marketplace options in the States they serve. The 
Committee encourages CMS to examine program regulations to 
reduce barriers for CO-OPs.
    Convenient Access Standards.--The Committee notes that 
existing convenient access standards for Medicare Part D 
beneficiaries based on geographic distance may not take into 
account all methods of access to medications. The Committee 
encourages CMS to provide feedback, information, and technical 
assistance to Congress on policies that could improve patient 
access to drugs and pharmacist services, including potential 
changes to Part D network adequacy standards.
    Diabetes Self-Management Training.--Given the prevalence 
and cost of diabetes, particularly among communities of color, 
the Committee continues to be 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 obtain additional feedback from stakeholders on barriers to 
accessing the diabetes self-management benefit and to consider 
changes to address these barriers to the extent permitted by 
the statute. Within 120 days of enactment of this act, the 
Committee directs CMS to provide a report to the Committees on 
Finance and Appropriations of the Senate detailing the agency's 
efforts to address these barriers.
    Disproportionate Share Hospital [DSH] Payments.--The 
Committee recognizes that the Federal Medicaid statute 
generally requires DSH payments to hospitals treating large 
numbers of low-income patients in every State except Tennessee, 
whose DSH allotment is currently scheduled to cease after 
fiscal year 2025. The Committee encourages CMS to provide the 
necessary and adequate data to Congress to ensure a long-term 
Medicaid DSH allotment for Tennessee in the near future.
    EMS Treat-in-Place Model.--The Committee is disappointed 
that CMS has not pursued a State-specific EMS demonstration 
project or Innovation Center model. Within 90 days of enactment 
of this act, the Committee requests a briefing on CMS' 
assessment of the EMS Treat-in-Place Model, including 
differences from the previously tested Emergency Triage, Treat, 
and Transport [ET3] model.
    Ensuring Patient Assistance Counts Toward Out-of-Pocket 
Limits.--The Committee requests a briefing within 180 days of 
enactment of this act on CMS' enforcement of the rule in the 
2020 HHS Notice of Benefit and Payment Parameters requiring 
that cost sharing assistance paid by drug manufacturers on 
behalf of patients to reduce their out-of-pocket costs be 
counted toward the annual limitation on cost sharing.
    Essential Medical Devices.--The Committee is concerned by 
the healthcare system's increased reliance on Chinese-made 
medical devices and supplies, which could negatively impact 
domestic manufacturing capacity. The Committee supports efforts 
to promote purchases of American-made medical devices, and is 
similarly encouraged by CMS payment policies to provide new 
payment adjustments to hospitals for their share of additional 
costs incurred for certain supplies, such as domestically-made 
N95 respirators. The Committee requests a briefing 1 year after 
enactment of this act on the bi-weekly interim payments for 
domestic N95 respirator procurement, including information on 
participation and payments provided during calendar year 2023, 
and additional efforts by CMS to support domestic procurement 
of essential medical devices and supplies.
    Expanding Support for Screening and Diagnostic Testing in 
Cancer Treatment.--The Committee again acknowledges 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 healthcare providers select 
treatment options with a greater probability of better outcomes 
for patients. The Committee continues to urge CMS to identify 
ways to expand access to such screening and testing.
    Generic Drug Shortages.--The Committee is concerned about 
generic drug shortages, particularly those impacting generic 
sterile injectables, which include many cancer drugs, emergency 
medicines, and anesthesiology medications. The Committee 
encourages CMS to work with Congress and relevant stakeholders 
on analyzing Medicare and Medicaid payment policies' impact on 
supply chains and economic incentives for generic drug 
suppliers, wholesalers, and healthcare providers.
    Ground Ambulance Data Collection.--The Committee recognizes 
the work of CMS in establishing the first round of the Ground 
Ambulance Data Collection System and supports ongoing data 
collection efforts, including efforts to address stakeholder 
concerns that arose during the first 2 years of collecting 
ground ambulance data.
    Health Insurance Exchange.--The Committee continues bill 
language that requires CMS to provide cost information for the 
following: Federal Payroll and Other Administrative Costs; 
Exchange related Information Technology [IT]; Non-IT Program 
Costs, including Health Plan Benefit and Rate Review, Exchange 
Oversight, Payment and Financial Management, Eligibility and 
Enrollment; Consumer Information and Outreach, including the 
Call Center, Navigator Grants and Consumer Education and 
Outreach; Exchange Quality Review; Small Business Health 
Options Program and Employer Activities; and Other Exchange 
Activities. Cost information should be provided for each fiscal 
year since the enactment of the Patient Protection and 
Affordable Care Act [ACA]. CMS is also required to include the 
estimated costs for fiscal year 2026.
    Home and Community-Based Services [HCBS].--The Committee is 
supportive of efforts to increase access to care in homes and 
communities, which includes support for family caregivers and 
direct care workers that provide essential care and services. 
Within existing resources, the Committee expects CMS to 
strengthen and expand access to HCBS, facilitate State 
planning, encourage innovative models that benefit the 
workforce and care recipients, and support quality and 
accountability. Further, the Committee encourages CMS to issue 
guidance outlining how States can implement intensive home and 
community-based behavioral health services to address the 
growing behavioral and mental health crisis. The Committee 
urges CMS to include in such guidance information regarding: 
(1) best practices from States that have improved the 
availability of home and community-based mental health and 
substance use disorder services; and (2) potential options for 
financing and expanding access to home and community-based 
mental health and substance use disorder services.
    Home Infusion.--The Committee notes the critical role that 
home infusion services can play in improving health outcomes 
and quality of life for patients who require infusion of 
medications for complex conditions, including for beneficiaries 
who might otherwise need to travel significant distances to 
receive drug infusions. The Committee is concerned by the low 
levels of utilization of Medicare's home infusion therapy 
benefit among Medicare fee-for-service beneficiaries and 
encourages CMS to examine options that could help ensure that 
beneficiaries have better access to drug infusion in their 
homes.
    Hospice and Dementia Care.--The Committee recognizes the 
value of hospice care for patients with Alzheimer's Disease and 
Related Dementias [ADRD], including hospice's potential to both 
improve quality of life and reduce Medicare expenditures. The 
Committee encourages CMS to work with Congress and relevant 
stakeholders to ensure that Medicare's enrollment and 
eligibility processes consider the unique nature of dementia 
care, including by reducing unnecessary barriers to services. 
The Committee directs CMS to provide a report in the fiscal 
year 2026 CJ on its efforts to analyze and address access 
challenges, including those that may result from existing 
protocols or processes, for beneficiaries with ADRD.
    Maternal Health.--The Committee recognizes the importance 
of rural hospitals in providing maternal healthcare services, 
educating patients, and ensuring postpartum safety. The 
Committee is concerned that insufficient reimbursement, coupled 
with difficulties in maternity care provider recruitment and 
retention, threaten the viability of rural hospitals. Such 
factors have contributed to the closures of labor and delivery 
departments and growing maternal health deserts. The Committee 
directs CMS to provide a briefing to the Committee within 180 
days of enactment of this act detailing insights into closures 
of labor and delivery departments, as well as how payment rates 
across payers can impact care options, the utilization of new 
treatment pathways, and access to devices for birthing 
complications.
    Medically Tailored Meals.--The Committee notes the benefits 
of medically tailored meals for individuals with a diet-
impacted disease and encourages CMS to examine options for 
increasing access to medically tailored meals.
    Medicare Payment Systems Modernization [MPSM] Fund.--The 
Committee supports efforts by CMS to modernize Medicare's fee-
for-service claims processing systems portfolio. Doing so will 
help the agency lay important groundwork for continued 
improvements and efficiencies in service delivery and payments 
for Medicare beneficiaries, providers, and claims processors. 
The Committee directs CMS to include in its fiscal year 2026 CJ 
status updates on all ongoing projects undertaken by CMS with 
respect to MPSM.
    Medicare Summary Notices.--The Committee recognizes the 
significant impact of Medicare fraud to the healthcare system 
and beneficiaries, as well as the need to increase mechanisms 
to better detect and report fraud. Therefore, the Committee 
encourages CMS to evaluate options to increase the frequency of 
Medicare Summary Notices provided to beneficiaries, either by 
mail or virtually, and to perform ``usability testing'' to 
ensure that the agency is formatting its statements so all 
beneficiaries understand their medical expenses and can more 
easily detect and report improper payments. The Committee 
directs CMS to provide a briefing within 180 days of enactment 
on the cost estimate for implementation of any proposed 
changes.
    Merit-Based Incentive Payment System [MIPS] Feedback 
Reports.--The Committee urges CMS to improve timely access to 
MIPS feedback reports and claims data for providers, consistent 
with existing law. In doing so, the Committee requests an 
update in the fiscal year 2026 CJ on actions CMS has taken and 
plans to take to utilize measures developed by national medical 
specialty societies, including qualified clinical data 
registries maintained by national medical specialty societies, 
for MIPS, MIPS Value Pathways, and alternative payment model 
reporting.
    Non-Addictive Opioid Alternatives.--The Committee remains 
concerned about the high mortality rate due to the opioid 
overdose epidemic and continues to support the development of 
non-addictive alternatives to opioids for pain treatment and 
management. The Committee encourages CMS to assess policies and 
procedures and to work with Congress on efforts to facilitate 
coverage of non-addictive alternatives to opioids for pain 
treatment and management.
    Non-Pharmacologic Treatments for Pain.--Non-pharmacologic 
treatments for pain management have shown to be effective in 
reducing pain and reliance on prescription opioids. The 
Committee encourages CMS to consider ways to expand the use and 
coverage of non-pharmacologic treatments, such as osteopathic 
manipulative treatment and other alternative treatments as 
appropriate, for back and other pain.
    Nursing Home Transparency.--The Committee acknowledges 
CMS's efforts to require nursing homes enrolled in Medicare or 
Medicaid to disclose additional information regarding owners, 
operators, and management. Further transparency is needed to 
better understand the impact of private equity ownership 
arrangements on patient care, facility closures, staffing, and 
healthcare costs in both nursing homes and other healthcare 
settings. The Committee requests a report within 180 days of 
enactment of this act on the enforcement of existing ownership 
transparency requirements.
    Obesity.--The Committee encourages CMS to ensure 
beneficiary access to obesity care when determined to be 
clinically appropriate by the patient's physician and when 
consistent with relevant statutory and regulatory authorities.
    Organ Recovery Cost Reimbursement.--The Committee notes 
that Organ Procurement Organization [OPO] Recovery Centers can 
increase the number of organs available for transplantation and 
intensive care unit bed capacity for living patients. The 
Committee recognizes that there are concerns with the current 
reimbursement methodology for organ transportation and 
recovery, including concerns that the methodology may serve as 
a financial disincentive to utilize OPO Recovery Centers 
effectively. Therefore, the Committee encourages CMS to assess 
existing policies to ensure that transplant centers are 
appropriately reimbursed for furnishing deceased donor organ 
management and recovery services.
    Pediatric Oral Health.--The Committee appreciates CMS's 
ongoing work to improve access to pediatric oral healthcare. 
However, as CMS and States work to meet Oral Health Initiative 
targets, the Committee urges CMS to continue to look towards 
innovative approaches to improve pediatric oral healthcare by 
coordinating with other agencies and programs that serve 
Medicaid and CHIP populations such as the Department of 
Agriculture's Women, Infants and Children [WIC] and 
Supplemental Nutrition Assistance Program [SNAP] programs. 
Efforts may include expanding programs to integrate care into 
different settings and increasing education for parents and 
families on the importance of oral healthcare for children 
throughout each stage of development.
    Physician Fee Schedule Codes.--When adjusting the number of 
relative value units needed to account for coding changes, new 
data on relative value components, or payment for new services, 
the Committee notes that CMS may overestimate or underestimate 
utilization, and therefore the overall cost of such changes, 
resulting in substantial adjustments to the physician fee 
schedule payments required by budget neutrality. The Committee 
urges CMS to work with Congress and relevant stakeholders to 
ensure payment methodologies are consistent with current 
statute.
    Prescription Payment Plan.--Beginning January 1, 2025, all 
Medicare prescription drug plans will be required to offer 
enrollees the option to pay out-of-pocket prescription drug 
costs in the form of capped monthly payments. The Committee 
recognizes the importance of ensuring that beneficiaries are 
aware of the option to enroll in a payment plan. The Committee 
directs CMS to provide a report to the Committees on Finance 
and Appropriations of the Senate within 1 year of enactment of 
this act detailing the number of beneficiaries who have taken 
up the payment plan option under Medicare Part D and the total 
number of beneficiaries categorized as ``likely to benefit'' 
from such option. The report should also include an assessment 
of the methods that CMS is utilizing to communicate 
participation options and the impact of such outreach efforts.
    Psychosocial Rehabilitation Model.--The Committee 
encourages CMS to explore alternative payment models that 
directly reflect the significant health, economic, and overall 
societal benefits associated with alleviating social isolation 
among people with serious mental illness [SMI]. Specifically, 
the Committee requests that CMS include a report in the fiscal 
year 2026 CJ analyzing how the Center for Medicaid and CHIP 
Services [CMCS] is using the Medicaid waiver process to 
encourage State Medicaid agencies to contract with payers that 
offer comprehensive psychosocial rehabilitation services that 
reduce social isolation and improve quality of life for people 
with SMI.
    Reducing False-Positive Sepsis Blood Cultures.--The 
Committee is aware that more than 40 percent of blood culture 
tests used to diagnose blood stream infections, like sepsis, 
are false-positive results due to blood culture contaminations. 
These false-positive test results can lead to serious morbidity 
and mortality among misdiagnosed patients, significant spending 
on unnecessary treatment, and the overuse of antibiotics. The 
Committee requests a briefing within 180 days of enactment of 
this act for CMS to provide an update on its efforts to adopt a 
blood culture contamination rate measure.
    Risk Corridor Program.--The Committee continues bill 
language to prevent the CMS Program Management appropriation 
account from being used to support risk corridor payments.
    Robotic Stereotactic Radiosurgery [SRS].--The Committee 
remains concerned that inadequate payments for robotic SRS and 
robotic stereotactic body radiation therapy may threaten 
patient access to this important treatment option for many 
types of cancer in both the hospital and freestanding cancer 
settings. The Committee urges CMS to protect Medicare 
beneficiary access to these services, which can safely deliver 
life-saving and life-changing cancer treatment in a timely and 
cost-efficient manner, improving patient compliance and 
reducing burdens on patients, providers, and the healthcare 
system.
    Rural Community Hospital Demonstration Program.--The 
Committee notes that the Rural Community Hospital Demonstration 
may include up to 30 hospitals for participation, which 
provides alternative reimbursement to certain large, rural 
hospitals. However, the Committee understands that not all 30 
authorized participation slots are currently filled. The 
Committee directs CMS, in alignment with underlying statutory 
authority and regulatory processes, to solicit applications for 
the remaining program slots. The Committee requests an update 
from CMS within 90 days of enactment of this act on the 
agency's completed actions to fulfill this directive.
    School-Based Services [SBS].--The Committee recognizes the 
importance of SBS in promoting the health of children and 
adolescents. As more States look to expand SBS, the Committee 
encourages CMS to examine State reporting requirements and 
review and update reporting systems to better collect 
information about SBS for students beyond what is provided 
pursuant to a student's individualized education program or 
individualized family services program.
    Tribal Health Care Reimbursements.--The Indian Health 
Service [IHS] rate does not reimburse Tribal healthcare 
providers for the cost of chemotherapeutics provided by a 
physician in the office setting. This makes the provision of 
cancer treatment on Indian reservations for Medicare patients 
challenging and damages the ability of American Indians to 
access cancer treatment locally. The Committee supports CMS 
efforts to clarify reimbursement procedures and ensure parity 
among IHS and non-IHS facilities.

State Survey and Certification

    The Committee recommends $397,334,000 for State Survey and 
Certification activities, which ensure that institutions and 
agencies providing care to Medicare and Medicaid beneficiaries 
meet Federal health, safety, and program standards. On-site 
surveys are conducted by State survey agencies, with a pool of 
Federal surveyors performing random monitoring surveys.
    Annual Reports.--The Committee continues to direct CMS to 
provide, in the CJ, a report to the Committees regarding 
operational milestones and funding activities under this 
heading. Such reports shall, at a minimum, include quarterly 
obligations, unobligated balances (including a breakdown of 
committed and uncommitted balances), and expenditures of 
current year discretionary budgetary authority by originating 
statute. Such reports shall also include operational metrics, 
such as those found on pages 82 and 85 of the fiscal year 2025 
CJ, regarding the numbers and rates of survey and complaint 
visits by provider type for the applicable quarter.

Federal Administration

    The Committee recommends $772,533,000 Federal 
Administration, which funds the majority of CMS's staff and 
operating expenses for routine activities, such as planning, 
implementing, evaluating, and ensuring accountability in the 
programs administered by CMS.

                   HEALTHCARE FRAUD AND ABUSE CONTROL

Appropriations, 2024....................................    $915,000,000
Budget estimate, 2025...................................     941,000,000
Committee recommendation................................     941,000,000

    The Committee recommends $941,000,000, to be transferred 
from the Medicare trust funds, for Health Care Fraud and Abuse 
Control activities. The Committee recommendation includes a 
discretionary base amount of $311,000,000 and an additional 
$630,000,000 in resources through a budget cap adjustment, in 
alignment with the parameters set forth in the Fiscal 
Responsibility Act of 2023. Proactively identifying healthcare 
waste, fraud, and abuse continues to be a priority for the 
Committee.

                Administration for Children and Families


   PAYMENTS TO STATES FOR CHILD SUPPORT SERVICES AND FAMILY SUPPORT 
                                PROGRAMS

Appropriations, 2024....................................  $3,309,000,000
Budget estimate, 2025...................................   3,924,000,000
Committee recommendation................................   3,924,000,000

    The Committee recommendation includes $3,924,000,000 in 
fiscal year 2025 mandatory funds for Child Support Enforcement 
and Family Support programs. In addition, the Committee 
recommends $1,700,000,000 in advance funding for the first 
quarter of fiscal year 2026.
    These funds support States' efforts to promote the economic 
security of low-income families, including administrative 
expenses, matching funds, and incentive payments to States for 
child support enforcement; grants to States to help establish 
and administer access and visitation programs between 
noncustodial parents and their children; payments to 
territories for benefits to certain aged, blind, or disabled 
individuals; and temporary benefits for certain repatriated 
citizens.

               LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2024....................................  $4,025,000,000
Budget estimate, 2025...................................   4,111,000,000
Committee recommendation................................   4,125,000,000

    The Committee recommendation includes $4,125,000,000 for 
the Low Income Home Energy Assistance Program [LIHEAP], which 
is $100,000,000 over the fiscal year 2024 enacted level. LIHEAP 
provides home heating and cooling assistance to low-income 
households. Sudden, significant, and unexpected decreases in 
annual funding for States, even when based in part on changes 
in home energy costs or other formula factors, can be difficult 
for States to manage. Accordingly, the Committee recommendation 
continues to limit year-to-year fluctuations in allocations to 
States.
    Technical Assistance and Program Administration.--Within 
the total, the Committee recommendation includes up to 
$10,000,000 for program integrity and oversight efforts, of 
which a portion is intended to continue to support a formula 
system, which will allow ACF to provide estimates more readily 
when requested by the Committee.
    Extreme Weather.--The Committee understands that the 
increased prevalence of extreme weather events can cause 
dangerous health outcomes for at-risk individuals, especially 
low income families that struggle to pay for home energy costs. 
The Committee requests a report, within 180 days of enactment 
of this act, detailing how the LIHEAP program supports States 
experiencing extreme weather events. The report should include 
information on how the Interagency Working Group on Extreme 
Heat is informing LIHEAP guidance to States, recommendations 
for making the LIHEAP formula more responsive to extreme 
weather events, and where available, each States' share of the 
LIHEAP formula devoted to cooling versus heating assistance.

                     REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2024....................................  $6,427,214,000
Budget estimate, 2025...................................   6,427,214,000
Committee recommendation................................   6,428,214,000

    The Committee recommends $6,428,214,000 in base 
discretionary funding for Refugee and Entrant Assistance [REA] 
programs. These programs provide a variety of benefits and 
services to refugees, asylees, Cuban and Haitian entrants, 
immigrants arriving on Special Immigrant Visas [SIV], 
trafficking victims, and torture victims (collectively referred 
to below as ``refugees''). These programs also provide 
temporary care and services for unaccompanied children 
apprehended by the Department of Homeland Security [DHS] or 
other law enforcement agencies, who have no lawful immigration 
status in the United States until they can be placed with a 
parent, guardian, or other sponsor while awaiting adjudication 
of their immigration status.
    The Committee recommendation continues the directive to 
provide monthly updates to the Committees on Appropriations of 
arrivals each month by category, including refugees, asylees, 
Cuban and Haitian Entrants, SIVs, and unaccompanied children. 
Such updates shall include any changes in estimated funding 
needs as a result of changing trends. The Committee notes that 
ORR has consistently relied on supplemental funding to address 
funding needs in this program and the budget request includes 
$2,914,179,000 in additional emergency funding, above the 
amounts included in this bill, for refugee programs in fiscal 
year 2025 including to support the goal of resettling 125,000 
refugees through the U.S. Refugee Admissions Program [USRAP] in 
fiscal year 2025. The Committee will continue to work closely 
with HHS to evaluate and address fiscal year 2025 funding 
needs.
    The Committee believes that the USRAP serves as a 
reflection of U.S. humanitarianism as well as the Nation's 
strategic interests. The Committee notes the need to maintain a 
baseline of capacity and 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.
    Community Engagement and Quarterly Consultation.--The 
Committee recognizes that quarterly consultations and regular 
community engagement are critical to support refugee 
integration and encourages HHS to pursue efforts to ensure 
robust participation in regular community consultations.
    Coordination with DHS and USCIS.--The Committee notes that 
not all refugees (including all populations eligible for ORR-
funded services) receive ORR-funded services. The Committee 
encourages ORR to better coordinate with DHS and USCIS to 
improve the referral process for eligible arrivals.
    Mental Health and Trauma Informed Care.--The Committee 
recognizes the importance of ORR providing trauma informed, 
culturally appropriate, comprehensive care to the individuals 
it serves, including unaccompanied children, refugees, victims 
of trafficking, and survivors of torture. Accordingly, the 
Committee encourages ORR to partner with an outside 
organization with expertise in providing such care to evaluate 
the mental healthcare needs of ORR-eligible populations and any 
ongoing gaps and challenges in current mental health provision 
across populations ORR serves. This should also include 
recommendations for enhancing programming or additional 
investments needed to ensure all eligible individuals have 
access to comprehensive, trauma-informed, and culturally 
appropriate mental health services. The Committee also 
encourages ORR to integrate a report on mental health needs 
into the Annual Survey of Refugees.
    Spend Plan.--The Committee directs ORR to continue to 
provide quarterly spend plans for the Unaccompanied Children 
[UC] program with actual and estimated obligations by major 
category, at the same level of detail that has been provided in 
previous years. The Committee further expects at least this 
level of detail to be included in future budget justifications. 
In addition, the Committee directs ORR to provide quarterly 
spend plans for refugee programs, including actual and 
estimated obligations under the TAMS and RSS programs.

Transitional and Medical Services

    The Committee recommendation includes $591,000,000 for 
Transitional and Medical Services. This program provides grants 
to States and nonprofit organizations to provide cash and 
medical assistance to arriving refugees, as well as foster care 
services to unaccompanied minors.
    Matching Grant Program.--The Committee continues to support 
the Matching Grant [MG] program and strongly encourages HHS to 
expand the program, including increasing the number and 
percentage of eligible arrivals served by the program; 
increasing the government's per capita contribution to respond 
to inflation and cost of living; and easing the burden of the 
match requirement. The Committee also strongly encourages HHS 
to give matching grant organizations flexibility in 
administering their programs, including, when justified, 
carrying over unexpended funding and slots and extending 
exemptions to the 31-day enrollment period. The Committee also 
encourages HHS to continue permitting flexibilities in 
dispersing MG funds, such as continuing to separate direct 
assistance and administrative portions and permitting sites to 
offer remote services, and encourages HHS to create a plan to 
expand case management for MG enrollees. The Committee also 
encourages ORR to consider adjusting the structure of the MG 
program to recognize cases where individuals are employed but 
not yet fully self-sufficient as opposed to solely economically 
self-sufficient or not economically self-sufficient 
measurements. Finally, the Committee encourages HHS to work 
with resettlement sites to ensure continuity of MG enrollments 
and services during the transition from one fiscal year to the 
next.

Refugee Support Services

    The Committee recommendation includes $307,201,000 for 
Refugee Support Services [RSS]. This program provides a 
combination of formula and competitive grants to States and 
nonprofit organizations to help refugees become self-sufficient 
and address barriers to employment.
    The Committee strongly encourages ORR to the greatest 
extent possible to allocate RSS funding based on the best data 
available that reflects actual needs of providing services to 
newly arrived refugees. The Committee directs ORR to include 
information in its fiscal year 2026 CJ on what flexibilities 
ORR has applied in allocating funding to better reflect needs, 
and any ongoing limitations in doing so.
    Education, Training, and Career Opportunities.--The 
Committee encourages ORR to ensure all eligible populations are 
made aware of the variety of education, training, and career 
opportunities available to them through ORR or other Federal 
partners, including adult education, credential evaluation, 
pre-apprenticeship, and registered apprenticeship programs. The 
Committee encourages ORR to continue to collaborate with the 
Departments of Education and Labor to ensure that new arrivals 
receive information about these employment and training 
opportunities within the first 90 days after arrival.
    Intensive Case Management.--The Committee recognizes the 
importance of expanding intensive case management [ICM] and 
virtual case management, particularly in locations where 
expanded resettlement capacity relies on remote placement. The 
Committee encourages HHS to expand the availability of virtual 
case management to provide ICM services, particularly in 
locations without existing resettlement sites nearby. The 
Committee directs HHS to include information in its fiscal year 
2026 CJ on such efforts, including an assessment of the use of 
virtual ICM services.
    Preferred Communities.--The Committee recognizes that the 
increase in refugee arrivals projected for fiscal year 2025 
requires expanded capacity among the resettlement network 
including through the Preferred Communities program. The 
Committee encourages ORR to expand the Preferred Communities 
program and directs HHS to include information in its fiscal 
year 2026 CJ on the Preferred Communities program, including an 
estimate of funding to be spent on the program and funding 
needed to maintain Preferred Communities programming at all 
resettlement sites.

Victims of Trafficking

    The Committee recommendation includes $31,755,000 for 
Victims of Trafficking programs. These programs support a 
national network of organizations that provide a variety of 
services-including case management, counseling, benefit 
coordination, and housing assistance-for victims of commercial 
sex and forced labor trafficking.
    Within this amount the Committee recommendation includes no 
less than $6,000,000 for the National Human Trafficking Hotline 
(Hotline). The Committee notes concern with reports that the 
Hotline has not consistently and promptly reported tips, when 
appropriate and consistent with Federal and State law, of 
trafficking of adults to law enforcement. The objectives of the 
Hotline include providing information and service referrals to 
victims of trafficking using a trauma-informed, victim-centered 
approach; and notifying law enforcement agencies of potential 
cases of human trafficking as well as instances when a 
trafficking victim is in imminent danger, and documenting 
emerging trafficking schemes to assist in the detection and 
investigation of trafficking cases.
    It is critical that that the Hotline maintain a person-
centered approach focused on the victim's well-being and those 
who utilize the Hotline's services and wish to be anonymous 
should stay anonymous when it is safe and appropriate to do so. 
The Committee also notes that Hotline plays an important role 
in notifying law enforcement of potential trafficking when that 
is appropriate. Accordingly, the Committee directs ACF to 
ensure the Hotline is complying with applicable laws and 
policies regarding the operation of the Hotline, assisting 
victims of severe forms of trafficking in persons, and 
referring potential cases of trafficking to law enforcement 
including reporting all third-party tips of potential human 
trafficking to State and local law enforcement when the 
signaler appears to be in imminent danger.

Unaccompanied Children

    The Committee recommendation includes $5,406,258,000 in 
base funding for the UC program. The UC program provides 
temporary care for children who have no lawful immigration 
status in the United States and who have been apprehended by 
DHS without a parent or a guardian. HHS provides care for 
children until they can be placed with a parent or other 
sponsor living in the United States pending resolution of their 
immigration status.
    Bond Hearings and Placement Reviews.--The Committee 
continues to direct HHS to approach placement review and Flores 
bond requests with expediency, fairness, child-centered 
procedures, and trauma-informed approaches prior to and during 
Flores bond hearings and placement review panel adjudications.
    Influx Care Facilities [ICFs].--The Committee appreciates 
that ORR has significantly reduced the need for and use of ICFs 
in recent years. The Committee continues to direct ORR to 
ensure that ICFs will only be used in the future when 
absolutely necessary and directs ORR to include in its fiscal 
year 2026 CJ estimates of how much it will spend on ICFs, its 
estimated capacity needs, the methodology it uses and factors 
it considers when estimating ICF capacity needs, and in what 
specific circumstances it will activate capacity in ICFs. The 
Committee also directs that if ICFs are needed in the future, 
HHS will continue to improve the quality of care provided in 
ICFs, including ensuring they have the physical infrastructure 
to provide developmentally appropriate care for children, 
including appropriate space for education services, and 
confidential space for the provision of healthcare, mental 
healthcare, and legal services.
    Maintaining Family Contact.--The Committee strongly 
encourages ORR to work with its care providers to ensure that 
children have as much access as possible via telephone and 
video calls to their parents, family members, and caregivers 
while maintaining appropriate child welfare safeguards.
    Mental Health and Related Services for Children in ORR-
Care.--The Committee appreciates the steps ORR has taken to 
improve mental health services for children in their care, and 
encourages ORR to continue to expand such services and ensure 
that they are developmentally appropriate, trauma-informed, 
culturally competent, and provided in the most integrated, 
least restrictive setting. This should also include in-person 
training for ORR and ORR-contracted staff on trauma and trauma-
informed care. The Committee also directs ORR to work with 
residential care providers, disability experts, and child 
welfare experts to ensure adherence to Federal, State, and 
local laws related to standards of care for children with 
disabilities. ORR should also work with protection and advocacy 
organizations to support monitoring visits and access to 
information. Finally, the Committee recognizes that 
unaccompanied children often share extensive personal 
information to case managers, clinicians, or other adults while 
in ORR care, and directs ORR and its grantees and contractors 
to protect sensitive personal information, behavioral health 
records, and mental health records consistent with all 
applicable child welfare laws, regulations, and licensing 
requirements. The Committee directs ORR to include information 
in its fiscal year 2026 CJ on these efforts.
    Office of the Ombudsperson.--The Committee strongly 
supports efforts to increase independent oversight of the UC 
program. Accordingly, the Committee supports the establishment 
of an Office of the Ombudsperson, to provide independent child-
welfare focused recommendations to ORR and the Secretary 
regarding the care of unaccompanied children, including on 
policies to ensure children are safe, cared for, and receive 
the services they need both while in HHS custody and after they 
have been released to a sponsor. The Ombudsperson shall 
monitor, including by making site visits, for compliance with 
all applicable laws and standards relating to unaccompanied 
children. The Committee directs the Ombudsperson to submit a 
report to Congress no less than once each fiscal year including 
a summary of activities carried out during the preceding fiscal 
year, as well as recommendations for improving the UC program 
and a description of the priorities for the subsequent fiscal 
year.
    Post-Release Services, Legal Services/Access to Counsel, 
and Child Advocates.--The Committee recommendation includes no 
less than the fiscal year 2024 funding level for post-release 
services; legal services and access to counsel; and child 
advocates. The Committee continues to direct HHS to expand 
child-welfare focused post-release services to increase the 
number of children and families receiving services, and improve 
the types of services they receive, including case management 
assistance with school enrollment, and access to legal 
services, healthcare, mental health, and community services. 
These post-release services are critical to ensuring that 
children are in safe and appropriate homes after they have been 
released from ORR's care and that children and families have 
access to the services they need. The Committee encourages 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 and children whose primary language is neither 
English nor Spanish are referred for post-release services. 
Finally, the Committee supports ORR's plans to provide tiered 
levels of services, and strongly encourages ORR to prioritize 
post-release services for children released to category 2 and 3 
sponsors.
    The Committee also continues to direct ORR to provide 
access to counsel, consistent with the goals of the Trafficking 
Victims Protection Reauthorization Act of 2008 for all children 
to have access to counsel in their immigration proceedings. The 
Committee understands the supply of service providers may be 
constrained in some areas, and encourages ORR to allow grantees 
to use flexibilities in contracting expenses, to the extent 
practicable, to build the capacity to ensure the necessary 
legal requirements are met to provide expanded services to 
children. The Committee also continues to direct ORR to ensure 
in-person Know Your Rights presentations and legal screenings 
for every child in ORR custody and access to legal counsel for 
any child in prolonged ORR-care. The Committee also continues 
to direct that legal services will be in person absent exigent 
circumstances and that ORR will ensure that there is sufficient 
confidential space available for legal services at all 
facilities, including emergency or influx facilities. When 
services are provided remotely, ORR must make sufficient 
technology and confidential space available for communication 
via video whenever possible, and telephone if necessary.
    The Committee directs ORR to include information in its 
fiscal year 2026 CJ on how children are prioritized for post-
release services, legal services, and child advocate services, 
and the number and percentage of children that have and are 
estimated to receive services annually, including broken out by 
specific types and levels of services.
    Prioritization of Small-Scale, Community- and Family-Based 
Placements.--The Committee continues to direct ORR to 
prioritize the placement of children in small-scale, community- 
and family-based care providers, including transitional foster 
care, small group homes, and long-term foster care. The 
Committee directs ORR to pursue efforts to expand capacity in 
such programs, which are both more appropriate for children and 
reduce the need for ICFs. This should include predictably 
posting funding opportunity announcements, providing technical 
assistance to both existing and potentially new providers, and 
working with providers to address any staffing-related issues 
that limit their capacity. The Committee recommendation 
includes funding for grants to high-performing State-licensed 
shelters to increase standard care capacity including the 
ability to expand capacity as needed. The Committee further 
directs ORR to ensure that 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.
    The Committee directs ORR to include information in its 
fiscal year 2026 CJ on its actual and planned capacity by 
program type, including steps taken and planned to be taken to 
expand capacity in small scale shelters and funding spent on 
such efforts. Finally, the Committee directs ORR to provide a 
report to the Committee within 180 days of enactment of this 
act on the feasibility of transitioning 100 percent of its bed 
census to small-scale facilities, including a description of 
any barriers, limitations, or challenges in doing so. In 
developing this report ORR should consult with current small-
scale shelter providers and other organizations with relevant 
expertise.
    Report.--The Committee directs ORR to continue to submit 
biannual reports to the Committees that include the number of 
UCs that remain in HHS care for longer than 1 year and the 
number of UCs that HHS has released to sponsors. The report 
should also include an explanation of the methods ORR uses to 
follow-up with unaccompanied children after releasing them to a 
sponsor, including the follow-up method used and number of 
attempts made. The Department shall make such a report 
available on its website.
    Special Education.--The Committee strongly encourages ORR 
to conduct a study on the education support needs of children 
with disabilities in its care, identify any gaps or challenges 
in addressing such needs, and take steps as necessary to 
address them.
    Sponsor Suitability Determination Policies.--The Committee 
continues to direct ORR to conduct targeted reviews of its 
sponsor suitability determination policies and procedures. This 
should include reviews of a sampling of cases of children 
released to different categories of sponsors during fiscal year 
2024 to evaluate specific policies for how they promote the 
welfare of all children referred to their care, and ensure that 
children are placed with safe and appropriate sponsors. The 
Committee looks forward to the briefing on this topic required 
in Senate Report 118-84.
    Trusted Adult Relatives.--The Committee recognizes efforts 
to co-locate ORR staff at the border in designated locations to 
verify family relationships, screen out risks of trafficking, 
and otherwise conduct sponsor suitability determinations for 
children travelling with a close adult relative. This allows 
children, when it's determined to be appropriate, safe, and in 
the best interest of the child, to be quickly released to the 
care and custody of a close relative, avoiding unnecessary 
trauma from separation. This also has the potential to decrease 
ORR shelter capacity and funding needs, as such children would 
otherwise be in ORR care for a longer period of time, in some 
cases significantly longer. The Committee requests information 
be included in the fiscal year 2026 CJ on any such efforts.
    Unaccompanied Alien Children Home Studies.--The Committee 
is concerned about reports of unaccompanied children being 
placed with sponsors who have not been fully vetted, including 
an OIG report ``Gaps in Sponsor Screening and Follow-up Raise 
Safety Concerns for Unaccompanied Children'' that reviewed 
implementation of sponsor screening in March and April 2021, 
when ORR received a surge in referrals of unaccompanied 
children, that found HHS has not consistently conducted safety 
and background checks of sponsors. This puts unaccompanied 
children at risk, including trafficking and child labor 
exploitation. The Committee is also concerned by reports that 
over 2021 and 2022, ORR was not able to contact 85,000 children 
as part of safety and well-being calls. The Committee strongly 
encourages ORR to conduct a home study for every potential 
sponsor. The Committee directs ORR to brief the Committees of 
jurisdiction, within 30 days of the enactment of this act, on 
the timeline and steps it will take to meet the recommendations 
of the OIG report and to provide a report to the Committee 
within 90 days of enactment of this act on the feasibility of 
conducting an in-person home study for every potential sponsor 
and a full accounting of minors that ORR has not been able to 
contact as part of safety and well-being calls.
    Youth Aging Out of ORR Care.--The Committee directs ORR to 
have developed a concrete post-18 plan for every 17-year-old 
unaccompanied child in ORR care at least 30 days in advance of 
their 18th birthday to ensure that an appropriate placement has 
been identified and arranged for the child, along with any 
necessary social support services, prior to discharge from ORR. 
The Committee directs ORR to ensure that it is complying with 
its obligation to protect children's private and confidential 
information in fulfilling its obligation to engage in post-18 
planning for children aging out of ORR care.

Victims of Torture

    The Committee recommendation includes $19,000,000 for the 
Victims of Torture program to provide support to non-profit 
organizations providing direct support to torture survivors and 
their families.

   PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2024....................................  $8,746,387,000
Budget estimate, 2025...................................   8,521,387,000
Committee recommendation................................  10,346,387,000

    The Committee recommends $10,346,387,000, an increase of 
$1,600,000,000 for the Child Care and Development Block Grant 
[CCDBG], a formula grant to States that provides financial 
assistance to families to help pay for child care, and 
otherwise improve the quality of child care programs.
    Child Care Preferences.--The Committee recognizes that 
parents eligible to receive subsidized childcare under the 
CCDBG Act may have varying preferences on how that childcare is 
provided. Some parents prefer to have their children cared for 
by a parent or close relative, yet an overwhelming majority of 
children served by CCDBG receive childcare at a center-based 
childcare facility. The Committee is aware that the National 
Survey of Early Care and Education collects information on 
parental perceptions and preferences related to child care and 
directs ACF to include information in the fiscal year 2026 CJ 
on which of the following child care providers are preferred by 
parents of eligible children (as defined at 42. U.S.C. 
9858n(4)): full-time paid childcare, part-time paid childcare, 
relative-provided childcare, or in-home care with the child's 
parent, based on available data.
    Data Reporting.--The Committee notes that the fiscal year 
2025 CJ included fiscal year 2021 data regarding the number of 
children and families served by CCDBG. The Committee is 
concerned by the lag in this data reporting and requests a 
briefing, no later than 180 days after enactment, on the 
challenges relative to collecting this data and recommendations 
for improving its timeliness.
    Native Hawaiian Child Care Programs.--The Committee 
requests a report within 90 days of enactment of this act 
providing the rationale of the funding allocation for past 
three grant cycles of the Native Hawaiian Non-Profit 
Organization Child Care Grant, and a plan to align funding with 
the Native Hawaiian service population in subsequent awards.

                      SOCIAL SERVICES BLOCK GRANT

Appropriations, 2024....................................  $1,700,000,000
Budget estimate, 2025...................................   1,700,000,000
Committee recommendation................................   1,700,000,000

    The Committee recommends $1,700,000,000 for the Social 
Services Block Grant [SSBG], a flexible source of funding that 
allows States to provide a diverse array of services to low-
income children and families, the disabled, and the elderly in 
order to reduce poverty.
    The Committee recognizes that Family Resource Centers 
provide direct assistance to families through parenting support 
and education, navigation of care and social services, mental 
health counseling, early learning and afterschool activities, 
family financial planning, and job training. The Committee 
notes that preliminary data shows promise in this area--with a 
63 percent reduction in child abuse cases and a $4.93 return 
for every tax dollar invested, according to current research. 
The Committee supports States that choose to use a portion of 
their SSBG funding to support services and programs at school 
and community-based Family Resource Centers to strengthen 
families through a localized, family-centered approach.

                CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriations, 2024.................................... $14,829,100,000
Budget estimate, 2025...................................  15,052,128,000
Committee recommendation................................  15,544,939,000

    The Committee recommends $15,544,939,000 for Children and 
Families Services programs. These funds support a variety of 
programs for children, youth, and families; Native Americans; 
survivors of child abuse, neglect, and domestic violence; and 
other vulnerable populations.

Head Start

    The Committee recommendation includes $12,971,820,000 for 
Head Start. Head Start provides grants directly to local 
organizations to provide comprehensive early childhood 
education services to children and their families, from before 
birth to age 5.
    Within the total, the Committee recommendation includes a 
$544,000,000 cost of living adjustment for all Head Start 
grantees to help keep up with rising costs, to recruit and 
retain highly qualified staff, and to continue to provide high-
quality services to children and families.
    Freely Associated States.--The Committee includes bill 
language to establish Head Start programs in the Republic of 
the Marshall Islands and the Federated States of Micronesia, as 
authorized in the Compact of Free Association Amendments Act of 
2024 (Public Law 118-42).
    Designation Renewal System [DRS].--The Committee continues 
to encourage HHS to consider the unique challenges faced by 
Head Start grantees in remote and frontier areas when reviewing 
such grantees' compliance with health and dental screening 
requirements as part of the DRS.
    Facility Improvement Funding.--The Committee continues to 
strongly encourage ACF to ensure that all Head Start grantees 
are aware of any funding opportunities, or funding otherwise 
available, for making capital improvements to their facilities. 
Further, the Committee continues to encourage ACF to 
standardize this process so all grantees have equal opportunity 
to apply and are aware of priorities and eligible uses of such 
funds.
    Native Hawaiian Programs.--The Committee notes that the 
American Indian Head Start is inclusive of Native Hawaiian Head 
Start agencies. The Committee directs ACF collaborate with 
Native Hawaiian leaders in family-based early childhood 
learning in order to advance a Head Start experience that is 
responsive to the unique and specific needs of the Native 
Hawaiian community, and to provide technical assistance to 
support providers to become Native Hawaiian Head Start 
agencies. ACF is directed to brief the Committee on these 
efforts no later than 180 days after enactment of this act.
    Quality Improvement Funding.--The Committee includes 
$125,000,000 in quality improvement funding. The Committee 
strongly believes the flexibility provided by this funding is 
necessary for Head Start programs to meet local needs, and 
expects funding to be prioritized for recruiting and retaining 
quality staff.
    Tribal Colleges and Universities-Head Start Partnership 
Program.--The Committee recommendation includes $10,000,000 for 
the Tribal Colleges and Universities-Head Start Partnership 
Program.

Preschool Development Grants

    The Committee recommendation includes $315,000,000 for 
Preschool Development Grants. This program, as authorized in 
the Every Student Succeeds Act (Public Law 114-95), provides 
competitive grants to States to improve the coordination, 
collaboration, and quality of existing early childhood 
programs; improve the transition from early childhood programs 
to kindergarten; implement evidence-based practices; improve 
professional development for early childhood providers; and 
generally improve educational opportunities for children.
    The Committee encourages ACF to continue to support States 
that choose to use a portion of their renewal grant funding to 
award sub-grants to programs in a mixed delivery system across 
the State, particularly for low-income and disadvantaged 
children prior to entering kindergarten, or to improve the 
quality of local programs through the enhancement of early 
childhood systems.
    Dual Language Learners [DLL].--The Committee encourages ACF 
to support States that choose to develop high-quality and 
culturally competent dual immersion preschool programs through 
Preschool Development Grants. The Committee recommends a focus 
on training, professional development, and postsecondary 
education for all caregivers, teachers, and directors to meet 
the needs of DLLs through dual language acquisition, engaging 
culturally and linguistically diverse families, home language 
support, and culturally and linguistically appropriate 
assessment.

Consolidated Runaway and Homeless Youth Program

    The Committee recommendation includes $125,283,000 for the 
Consolidated Runaway and Homeless Youth program. This program 
supports the Basic Centers program, which provides temporary 
shelter, counseling, and after-care services to runaway and 
homeless youth under age 18 and their families; the 
Transitional Living Program, which provides longer-term shelter 
and services for older youth; and a national toll-free runaway 
and homeless youth crisis hotline.
    The Committee continues to support the ability of grantees 
to provide prevention services such as counseling and case 
management, regardless of their enrollment in residential 
services. The Committee urges ACF to advise grantees that they 
are not required to enroll youth in shelter or residential 
services, nor require the young person to physically travel to 
the grantee's location in order for an at-risk youth to receive 
prevention and supportive services.
    The Committee continues to encourage the program to notify 
applicants if grant applications are successful at least 30 
days before the grant begins or no less than 30 days before an 
existing grant is set to end.
    The Committee again strongly urges the program to ensure 
that service delivery and staff training comprehensively 
address the individual strengths and needs of youth, as well as 
language-appropriate, gender-appropriate interventions that are 
culturally sensitive and respectful of the complex social 
identities of youth. 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.
    Child, Youth, and Family Homelessness.--The Committee is 
concerned about the impact of homelessness on the wellbeing and 
development of children, youth, and families, including the 
instability and overcrowding that accompany child, youth, and 
family homelessness. In light of this, the Committee urges ACF 
to assess the current state of child, youth, and family 
homelessness, including the strengths, barriers, and 
opportunities across ACF and HHS to provide two-generation 
services to end the cycle of homelessness. In particular, the 
Committee urges ACF to develop a plan to lead and coordinate 
efforts to provide holistic services to homeless children, 
youth, and families to break the cycle of homelessness, 
including by identifying existing resources and gaps. The 
Committee looks forward to the report outlining progress on 
these efforts required in Senate Report 118-84.
    Cross System Issues.--The Committee strongly encourages 
programs to have the ability to serve youth involved in other 
systems (such as child welfare and juvenile justice) that are 
not currently housed by that system. The Committee strongly 
encourages programs to have the ability to serve youth funded 
by systems of care other than the Runaway and Homeless Youth 
Act to be housed within the Runaway and Homeless Youth Act 
funded program.
    National Communications System, National Runaway 
Safeline.--The Committee remains concerned with the number of 
homeless children and youth and those at risk of homelessness 
and the ability of those youth and parents to access 
information that can help connect them with the needed 
services, resources, and support both at school and in the 
community. The Committee encourages ACF to coordinate with the 
Department of Education to increase outreach and raise 
awareness in school districts and community-based organizations 
of services and resources provided by the National Runaway 
Safeline.

Education and Prevention Grants to Reduce Sexual Abuse of Runaway Youth

    The Committee recommendation includes $21,000,000 for 
Education and Prevention Grants to Reduce Sexual Abuse of 
Runaway and Homeless Youth. This program provides competitive 
grants for street-based outreach and education services for 
runaway and homeless youth who are subjected to, or are at risk 
of being subjected to, sexual abuse or exploitation.

Child Abuse Prevention and Treatment State Grants

    The Committee recommendation includes $110,091,000 for the 
Child Abuse Prevention and Treatment State Grant program. This 
program provides formula grants to States to improve their 
child protective service systems.
    Infant Plans of Safe Care.--Within the total, the Committee 
recommendation includes $60,000,000 to help States continue to 
develop and implement plans of safe care as required by section 
106(b)(2)(B)(iii) of the Child Abuse Prevention and Treatment 
Act (Public Law 93-247). The Committee again urges HHS to 
support States in their implementation of the plans by 
providing specialized, non-punitive family support services for 
infants and their birth parents affected by substance use 
disorders to reduce the need for child welfare or foster care 
system involvement. The Committee recognizes the intent of 
plans of safe care and encourages these plans to be put into 
place before the birth of a child to foster the best outcome 
for the baby. The Committee continues to direct HHS to provide 
technical assistance to States on best-practices in this area 
to address the health, developmental, housing, and treatment 
needs of infants and their parents and to evaluate States' 
activities on plans of safe care. The Committee also encourages 
HHS to provide technical assistance to States on best practices 
for developing notification systems that are distinct and 
separate from the system used in the State to report child 
abuse and neglect in order to promote a public health response 
to infants affected by substance use disorders, and not for the 
purpose of initiating an investigation of child abuse or 
neglect. The Committee also encourages HHS to ensure such 
technical assistance includes an emphasis on the role of public 
health focused plans of safe care in reducing racial 
disproportionality in child protective services investigations 
and removals.

Child Abuse Discretionary Activities

    The Committee recommendation includes $36,000,000 for Child 
Abuse Discretionary Activities. This program supports 
discretionary grants for research, demonstration, and technical 
assistance to increase the knowledge base of evidence-based 
practices and to disseminate information to State and local 
child welfare programs.
    Child Abuse Hotline.--The Committee continues funding for 
this program.

Community-Based Child Abuse Prevention

    The Committee recommendation includes $74,660,000 for the 
Community-based Child Abuse Prevention program. This program 
provides formula grants to States that then disburse funds to 
local community-based organizations to improve local child 
abuse prevention and treatment efforts, including providing 
direct services and improving the coordination between State 
and community-based organizations. The Committee recognizes the 
importance of prevention and encourages funds to be used for 
primary prevention activities and to engage in partnerships at 
the State and local level to reduce child abuse and neglect and 
provide supports to families.

Child Welfare Services

    The Committee recommendation includes $268,735,000 for 
Child Welfare Services. This formula grant program helps State 
and Tribal public welfare agencies improve their child welfare 
services with the goal of keeping families together. These 
funds help States and Tribes provide a continuum of services 
that prevent child neglect, abuse or exploitation; allow 
children to remain with their families, when appropriate; 
promote the safety and permanence of children in foster care 
and adoptive families; and provide training and professional 
development to the child welfare workforce.
    The Committee understands that children at risk of entering 
foster care achieve better outcomes when families are able to 
provide a safe and stable environment for their children, 
thereby allowing children to stay safely at home. The Committee 
acknowledges ACF's recent regulatory efforts to allow Title IV-
E foster care agencies to claim Federal financial participation 
for the administrative cost of an attorney providing legal 
representation to eligible children and certain other 
individuals involved in foster care and other civil legal 
proceedings.

Child Welfare Research, Training, and Demonstration

    The Committee recommendation includes $21,984,000 for child 
welfare research, training, and demonstration projects. This 
program provides grants to public and nonprofit organizations 
for demonstration projects that encourage experimental and 
promising types of child welfare services, as well as projects 
that improve education and training programs for child welfare 
service providers.
    Centers of Excellence.--The Committee urges ACF to 
establish a centers of excellence demonstration program that 
will develop, implement, and disseminate evidence-based 
programs and best practices related to interventions for youth 
transitioning from foster care to adulthood in States with the 
highest rates of youth per population involved in the child 
welfare system, with a focus on States that have been most 
severely affected by substance use disorders. Eligible grantees 
should include institutions of higher education in the most 
affected States.
    Community Partnership Pilot Program.--The Committee urges 
ACF to carry out a community partnership pilot program to 
provide grants to non-profit organizations building 
partnerships between child welfare agencies and local community 
organizations, to leverage private dollars, goods, and human 
resources in the community to meet the needs of at-risk 
children and their families interacting with the child welfare 
system, which may include establishing the ability for child 
welfare agency employees to seek community support for the 
needs of children and families through an electronic portal.
    Disseminate Best Practices in the Child Welfare 
Workforce.--The Committee recognizes that States, counties, and 
not-for-profit agencies have been long engaged in addressing 
the child welfare workforce crisis, and many best and promising 
practices have emerged through their efforts. The Committee 
encourages ACF to compile and disseminate best practices from 
one or more current grant recipients on recruitment, retention, 
and training efforts and promoting a diverse workforce.
    Driver's License Program Foster Youth.--The Committee 
encourages the establishment of a demonstration expanding 
foster care and adoption assistance programs to provide driving 
preparation assistance to foster youth and related training for 
foster parents, as well as assistance to States and Tribal 
organizations for age-appropriate foster youth to, among other 
things, obtain automobile insurance, complete driver's 
education, obtain a driver's license, and purchase a vehicle.
    Strengthening State ICWA Compliance.--The Committee 
recognizes the important role State child welfare agencies play 
in ensuring the safety of Indian children who come into contact 
with the State child welfare system. The Committee appreciates 
the work of the Children's Bureau to support State compliance 
with the Indian Child Welfare Act [ICWA] through technical 
assistance and through grants to develop strong working 
relationships between States and tribes. The Committee 
continues $3,000,000 for State-Tribal partnership grants to 
build collaborations between States and tribes to better 
address the ongoing challenges Tribal communities face. 
Further, the Committee recommends ACF, in coordination with the 
relevant Federal agencies, develop guidance for States to 
better serve Indian children who come into contact with the 
child welfare system. This guidance may include best practices 
on the timely identification of Indian children and extended 
family members; timely notice to Tribes of State child custody 
proceedings; foster care or adoptive placements of Indian 
children; and case recordkeeping as it relates to transfers of 
jurisdiction, termination of parental rights, and insufficient 
active efforts, as defined by ICWA.

Adoption Opportunities

    The Committee recommends $54,000,000 for the Adoption 
Opportunities program. This program funds discretionary grants 
to help facilitate the elimination of barriers to adoption and 
provide technical assistance to help States increase the number 
of children adopted, particularly children with special needs.
    The Committee recognizes that adoption arrangements at risk 
of a disruption or dissolution that would result in a foster 
care placement are eligible for funding under the Family First 
Prevention Services Act. However, no programs expressly 
designed to meet the needs of these families have been approved 
by the Title IV-E Prevention Services Clearinghouse. The 
Committee directs not less than $2,000,000 for the evaluation 
of such programs that could qualify for funding under the 
Family First Prevention Services Act and aim to meet the 
evidence standards established by the Title IV-E Prevention 
Services Clearinghouse in accordance with the Family First 
Prevention Services Act. The Committee encourages ACF to 
prioritize the evaluation of programs with existing evidence 
and to support studies that can be completed as rapidly as 
possible while meeting the evidence standards of the Title IV-E 
Prevention Services Clearinghouse.
    The Committee recommendation includes $2,000,000 to 
continue the National Adoption Competency Mental Health 
Training Initiative. This initiative supports ongoing resources 
for a national organization with the capacity and expertise to 
continuously evaluate and update the training curriculums, and 
will provide all States, tribes, and territories the necessary 
technical assistance to ensure that the curriculums are 
appropriately used by State child welfare and mental health 
professionals. This funding should also be used to initiate the 
development of derivative trainings for courts and continuing 
medical education for medical professionals to ensure 
consistency across disciplines. The Committee again recommends 
the agency take steps to standardize the National Adoption 
Competency Mental Health Training Initiative's curriculum to 
provide consistent training in all State child welfare 
agencies.

Adoption and Legal Guardianship Incentive Payments

    The Committee recommends $75,000,000 for the Adoption and 
Legal Guardianship Incentive Payments program. This program 
provides formula-based incentive payments to States to 
encourage them to increase the number of adoptions of children 
from the foster care system, with an emphasis on children who 
are the hardest to place.

Social Services Research and Demonstration

    The Committee recommends $78,862,000 for Social Services 
Research and Demonstration. These funds support research and 
evaluation of cost-effective programs that increase the 
stability and economic independence of families and contribute 
to the healthy development of children and youth.
    Benefits Programs.--The Committee recommends the creation 
of a pilot program to align Federal assistance programs for 
low-income Americans into one application. The result of these 
improvements should expand access and enrollment in Federal, 
State, Tribal, and local benefits, such as SNAP, WIC, Medicaid, 
TANF, and the Housing Choice Voucher program, and improve 
coordination of critical services such as mental healthcare and 
childcare.
    Congressionally Directed Spending.--Within the funds 
included in this account, $42,850,000 shall be for the 
Congressionally Directed Spending projects, and in the amounts, 
as specified in the table titled ``Congressionally Directed 
Spending Items'' at the end of this Committee Report.
    Diaper Distribution Grant Demonstration.--The Committee 
recommendation continues $20,000,000 for the purposes of 
carrying out a diaper distribution grant program. The diaper 
distribution program will provide grants to social service 
agencies or other non-profit organizations specifically for 
diaper and diapering supply needs.
    Institutional Child Abuse Study.--The Committee provides 
$2,000,000 and directs the Secretary to enter into a contract 
with the National Academies of Sciences, Engineering, and 
Medicine [NASEM] to conduct a study to examine the state of 
youth in youth residential programs and make recommendations. 
Pursuant to the contract, NASEM shall issue a report informed 
by the study conducted that includes identification of the 
nature, prevalence, severity, and scope of child abuse, 
neglect, and deaths in youth residential programs, including 
types of abuse and neglect, causes of abuse, neglect, and 
deaths, and criteria used to assess abuse, neglect, and deaths; 
identification of all funding sources for youth residential 
programs; and identification of existing barriers in policy for 
blending and braiding of funding sources to serve youth in 
community-based settings.
    Preventing Youth Homelessness.--The Committee includes 
$4,000,000 to continue the preventing youth homelessness 
demonstration program to identify and implement strategies and 
services for youth between ages 12 and 26 in order to prevent 
homelessness, including strategies designed to serve youth and 
young adult populations with a high likelihood of imminently 
experiencing homelessness, housing instability, or other forms 
of victimization such as human trafficking to include 
individuals transitioning out of foster care, the juvenile 
justice system, or a residential behavioral health system.
    The Committee directs that a portion of funds be made 
available to State agencies, tribes, counties, cities, other 
units of local government, or community-based organizations for 
planning and implementation demonstration grants to provide 
primary prevention for youth and young adults at risk of 
homelessness. Grantees shall show collaboration with youth with 
lived expertise in project design and implementation and funds 
may be used to support the establishment and operation of local 
youth advisory boards. The remaining funds shall be used to 
support the demonstrations through evaluation, training, and 
technical assistance and also to support the aligned work of 
the National Prevention Learning Collaborative. The Committee 
notes that this demonstration program is in addition to other, 
ongoing Family and Youth Services Bureau initiatives.
    Whole Family Approach to Service Delivery.--The Committee 
includes $2,500,000 to again support demonstrations of whole-
family approaches to service delivery across the lifecycle of 
families' interaction with benefits programs. The demonstration 
project should focus on coordinating and centralizing service 
access and delivery, with a special focus on projects that aim 
to reduce the impacts of and smooth the benefit cliffs that 
working families face as their incomes rise, resulting in the 
sudden reduction or elimination of financial benefits. ACF is 
encouraged to prioritize demonstration projects in States with 
large rural populations and high rates of poverty.

Native American Programs

    The Committee recommends $60,500,000 for Native American 
programs. These funds support a variety of programs to promote 
self-sufficiency and cultural preservation activities among 
Native American, Native Hawaiian, Alaska Native, and Pacific 
Islander organizations and communities.
    Native American Language Preservation.--Within the total, 
the Committee recommendation includes $15,000,000 for Native 
American language preservation activities, including no less 
than $6,000,000 for Native American language immersion 
programs, as authorized by section 803C(b)(7)(A)-(B) of the 
Native American Programs Act (Public Law 88-452).
    Tribal Programs.--The Committee notes the importance of 
integrated and tribally-determined, high-quality early 
childhood services for Tribal children and their families. The 
Committee requests a briefing within 90 days of enactment on 
the fiscal year 2025 budget proposal that would allow Tribes to 
fully integrate funding across Head Start, CCDBG, and the 
Tribal Maternal, Infant, and Early Childhood Home Visiting 
programs.

Community Services Block Grant

    The Committee recommendation includes $770,000,000, for the 
Community Services Block Grant [CSBG]. CSBG is a formula grant 
to States and Indian tribes to provide a wide-range of services 
to alleviate causes of poverty in communities and to assist 
low-income individuals. States are required to pass on at least 
90 percent of these funds to local community-based 
organizations, the vast majority of which are community action 
agencies.

Community Economic Development

    The Committee recommendation includes $22,383,000 for the 
Community Economic Development program. Community Economic 
Development grants fund non-profit, Community Development 
Corporations that help communities address the needs of low-
income individuals and families by creating employment and 
business development opportunities.

Rural Community Facilities

    The Committee recommendation includes $12,000,000 for the 
Rural Community Facilities program. The Rural Community 
Facilities program provides grants to regional non-profit 
organizations to provide technical assistance to small, low-
income rural communities, that are not served by other similar 
Federal programs, to help manage, develop, and improve safe 
drinking and waste water facilities.

National Domestic Violence Hotline

    The Committee recommendation includes $20,500,000 for the 
National Domestic Violence Hotline. This national, toll-free 
hotline provides critical emergency assistance and information 
to victims of domestic violence 24 hours a day.
    The Committee recommendation includes continued support for 
the StrongHearts Native Helpline, which provides critical 
support and resources to meet the unique legal and cultural 
needs of American Indians and Alaska Natives affected by 
domestic violence.

Family Violence Prevention and Services

    The Committee recommendation includes $242,000,000 for 
Family Violence Prevention and Services programs. These funds 
support programs to prevent family violence and provide 
immediate shelter and related assistance for survivors of 
domestic violence and their dependents.
    Culturally Specific Services for Domestic Violence.--The 
Committee understands that women and girls of color are often 
disproportionally impacted by domestic violence and sexual 
assault yet often lack access to family violence prevention 
services in their communities that incorporate or reflect their 
specific needs. In order to foster programming for this 
community, the Committee continues $7,500,000 for culturally 
specific, community-based organizations to provide culturally 
specific services for survivors of domestic violence.
    Family Violence Prevention and Services Resource Centers.--
The Committee understands the benefits of Family Violence 
Prevention and Services Resource Centers to support communities 
in building local responses and services for domestic violence 
survivors. The Committee includes $2,000,000 for the Alaskan 
Native Women's Resource Center, $2,000,000 for the Native 
Hawaiian Resource Center on Domestic Violence, and $2,000,000 
for the National Indigenous Women's Resource Center to support 
critical networking and coalition building between these 
communities across the State and the Nation.
    Intersection of Domestic Violence, Mental Health, 
Substance-use Coercion, Housing Instability, and Child Welfare 
Involvement.--The Committee recognizes that research has 
consistently demonstrated that experiencing abuse by an 
intimate partner is associated with a wide range of mental 
health and substance use-related consequences, and it is not 
uncommon for an abusive partner to undermine efforts to 
maintain their recovery or intentionally use their partner's 
struggles with mental health against them. The Committee 
supports the work of the Office of Family Violence and 
Prevention Services to invest in targeted support for families 
affected by domestic violence at the intersection of domestic 
violence, housing insecurity, mental health and substance use 
conditions, while ensuring families remain together through 
recovery and prioritize the best interests of children exposed 
to violence in the home.

Chafee Education and Training Vouchers

    The Committee recommendation includes $44,257,000 for the 
Chafee Education and Training Voucher program. This program 
supports vouchers to foster care youth to help pay for expenses 
related to postsecondary education and vocational training.

Disaster Human Services Case Management

    The Committee recommends $1,864,000 for Disaster Human 
Services Case Management. This program assists States in 
establishing the capacity to provide case management services 
in a timely manner in the event of a disaster. It ensures that 
States are able to meet social service needs during disasters 
by helping disaster victims prepare recovery plans, referring 
them to service providers and Federal Emergency Management 
Agency contacts to identify needed assistance, and providing 
ongoing support and monitoring through the recovery process.

Program Administration

    The Committee recommendation includes $219,000,000 for the 
Federal costs of administering ACF programs.

                   PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2024....................................    $417,515,000
Budget estimate, 2025...................................     421,515,000
Committee recommendation................................     417,515,000

    The Committee recommends $417,515,000 for the Promoting 
Safe and Stable Families program. The Committee recommendation 
includes $345,000,000 in mandatory funds authorized by the 
Social Security Act (Public Law 74-271) and $72,515,000 in 
discretionary appropriations.
    This program enables States to operate coordinated programs 
of family preservation services, time-limited family 
reunification services, community-based family support 
services, and adoption promotion and support services.
    Family First Clearinghouse.--The Committee includes 
$2,750,000 for the Family First Clearinghouse. The Committee 
continues to recognize the need to support research into 
programs that provide rigorous evaluations of established 
foster care prevention and family support programs within the 
child welfare population, including programs that support 
adoption arrangements at risk of a disruption or dissolution 
that would result in foster care placement, provide mental 
health prevention and treatment services, substance abuse 
prevention and treatment services, in-home parent skill-based 
programs, and kinship navigator programs.
    Kinship Navigator Programs.--The Committee recommendation 
includes $10,000,000 for Kinship Navigator Programs to improve 
services for grandparents and other relatives taking primary 
responsibility for children, particularly children and families 
affected by opioid addiction and substance use disorder. The 
Committee encourages HHS to encourage States to collaborate 
with agencies with experience serving kinship families both 
inside and outside foster care, and to demonstrate how they are 
preparing their navigator programs to meet evidence-based 
kinship navigator standards included in the Family First 
Prevention Services Act (Public Law 115-123).

                PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2024....................................  $8,594,000,000
Budget estimate, 2025...................................   6,768,000,000
Committee recommendation................................   6,768,000,000

    The Committee recommends $6,768,000,000 in mandatory funds 
for Payments for Foster Care and Permanency. In addition, the 
Committee recommends $3,600,000,000 in advance mandatory 
funding for the first quarter of fiscal year 2026. These funds 
support programs that assist States with the costs of 
maintaining eligible children in foster care, prepare children 
for living on their own, assist relatives with legal 
guardianship of eligible children, and find and support 
adoptive homes for children with special needs.

                  Administration for Community Living


                 AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2024....................................  $2,548,042,000
Budget estimate, 2025...................................   2,634,043,000
Committee recommendation................................   2,543,817,000

    The Committee recommends $2,543,817,000 for the 
Administration for Community Living [ACL], which includes 
$27,700,000 to be transferred to ACL from the PPH Fund.
    ACL was created with the goal of increasing access to 
community support for older Americans and people with 
disabilities. It is charged with administering programs 
authorized under the Older Americans Act [OAA] (Public Law 116-
131) and the Developmental Disabilities Act (Public Law 106-
402), as well as promoting community living policies throughout 
the Federal Government for older Americans and people with 
disabilities. 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 $410,000,000 for the Home and 
Community-Based Supportive Services program. This program 
provides formula grants to States and territories to fund a 
wide-range of social services that enable seniors to remain 
independent and in their homes for as long as possible. State 
agencies on aging award funds to designated area agencies on 
aging that, in turn, make awards to local service providers. 
This activity supports services such as transportation, adult 
day care, physical fitness programs, and in-home assistance.
    Senior Centers.--Senior centers play an important role in 
providing programs to combat isolation and loneliness, which 
can be risk factors for depression, substance use disorder, and 
even suicide. The Committee encourages ACL and the State and 
local agencies administering programs funded through the OAA to 
provide ample funding to senior centers to support their 
general operations and for programming that promotes the health 
and well-being of seniors, including fitness and falls 
prevention programs, nutrition classes and consultations, and 
foot clinics.

Preventive Health Services

    The Committee recommends $26,339,000 for Preventive Health 
Services. This program funds activities such as medication 
management and enhanced fitness and wellness programs. These 
programs help seniors stay healthy and avoid chronic disease, 
thus reducing the need for costly medical interventions. The 
Committee maintains bill language that requires States to use 
these funds to support evidence-based models that enhance the 
wellness of seniors.

Protection of Vulnerable Older Americans

    The Committee recommends $26,658,000 for grants to States 
for the Long-term Care Ombudsman program and the Prevention of 
Elder Abuse program. Both programs provide formula grants to 
States to prevent the abuse, neglect, and exploitation of older 
individuals. The Ombudsman program focuses on the needs of 
residents of nursing homes and other long-term care facilities, 
while the elder abuse prevention program targets the elderly 
community at large.

National Family Caregiver Support Program

    The Committee recommends $209,000,000 for the National 
Family Caregiver Support program. Funds appropriated for this 
activity establish a multifaceted support system in each State 
for family caregivers, allowing them to care for their loved 
ones at home for as long as possible. States may use funding to 
provide information to caregivers about available services, 
assistance to caregivers in gaining access to services, 
caregiver counseling and training, respite care to enable 
caregivers to be temporarily relieved from their caregiving 
responsibilities, and limited supplemental services that fill 
remaining service gaps.
    National Family Caregiver Strategy.--The Committee provides 
$3,000,000, an increase of $1,000,000, to support demonstration 
grants that develop, test, and scale models that implement 
commitments and recommended actions from the National Strategy 
to Support Family Caregivers. The Committee directs ACL to 
provide a briefing for the Committee on Appropriations no later 
than 90 days after enactment of this act with an update on the 
implementation of this effort.
    Direct Care Worker Shortage.--The Committee notes worker 
shortages occurring in parts of the direct care sector, such as 
aging care and disability care. The Committee notes that such 
shortages may be driven by a host of factors which can make it 
difficult to recruit and retain qualified workers. Expanding 
access to quality, long-term care will become more urgent as 
the U.S. population of adults who are 65 and older will grow 
substantially in the coming decades. ACL is encouraged to work 
with the Department of Labor to study the effects of worker 
shortages in the direct care sector and the impact that worker 
shortages will have on long-term care affordability and 
accessibility.
    The Committee notes ACL's recent launch of the Direct Care 
Workforce [DCW] Capacity Building Center, which will serve as a 
hub to improve home and community-based services and enhance 
the direct care workforce. DCW will disseminate best practices 
for agency-based and consumer-directed care arrangements, as 
well as provide tools, resources, and training to assist state 
systems, service providers, and other key stakeholders to 
strengthen the direct care workforce. The Committee encourages 
ACL, in coordination with DOL and CMS, to examine data on the 
potential impacts of worker shortages on long-term care 
affordability and accessibility, and looks forward to the 
report requested in Senate Report 118-84.

Native American Caregiver Support Program

    The Committee recommends $12,000,000 to carry out the 
Native American Caregiver Support program. 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 disability, as well as for 
grandparents caring for grandchildren.

Congregate and Home-Delivered Nutrition Services

    The Committee recommends $565,342,000 for congregate 
nutrition services and $381,342,000 for home-delivered meals. 
These programs address the nutritional needs of older 
individuals, thus helping them to stay healthy and reduce their 
risk of disability. Funded projects must make home-delivered 
and congregate meals available at least once per day, 5 days a 
week, and each meal must meet a minimum of one-third of daily 
dietary requirements. While States receive separate allotments 
of funds for congregate meals, home-delivered meals, and 
supportive services, they have flexibility to transfer funds 
between these programs.
    Community-Based Organizations.--The Committee recognizes 
the important work of community-based organizations that 
provide home-delivered and congregate meals and act as a point 
of social connection for vulnerable older adults. The Committee 
encourages State units on aging and area agencies on aging to 
continue to work with experienced, community-based 
organizations, such as Meals on Wheels programs, when selecting 
local nutrition providers and distributing OAA funding.
    Nutrition Services Incentives Program [NSIP].--The 
Committee recommends $112,000,000 for NSIP. NSIP augments 
funding for congregate and home-delivered meals provided to 
older adults. States and Tribes may choose to receive all or 
part of their funding in the form of commodities from the U.S. 
Department of Agriculture.

Aging Grants to Indian Tribes and Native Hawaiian Organizations

    The Committee recommends $38,264,000 for grants to Native 
Americans. This program provides grants to eligible Tribal 
organizations for the delivery of nutrition and supportive 
services to Native Americans.
    In-Home Modifications.--The Committee recognizes the 
importance of in-home services in facilitating the ability of 
older individuals to remain at home. The Committee encourages 
ACL to better understand these needs in Native American 
communities and encourages ACL to undertake an evaluation of 
the level of need for in-home services that include accessible 
home modifications for older individuals who are Native 
Americans. In doing so, ACL should also examine the extent to 
which current ACL programming is able to meet such needs.
    Native American Nutrition and Support Services.--The 
Committee is aware of concerns regarding potential barriers to 
Indian Tribes accessing programs and resources under title VI 
and title III of the OAA. The Committee encourages ACL to 
convene with stakeholders to understand these concerns and work 
to ensure that programs and resources are reaching Tribal 
members.

Aging Network Support Activities

    The Committee recommends $30,461,000 for Aging Network 
Support activities. These funds support activities that expand 
public understanding of aging and the aging process, apply 
social research and analysis to improve access to and delivery 
of services for older individuals, test innovative ideas and 
programs, and provide technical assistance to agencies that 
administer programs authorized by the OAA.
    EngAGED Update.--The Committee directs ACL to provide an 
update in the fiscal year 2026 CJ describing activities funded 
and undertaken by the National Resource Center for Engaging 
Older Adults. Such update shall include programmatic goals for 
fiscal year 2026, budgetary resources proposed for the Center 
in fiscal year 2026, and details about the target and served 
populations of the Center, including the Center's outreach and 
activities with regard to multigenerational family units.
    Holocaust Survivor Assistance.--The Committee provides 
$8,500,000 for the Holocaust Survivor Assistance program, which 
provides supportive services for aging Holocaust survivors and 
their families, and to other older adult populations that have 
been exposed to and impacted by traumatic events, including 
aging military veterans, first responders, victims of childhood 
and domestic violence, and survivors of man-made or natural 
disasters.
    In addition, the Committee continues the programs specified 
under this heading and in the amounts specified in the 
explanatory statement that accompanied division H of Public Law 
117-328.

Alzheimer's Disease Program

    The Committee recommends $31,500,000, including $14,700,000 
to be transferred from the PPH Fund, for the Alzheimer's 
Disease Program which includes Demonstration Grants to States 
and the Alzheimer's Disease Initiative. Within this funding, 
the Committee supports the continuation of the National 
Alzheimer's Call Center, which is available in all States, 24 
hours a day, 7 days a week, year-round, to provide expert 
advice, crisis counseling, care consultation and information 
referral services in at least 140 languages, for persons with 
Alzheimer's disease, their family members and informal 
caregivers. The Committee recommends no less than $2,000,000 to 
continue the National Alzheimer's Call Center.

Lifespan Respite Care

    The Committee recommends $11,000,000, an increase of 
$1,000,000, for the Lifespan Respite Care program. The Lifespan 
Respite Care program provides grants to States to expand 
respite care services to family caregivers, improve the local 
coordination of respite care resources, and improve access to 
and quality of respite care services, thereby reducing family 
caregiver strain.

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 [CDSMP]. This program assists those with chronic 
disease with education to manage their conditions and improve 
their health status. Topics covered by the program include 
nutrition; appropriate use of medications; fitness; and 
effective communications with healthcare providers. Multiple 
studies have shown CDSMP to result in significant and 
measurable improvements in health and quality of life, as well 
as reductions in hospitalizations and emergency room visits.

Elder Falls Prevention

    The Committee recommends $7,500,000, including $5,000,000 
to be transferred from the PPH Fund, for Elder Falls Prevention 
activities at ACL. Preventing falls will help seniors stay 
independent and in their homes and avoid costly 
hospitalizations and hip fractures, which frequently lead to 
nursing home placement.

Elder Rights Support Activities

    The Committee recommends $33,874,000 for Elder Rights 
Support activities, which support programs that provide 
information, training, and technical assistance to legal and 
aging services organizations in order to prevent and detect 
elder abuse and neglect.

Aging and Disability Resource Centers

    The Committee recommendation includes $8,619,000 for Aging 
and Disability Resource Centers. These centers provide 
information, one-on-one counseling, and access for individuals 
to learn about their long-term services and support options 
with the goal of allowing seniors and individuals with 
disabilities to maintain their independence.

State Health Insurance Assistance Program

    The Committee recommends $55,242,000 for State Health 
Insurance Assistance Programs, which provide accurate and 
understandable health insurance information to Medicare 
beneficiaries and their families.

Paralysis Resource Center

    The Committee recommends $10,700,000 for the Paralysis 
Resource Center [PRC]. This program has long provided 
essential, comprehensive information, and referral services 
that promote independence and quality of life for the over five 
million people living with paralysis and their families. The 
Committee directs ACL to support the National PRC at not less 
than $10,000,000.

Limb Loss

    The Committee recommends $4,200,000 for the Limb Loss 
program, which supports programs and activities to improve the 
health of people with limb loss and promote their well-being, 
quality of life, prevent disease, and provide support to their 
families and caregivers. Maintaining these programs is critical 
to support independent living within the disability community 
across their life course.

Traumatic Brain Injury

    The Committee recommends $13,118,000 for the Traumatic 
Brain Injury program. The program supports implementation and 
planning grants to States for coordination and improvement of 
services to individuals and families with traumatic brain 
injuries. Such services can include pre-hospital care, 
emergency department care, hospital care, rehabilitation, 
transitional services, education, employment, long-term 
support, and protection and advocacy services.

Developmental Disabilities State Councils

    The Committee recommends $81,000,000 for State Councils on 
Developmental Disabilities. These Councils work to develop, 
improve, and expand the system of services and supports for 
people with developmental disabilities at the State and local 
level. Councils engage in activities such as training, 
educating the public, building capacity, and advocating for 
change in State policies with the goal of furthering the 
inclusion and integration of individuals with developmental 
disabilities in all aspects of community life.
    Technical Assistance.--The Committee recommends that ACL 
provide not less than $800,000 for technical assistance and 
training for the State Councils on Developmental Disabilities. 
In addition, the Committee encourages ACL to consult with 
Developmental Disabilities Assistance and Bill of Rights Act 
[DD 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 $45,000,000 for protection and 
advocacy programs for people with developmental disabilities. 
This formula grant program provides funds to States to 
establish and maintain protection and advocacy systems that 
protect the legal and human rights of persons with 
developmental disabilities who are receiving treatment, 
services, or rehabilitation.
    Proper Settings of Care.--The Committee encourages ACL to 
consider the needs and desires of patients, families, 
caregivers, legal representatives, and other stakeholders, as 
well as the need to provide proper settings for care, in its 
enforcement of the DD Act.

Voting Access for Individuals with Disabilities

    The Committee recommends $10,000,000 to improve voting 
access for individuals with disabilities. This program provides 
grants to protection and advocacy organizations to ensure that 
individuals with disabilities have the opportunity to 
participate in every step of the electoral process, including 
registering to vote, accessing polling places, and casting a 
vote.

Developmental Disabilities Projects of National Significance

    The Committee recommends $12,250,000 for projects of 
national significance to assist persons with developmental 
disabilities. This program funds grants and contracts that 
develop new technologies and demonstrate innovative methods to 
support the independence, productivity, and integration into 
the community of persons with developmental disabilities.

University Centers for Excellence in Developmental Disabilities

    The Committee recommends $43,119,000 for the University 
Centers for Excellence in Developmental Disabilities [UCEDDs] 
to continue to meet their obligations under the DD Act. UCEDDs 
provide training, technical assistance, service, research, and 
information dissemination to people with disabilities, their 
families, State and local government agencies, and providers, 
to build the capacity of communities and create improvements in 
the service delivery system for people with intellectual and 
developmental disabilities [I/DD] and other disabilities, 
including those from underrepresented populations. The funding 
also will support technical assistance to strengthen and 
support the National network of UCEDDs as they disseminate 
research, training, and practices nationwide.

Independent Living

    The Committee recommends $128,183,000 for the Independent 
Living program, which helps ensure that individuals with 
disabilities can live productive and independent lives in 
society. Funding helps States sustain, improve, and expand 
independent living services and establish and support a network 
of centers for independent living.

National Institute on Disability, Independent Living, and 
        Rehabilitation Research [NIDILRR]

    The Committee recommends $119,000,000 for the NIDILRR, 
which supports research and activities that help to maximize 
the full potential of individuals with disabilities in 
employment, independent living, and social activities. NIDILRR 
is the only government entity charged to focus on the whole 
person with a disability and their ability to function 
independently and maintain a high quality of life among all 
personal, societal and environmental factors. The 
recommendation continues funding to support the Traumatic Brain 
Injury Model Systems National Data and Statistical Center.

Assistive Technology

    The Committee recommends $40,000,000 for Assistive 
Technology [AT]. AT provides States with funding to support 
individuals with disabilities of all ages to obtain devices and 
services that will increase, maintain, or improve their 
functional capabilities. With the reauthorization of the 21st 
Century Assistive Technology Act, the Committee supports 
implementation to meet the increased demand for access to 
assistive technology for people with disabilities and older 
adults. In doing so, the Committee eliminates the alternative 
financing program that duplicates resources already available 
under the 21st Century Assistive Technology Act.

Program Administration

    The Committee recommends $48,063,000 for program 
administration at ACL. These funds support salaries and related 
expenses for program management and oversight activities.
    Congressionally Directed Spending.--The Committee includes 
$22,043,000 for aging and disability services projects, as 
specified in the table at the end of this Committee Report.

         Administration for Strategic Preparedness and Response

    The Committee recommends $3,827,597,000 for the 
Administration for Strategic Preparedness and Response [ASPR]. 
This appropriation supports the activities of ASPR and other 
components within the Office of the Secretary to prepare for 
the health consequences of bioterrorism and other public health 
emergencies, including pandemic influenza.
    Department of Defense Coordination.--The Committee 
understands the critical role of the Department of Defense 
[DoD] in the larger U.S. Government and private sector efforts 
to address chemical, biological, radiological, and nuclear 
[CBRN] threats as well as emerging infectious diseases. The DoD 
possesses unique capabilities that contribute to interagency 
efforts to prevent, detect, and respond to outbreaks of 
infectious disease worldwide. The Committee encourages 
prioritizing and aligning investments in medical 
countermeasures among all Federal stakeholders to ensure that 
effective countermeasures are developed to meet both military 
and civilian needs, and to prevent potential duplication of 
efforts. The Committee urges ASPR and DoD to coordinate to 
leverage private industry expertise to meet these needs.
    Essential Medicines List.--The Committee requests the 
Secretary to update and maintain, in consultation with relevant 
stakeholders, the list of essential medicines initially 
developed in response to Executive Order 13944 (85 Fed. Reg. 
49929) to include drugs and active pharmaceutical ingredients 
[APIs] that are reasonably likely to be required to respond to 
a public health emergency or chemical, biological, 
radiological, or nuclear threat, or the shortage of which would 
pose a significant threat to the U.S. healthcare system or at-
risk populations.
    Interagency Alignment of Biomedical Countermeasures 
Research and Development.--The Committee has prioritized 
investments in R&D of biodefense medical countermeasures 
through several different HHS components, depending on their 
particular missions and areas of expertise; however, there are 
no rigorous mechanisms in place to ensure the alignment of 
medical countermeasures requirements, priorities, projects, and 
project transitions across each of the agencies responsible for 
various phases of product development, including basic 
research, preclinical development, advance development, and 
procurement. The Committee urges ASPR to coordinate with the 
White House Office of Pandemic Preparedness and Response 
[OPPR], and interagency partners that comprise the Public 
Health Emergency Medical Countermeasures Enterprise, to improve 
alignment and efficiency of medical countermeasures research 
and development activities across Federal agencies, especially 
to ensure the end-to-end development of needed products, 
technologies, or platforms. ASPR is encouraged to work with 
NIAID, BARDA, FDA, CDC, related efforts of the Department of 
Defense's biodefense R&D programs, and similar R&D programs 
funded by the Department of Energy.
    Medical Supply Chain Surveillance.--The Committee urges 
ASPR, in coordination with FDA, to prioritize the 
identification of upstream pharmaceutical supply chain risks to 
reduce medicine supply disruptions while also providing 
evidence to inform public investment and policy reforms that 
build more resilience in the medical supply chain. This 
includes the ability to leverage integrated data analytics from 
a range of data sources to identify key risk indicators and 
improve both demand forecasting and capacity management. The 
Committee directs ASPR to identify opportunities to support the 
development of capabilities to continually assess the global 
supply chain for essential medicines, that covers source 
location, volume, and the number of facilities involved in the 
production of APIs and key starting materials [KSMs], finished 
dosage forms, and other required components. A special emphasis 
should be placed on drug shortages, particularly sterile 
injectable drugs, which were found to be the drugs most 
commonly in short supply in the FDA's report Drug Shortages: 
Root Causes and Potential Solutions.
    Public Health Emergency Medical Countermeasures Enterprise 
[PHEMCE].--The Committee recognizes the importance of the 
PHEMCE in ensuring the Nation's preparedness for CBRN and 
emerging infectious disease threats. The Committee directs ASPR 
to continue to partner with PHEMCE interagency partners in the 
execution of those functions. The Committee further directs 
ASPR, working with PHEMCE and intelligence community partners, 
to provide an annual classified threat briefing to the 
Committee, and as situations arise that may materially impact 
our medical countermeasure enterprise. This advisory committee 
should encompass a diverse array of external partners to ensure 
comprehensive expertise in addressing various threats, thus 
fortifying the Nation's overall preparedness. To the extent 
practicable, PHEMCE's strategic planning and decision-making 
around stockpile needs, requirements, and interactions with 
other government agencies and the communication of such 
decisions should be made in concert with the advisory committee 
considering the inputs from private partners. ASPR is directed 
to report to the Committee within 120 days of enactment to 
provide an update on these activities.
    Reporting.--The Committee directs ASPR to brief the 
Committees on Appropriations monthly regarding activities 
funded by this act and other available appropriations. The 
agency shall notify the Committee at least 24 hours in advance 
of any obligation greater than $25,000,000 from any 
appropriation available to ASPR. Such notification shall 
include the source of funding, including the applicable 
legislative citation, and a description of the obligation. In 
addition, ASPR shall submit a monthly obligation report in 
electronic format summarizing the details of these obligations 
to the Committees on Appropriations. Such report shall be due 
not later than 30 days after the end of each month and shall be 
cumulative for the fiscal year with the most recent obligations 
listed at the top. Furthermore, the Secretary shall include in 
this monthly report the current inventory of COVID-19 
therapeutics, as well as the deployment of these therapeutics 
during the previous month as reported by States and other 
jurisdictions until the inventory is expended.
    Report on Essential Medicines Risk Assessment.--The 
Committee requests the Secretary, in consultation with the 
Secretaries of Defense and Homeland Security as well as the 
Director of the Office of Pandemic Preparedness and Response 
Policy, to submit a report within 18 months of enactment of 
this act, assessing the FDA's updated Essential Medicines List. 
Specifically, the report shall assess and identify, to the 
extent available: (1) key starting materials and excipients 
used in manufacturing the active pharmaceutical ingredients and 
drugs on the essential medicines list; (2) the names of the 
active pharmaceutical ingredients and drugs on the essential 
medicines list that rely on high-risk foreign suppliers for 
more than 50 percent of production; (3) current domestic 
manufacturing capabilities for drugs and active pharmaceutical 
ingredients on the essential medicines list, including their 
key starting materials and excipients, and any cost-effective 
manufacturing technologies, including advanced manufacturing, 
that should or should not be considered; (4) national security 
risks, including cybersecurity threats and critical 
infrastructure designations; (5) any deficiencies, lack of 
authorities, or limitations in policy or process that limit the 
Departments of Health and Human Services, Defense, or Homeland 
Security to address any national security risks in the 
pharmaceutical supply chain; and (6) how the Departments of 
Health and Human Services, Defense, or Homeland Security will 
mitigate such national security risks, including through its 
use of the Defense Production Act.

                 RESEARCH, DEVELOPMENT, AND PROCUREMENT

Appropriations, 2024....................................  $3,135,000,000
Budget estimate, 2025...................................   3,082,991,000
Committee recommendation................................   3,250,991,000

    The Committee recommends $3,250,991,000 for ASPR's 
Research, Development, and Procurement activities. This 
appropriation supports the advanced research, development, 
regulatory approval, and procurement of life-saving medical 
products-drugs, vaccines, therapeutics, diagnostics, and 
medical devices-that are collectively known as medical 
countermeasures [MCMs]. These MCMs serve as life-saving 
technologies during public health emergencies involving CBRN 
threats and other emerging threats, while advancing the day-to-
day public health and medical capabilities. In addition to 
developing these products, this appropriation also supports 
ensuring certain qualifying MCMs and medical supplies are 
stockpiled to be ready to deploy when needed.

Biomedical Advanced Research and Development Authority [BARDA]

    The Committee recommendation includes $1,070,000,000, an 
increase of $55,000,000, for BARDA. BARDA supports the advanced 
development of vaccines, therapeutics, diagnostics and devices 
for potential serious public health threats, including 
chemical, biological, radiological, and nuclear threats, 
pandemic influenza, and emerging and re-emerging infectious 
diseases. BARDA played a critical role in the COVID-19 and Mpox 
outbreak responses, and swiftly acted in response to recent 
Marburg, Sudan, and Ebola Zaire outbreaks. The Committee 
encourages BARDA to expand its portfolio of partnerships for 
broader success.
    Antimicrobial Resistance [AMR].--The Committee continues to 
support advanced research and development of broad-spectrum 
antimicrobials, particularly for multi-drug resistant 
pathogens, and next-generation therapeutics that address the 
increasing incidence of antimicrobial resistance.
    Antimicrobial Resistance Research Using Bispecific 
Agents.--The Committee understands that research exists to 
develop therapies that directly engage the host immune system 
to kill bacterial cells, mirroring treatments in proven cancer 
drugs. Such an approach may open the door to new variations of 
treatment, allowing for more personalized and more precise 
medicinal treatments. The Committee encourages BARDA to invest 
in these and additional novel ways to treat bacterial 
infections that reduce or circumvent the antimicrobial 
resistance seen with conventional antibiotics.
    Blood Supply.--The Committee remains concerned about the 
vulnerability of the blood supply after the peak COVID 
shortages and the HHS Advisory Committee on Blood and Tissue 
Safety and Availability report indicating that the blood supply 
faces significant threats and challenges. The Committee 
supports the report's recommendation to implement new 
technologies to improve the safety and reliability of the blood 
supply. The BARDA strategic objective to develop next 
generation blood products must go beyond treatment of radiation 
injuries and be expanded to include products that can be used 
regardless of the patient's blood group, expand availability to 
all hospitals, prevent shortages, and be suitable for use 
throughout the continuum of care including first responders. 
Suitable products that are in clinical trials should be 
considered a priority for funding. The Committee urges BARDA to 
expand the development of freeze-dried hemostatic products, 
especially platelet-derived products, to include a wide range 
of indications encompassing treatment of hemorrhagic disease, 
use in general surgery, obstetrics, and trauma. The Committee 
encourages the Secretary to consider a pilot project to expand 
manufacturing capacity such that a national inventory adequate 
to provide a national response capability can be established. 
The Secretary shall provide a biannual report to the Committee 
detailing the progress on these efforts.
    Biopharmaceutical Manufacturing Partnership [BioMAP].--The 
Committee appreciates BARDA taking steps to strengthen our 
Nation's MCM enterprise, including through the BioMaP and 
supports efforts to expand domestic manufacturing 
infrastructure for MCMs. Given the global nature of certain 
clinical research, development, and manufacturing activities, 
it is critical for BARDA to strengthen, expand, and make 
progress in onshoring these programs. Within 120 days of 
enactment, BARDA shall brief the Committee on BARDA's plans in 
fiscal year 2025 to support the onshoring of MCM development 
activities, including actions taken by BioMaP.
    CBRN Threats.--The Committee expresses deep concern 
regarding the heightened risks posed by CBRN weapons worldwide. 
The Committee provides robust funding for BARDA's core national 
security mission to protect Americans against these deliberate, 
man-made threats. The Committee urges ASPR to prioritize the 
development and stockpiling of critical CBRN vaccines, 
treatments, and diagnostics to ensure uninterrupted access to 
these life-saving MCMs within the Strategic National Stockpile 
[SNS]. The Committee encourages ASPR to engage more frequently 
with private sector partners to speed the development of new 
MCMs and stockpiling of existing MCMs against CBRN threats.
    Infectious Diseases.--The Committee supports robust funding 
for BARDA's naturally occurring infectious disease programs, 
including emerging infectious diseases, AMR, and pandemic 
influenza. The Committee encourages BARDA to account for low-
resource settings and vulnerable populations, such as children 
and neonates, in its funding decisions to produce tools that 
have wide applicability for many geographies in the U.S. and 
globally that lack advanced health infrastructure. The 
Committee encourages ASPR to project its spending on emerging 
infectious diseases, AMR, and pandemic influenza in its annual 
5-year budget plan. The Committee requests that BARDA continue 
publicly updating its research portfolios to include pathogen, 
product, phase, and funding data for all its programs, and to 
provide the underlying data in tabular form.
    Infectious Disease Outbreaks With Pandemic Potential.--The 
Committee supports robust funding for BARDA to engage in 
public-private partnerships to support advanced R&D of 
innovative platform technologies and MCM programs focused on 
(but not limited to) vaccines, therapeutics, diagnostics, and 
other MCMs for emerging infectious diseases, including novel 
pathogens and viral families with pandemic potential. The 
Committee encourages ASPR to prioritize the identification and 
development of promising technologies that can be leveraged to 
address a range of future pathogens, including virus families 
with significant pandemic potential. In addition, the Committee 
directs BARDA to allocate no less than $10,000,000 in fiscal 
year 2025 to support the Disease X Medical Countermeasure 
Program at BARDA for expeditious development of MCMs against 
priority viral families, including those effective against 
novel pandemic pathogens.
    Red Blood Cell Clinical Trial Program.--The Committee urges 
BARDA to continue investments in red blood cell pathogen 
reduction technology to ensure that completion of technology 
development as defined in BARDA contracts is accomplished in 
parallel with the clinical trials.
    Securing BARDA's Partnerships from Malign Actors.--The 
Committee directs BARDA to submit a report to the Committees 
within 180 days of enactment on all partnerships with entities 
that are based in the People's Republic of China [PRC] or under 
the jurisdiction of the PRC government and their subsidiaries. 
The report shall include partnerships spanning the entire scope 
of BARDA's work including the development of vaccines, drugs, 
therapies, and diagnostic tools for public health medical 
emergencies such as CBRN accidents, incidents and attacks; 
pandemic influenza [PI], and emerging infectious diseases 
[EID]. Additionally, the report shall include the type of 
agreement that BARDA has entered into with a PRC entity, the 
scope of the agreement, the length of the agreement, and what 
data or information has been or will be shared with the BARDA 
partner.
    Whole Blood Platelet Collection.--The Committee urges BARDA 
to initiate investments in whole blood platelet technologies 
during fiscal year 2025 to achieve timely FDA approval for use 
of these technologies in all 50 States to increase sufficient 
platelet production capacity for routine blood center 
operations and pandemic preparedness as soon after FDA approval 
as practicable. Production of whole blood platelets will enable 
pandemic preparedness and surge capacity in times of national 
disaster when platelet transfusion is required to support 
injured patients in the civilian and military population.
    Tuberculosis [TB].--Drug resistant TB is identified as a 
serious threat level pathogen to the U.S. by the Combating 
Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator 
[CARB-X]. As drug resistant TB cases are on the rise globally, 
the threat to the United States also grows and BARDA's 
investment in new TB diagnostics, drugs, and vaccines is 
critical. The Committee requests an update on BARDA's 
investments in drug resistant TB research in the fiscal year 
2026 CJ.

Project Bioshield Special Reserve Fund

    The Committee recommendation includes $835,000,000, an 
increase of $10,000,000, for Project Bioshield. The Committee 
is committed to ensuring the Nation is adequately prepared 
against chemical, biological, radiological, and nuclear 
attacks. These funds support the acquisition of promising MCMs 
developed through BARDA contracts for the most serious public 
health threats.

Strategic National Stockpile

    The Committee includes $1,010,000,000, an increase of 
$30,000,000, for the Strategic National Stockpile [SNS].
    Acute Radiation Syndrome [ARS].--The Committee notes ASPR 
has the responsibility of developing and procuring MCMs for 
naturally occurring and intentional threat agents while 
ensuring that these are quickly available in the event of an 
emergency, and that these threats include nuclear and 
radiological events. The Committee is concerned, however, that 
ASPR/SNS has only been able to meet 45 percent of the published 
requirement to protect Americans from ARS. Considering the 
risks associated with international supply chains and recent 
geopolitical developments, the Committee directs ASPR/SNS to 
prioritize domestically sourced FDA-approved MCMs for ARS and 
thermal burns. Additionally, given the anticipated delays in 
treatment initiation due to the extended time needed to deploy 
personnel and MCMs in the event of a nuclear or radiological 
incident, the Committee urges ASPR/SNS to prioritize FDA-
approved countermeasures with an extended treatment window. 
Such countermeasures should be effective for deployment at 
least 96 hours after a radiological event. The Committee 
requests a report within 30 days of enactment that includes an 
update on ASPR's plans to ensure existing ARS products are 
maintained at a level that meets the requirement and secure the 
continued availability of a diverse set of domestically 
manufactured countermeasures that will be effective under 
expected conditions of deployment and use.
    Feasibility of a Loan Program for MCM Development.--The 
Committee recognizes the success of the Department of Energy's 
loan programs in advancing national security and high 
technology assets and acknowledges the potential benefits of a 
similar approach within HHS. Specifically, the Committee 
requests ASPR to conduct a comprehensive feasibility analysis 
of establishing a Health Security Loan Program within BARDA. 
This program would aim to address the critical financing gaps 
in the development and commercialization of MCMs across various 
stages of the product life cycle. The analysis should consider 
the structure and success factors of DOE's Title 17 Innovative 
Energy Loan Guarantee Program, evaluating its applicability to 
the unique challenges and opportunities in the health security 
sector. The report should assess the potential impact of such a 
loan program on accelerating the availability of MCMs during 
both emergency and non-emergency periods, drawing parallels 
with the Small Business Administration's role in providing 
loans to small businesses during critical phases of their 
development. ASPR is directed to provide a detailed report 
within 180 days of enactment. The report should outline the 
findings of the feasibility analysis, including any policy 
restrictions or limitations that may hinder the implementation 
of a Health Security Loan Program, and offer recommendations 
for a strategic plan to ensure that agencies responsible for 
disease prevention, detection, and outbreak response have 
access to the necessary financing mechanisms to support the 
development and commercialization of vital MCMs.
    Made in America Strategic National Stockpile.--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 [PPE]. The Committee strongly urges ASPR 
to develop a long-term sustainable procurement plan that gives 
preference to and results in purchases directly from domestic 
manufacturers to the maximum extent practicable.
    Resupply of Nerve Agent Countermeasures.--The Committee 
remains concerned that the Nation is not sufficiently prepared 
for the threats posed by chemical weapons and nerve agents, 
particularly threats to the American public. Anti-convulsant 
medicines provide a key means of treatment, yet the SNS 
currently stockpiles only diazepam auto-injectors, all of which 
expired in October 2023. The Committee notes each of ASPR's 
fiscal year 2023, 2024, and 2025 congressional justifications 
requested funding to procure FDA-approved next generation 
midazolam auto-injectors to resupply the SNS. However, the 
Committee is concerned that ASPR does not intend to execute the 
appropriated funds for FDA-approved midazolam auto-injectors 
from fiscal year 2023 or 2024 and reiterates the request for a 
report included in the Consolidated Appropriations Act, 2024 
(Public Law 118-47). Therefore, the Committee urges ASPR to 
take appropriate steps to resupply the expired stock of anti-
convulsant medicines in the SNS.
    Poxvirus Countermeasures.--The Committee commends ASPR for 
their role in the successful campaign to stop the 2022 MPox 
outbreak in the United States by deploying medical 
countermeasures that were previously developed, purchased and 
stockpiled for smallpox preparedness. The Committee is 
concerned however that there may now be an insufficient supply 
of poxvirus vaccine for immunocompromised individuals as well 
as poxvirus treatments in the stockpile, especially in light of 
the continued national security threat of an intentional or 
accidental release of smallpox. The Committee urges ASPR to 
prioritize replenishment of MCMs used during the MPox outbreak 
and requests a briefing within 60 days of the date of enactment 
on the stockpiling requirements for poxvirus vaccine and 
therapeutics as included in the 2022 Medical Countermeasure 
Preparedness Report, submitted to Congress as part of the 
required annual threat based review of the SNS.
    Replenishing Influenza Antivirals.--The Committee remains 
concerned about the perennial threat of pandemic influenza, 
which could be exacerbated by expiring antivirals in the SNS. 
The Committee strongly urges HHS to diversify and replenish its 
stockpile of emergency influenza antivirals to ensure the 
Nation has multiple current treatment options in the event of 
an influenza pandemic.
    Shelf-life Extension Program [SLEP].--The Committee remains 
concerned with aging products in the SNS and the use of the 
SLEP for MCMs. While the SLEP can result in cost savings and 
efficiencies, it is not a substitute for the timely 
replenishment of aging products in stockpile. For example, the 
most recent Medical Countermeasures Preparedness Review, 
submitted to Congress as part of the required annual threat-
based review of the SNS, found that ASPR often relies on 
decades-old products to fulfill current PHEMCE stockpiling 
requirements. The Committee remains concerned that efforts to 
achieve cost savings through SLEP could negatively impact the 
distribution of, patient adherence to, and ultimately consumer 
confidence in products in the SNS used during an emergency. In 
the annual SNS threat-based review, the Secretary will include 
the quantity of each countermeasure that is beyond 10 years of 
the initial FDA expiration date and the number of these aged 
products in the SLEP that have no industry sponsor.
    State Strategic Stockpiles.--The Committee supports a State 
stockpile program, as authorized in Public Law 117-328, to 
supplement the Federal SNS by allowing States to secure 
appropriate drugs, vaccines, and other biological products, 
medical devices, and other medical supplies necessary to 
respond to a public health emergency or a major disaster. This 
may include products for regional threats such as mosquito-
borne diseases and natural disasters such as hurricanes, 
tornados, blizzards, or extreme drought. The Committee 
recognizes the importance of guidance to States on how best to 
establish, expand, procure, replenish, maintain, and manage 
State stockpiles, while ensuring appropriate collaboration with 
the Federal SNS. ASPR is directed to report to the Committees 
within 180 days of enactment to provide an update on plans to 
issue guidance related to state stockpiles. The Committee notes 
that empowering States to support their own stockpiles and to 
stockpile products that may not be procured on the Federal 
level will improve States' ability to protect their specific 
populations and appropriately prepare for and respond to 
emergencies. Therefore, ASPR is encouraged to establish, 
expand, or maintain a State stockpile program for States' 
specific and unique needs, while ensuring such a program is 
appropriately coordinating with the Federal SNS. The Committee 
directs ASPR to include an update in the fiscal year 2026 CJ on 
its plans to implement the program, including providing a draft 
budget.
    SNS Transparency.--The SNS has received funding increases 
for the past 4 years, on top of the tens of billions of dollars 
it received during the COVID-19 pandemic. Yet, the Committee 
continues to hear significant concerns with the SNS' 
contracting bandwidth and its ability to execute on contracts 
in a timely manner. In addition, as products move through 
development and are approved by BARDA, which is publicly 
disclosed, the Committee does not have transparency on which 
products are entering the stockpile and when. Therefore, the 
Committee directs ASPR to include in its monthly briefings to 
the Committee information on which products approved by BARDA 
are being stockpiled. The briefing should be accompanied by a 
semiannual report on the contracts executed in the past 6 
months. This should be an ongoing listing that will allow the 
Committee to continuously track products as they move through 
the development pipeline from BARDA through the lifecycle of 
product replenishment for all products in the SNS.
    Temperature Sensitive Products.--The Committee encourages 
ASPR to ensure that vaccines, drugs, and other temperature 
sensitive products are packaged, stored, and distributed using 
best practices for appropriate temperature control, including 
through the use of temperature monitoring technologies that may 
be placed on individual packaging.

Pandemic Influenza Preparedness

    The Committee recommendation includes $335,991,000, for 
Pandemic Influenza Preparedness. This funding supports efforts 
to modernize influenza research and development of vaccines and 
next-generation influenza medical countermeasures, preparedness 
testing and evaluation, as well as critical domestic vaccine 
manufacturing infrastructure.
    Test-to-Treat.--The Committee believes the test-to-treat 
model, which was implemented for COVID-19 in retail pharmacies 
and health clinics, can make other infectious disease 
treatments available more quickly and reduce disease 
transmission and illness severity. The availability of accurate 
diagnostics and the rapid prescription of treatments is 
especially critical given the recent co-circulation of multiple 
respiratory diseases during the winter season. The Committee 
believes the test-to-treat model should be evaluated for the 
confluence of influenza, COVID-19 and RSV, given the 
availability of multiple diagnostic tests and antivirals. The 
Committee directs HHS to submit a report to Congress within 120 
days of enactment on the findings of the NIH Home Test-to-Treat 
demonstration for influenza, lessons learned from the COVID-19 
Federal Retail Pharmacy Program, and the design of a potential 
test-to-treat demonstration for COVID-19, influenza, and RSV to 
serve vulnerable populations.

            OPERATIONS, PREPAREDNESS, AND EMERGENCY RESPONSE

Appropriations, 2024....................................    $499,606,000
Budget estimate, 2025...................................     685,097,000
Committee recommendation................................     576,606,000

    The Committee recommends $576,606,000, an increase of 
$77,000,000, for ASPR's Operations, Preparedness, and Emergency 
Response activities. This appropriation supports the operations 
and logistics capabilities across ASPR's programs as well as 
the tools and resources necessary to support its emergency 
preparedness and response mission. This includes ASPR's 
financial management, acquisition, information technology, and 
its suite of integrated Federal medical response capabilities 
that is prepared to respond when disaster strikes.
    HHS Coordination Operations and Response Element [H-
CORE].--The Committee includes $15,000,000 to ensure the 
operational coordination and logistical support for the COVID-
19 response and other threats, as they arise.
    Supply Chain Control Tower [SCCT] Program.--The Committee 
recognizes the importance of the SCCT Program, a voluntary 
collaboration between distributor partners and ASPR, to provide 
partial visibility for supply chain monitoring and readiness. 
In addition to providing insights for demand and supply 
forecasting, the Committee encourages ASPR to coordinate with 
FDA and CDC to use the SCCT to monitor the availability of a 
broader list of essential health and medical products.

Preparedness and Emergency Operations

    The Committee includes $31,154,000 for Preparedness and 
Emergency Operations. The Preparedness and Emergency Operations 
account funds the Office of Emergency Management, which 
supports the 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 $81,904,000, an increase of 
$3,000,000, for the National Disaster Medical System [NDMS] to 
improve the disaster readiness of the Nation by better 
coordinating existing assets with States and regions.
    Mission Zero.--The Committee includes $4,000,000, for 
civilian trauma centers to train and incorporate military 
trauma care providers and teams into care centers.
    Pediatric Disaster Care.--The Committee includes 
$7,000,000, to support the pediatric disaster care program.
    Public Health Preparedness Equipment.--The Committee 
includes $2,000,000 for ASPR to maintain next generation air 
mobility solutions that will ensure more cost-effective health 
delivery systems.
    Prepositioning Response Medical Caches Outside the 
Contiguous United States.--The Committee recognizes the 
geographic distance of Hawaii and the U.S. Affiliated Pacific 
Islands [USAPI] and the need to pre-position emergency medical 
resources in Hawaii to mitigate risks associated with disrupted 
transportation networks, communications, and supply chains. The 
Committee therefore includes a $3,000,000 increase for NDMS and 
directs ASPR to maintain its prepositioning of response medical 
caches in Hawaii to serve the State and USAPI. These medical 
caches should have a minimum capability to support up to two 
38-person Disaster Management Assistance Teams, in order to 
provide immediate support to Hawaii and the USAPI during a 
public health or disease response.

Health Care Readiness and Recovery

    The Committee's recommendation includes $309,055,000, an 
increase of $4,000,000, for Health Care Readiness and Recovery 
[HCRR], formerly the Hospital Preparedness Program. The HCRR 
portfolio includes critical programs and activities that 
strengthen healthcare sector readiness to provide innovative, 
coordinated, and lifesaving care in the face of emergencies and 
disasters. The Committee believes this funding should be 
carefully coordinated within communities to continue to provide 
our Nation's hospitals and emergency responders the necessary 
tools to respond quickly and collaboratively to public health 
emergencies. Within HCRR, the Committee includes $240,000,000, 
for cooperative agreements, critical support to State, local, 
and regional partners to advance healthcare system preparedness 
and response.
    Biocontainment Care Capabilities.--The Committee requests a 
briefing within 60 days of enactment on the planning and design 
resource requirements of Next Generation Biocontainment Care 
Capabilities at a leading civilian NDMS medical surge pilot 
site, as called for in section 741 of the National Defense 
Authorization Act for fiscal year 2021.
    Collaborative Learning Models.--The Committee notes the use 
of technology-enabled collaborative learning models, such as 
Project ECHO, during the COVID-19 pandemic and encourages ASPR 
to leverage these solutions in its healthcare emergency 
preparedness and response.
    Medical Innovation for Disaster Response.--The Committee 
commends ASPR for its work on medical innovation for disaster 
response, and encourages ASPR to continue to build on this work 
to improve far forward medical innovation and emergency 
responder training. The Committee reiterates the request for a 
report included in the Consolidated Appropriations Act, 2024 
(Public Law 118-47) describing the potential role of a 
federally funded research and development center.
    EMS Preparedness and Response Workforce Shortage Program.--
The Committee urges ASPR to address the crippling EMS workforce 
shortage, including in underserved, rural, and Tribal areas 
and/or address health disparities related to accessing 
prehospital ground ambulance healthcare services, including 
critical care transport. The Committee encourages ASPR, in 
consultation with the National Highway Traffic Safety 
Administration's Office of EMS, to develop a national pilot 
program of grants to governmental and non-governmental EMS 
organizations to support the recruitment and training of 
emergency medical technicians and paramedics in underserved, 
rural, and Tribal areas and/or addressing health disparities 
related to accessing prehospital ground ambulance healthcare 
services.
    National Special Pathogen System [NSPS].--The Committee 
includes $7,500,000, to continue to support the National 
Emerging Special Pathogens Training and Education Center 
[NETEC], and $21,000,000 to continue to support existing 
Regional Emerging Special Pathogen Treatment Centers [RESPTCs] 
and Special Pathogen Treatment Centers [SPTCs] to prepare for 
future pandemic threats. Funding will support efforts to 
maintain and improve the Nation's preparedness against highly 
infectious pathogen threats. Funding will continue to be 
available to NETEC and RESPTCs for readiness to respond to 
outbreaks of infectious diseases, for additional treatment 
centers, for special pathogen medical transport and further 
establish the National Special Pathogen Systems of Care tier 
network.
    Regional Disaster Health Response System.--The Committee 
includes $7,000,000 to support ASPR's efforts to improve 
disaster readiness by better coordinating healthcare 
infrastructure and systems with States and across regions. The 
Committee urges ASPR to continue improving regional readiness 
efforts to increase regional ability to respond to threats, 
leverage local, State, and Federal healthcare assets across 
coalition and State lines, and improve communications and 
coordination among participating agencies.
    Trauma Care Readiness and Coordination.--The Committee 
includes $4,000,000 to support the efforts of States and 
consortia of States to coordinate and improve emergency medical 
services and trauma care during a public health emergency. ASPR 
shall use these funds to award up to five grants to eligible 
entities for the purpose of carrying out research and 
demonstration projects to support the improvement of emergency 
medical services and trauma care in support of the duties and 
functions included in 42 U.S. Code Sec. 300hh-10 (b)(4)(C) of 
the Public Health Service Act.

Medical Reserve Corps

    The Committee recommendation includes $6,240,000 for the 
Medical Reserve Corps [MRC] program, which is a national 
network of local volunteer doctors, dentists, nurses, 
pharmacists, and other community members. The Committee 
appreciates that funding for MRCs has historically been 
provided to local units quickly and effectively, thereby 
allowing for grants to help build and sustain local 
communities' ability to prepare for and respond to emergencies. 
The Committee encourages ASPR to continue this locally-driven 
approach and to allocate this funding and any remaining funding 
from the American Rescue Plan Act via established mechanisms 
that provide funds directly to local MRC units, which are made 
up of representatives from their communities.

Industrial Based Management and Supply Chain [IBMSC]

    The Committee recommends $80,000,000, an increase of 
$70,000,000, for ASPR's Pandemic Preparedness and Biodefense 
activities. This appropriation supports the permanent 
establishment of the Industrial Based Management and Supply 
Chain Office to ensure that critical supplies are manufactured 
in the United States. It also provides resources to bolster 
pandemic preparedness and biodefense against new and emerging 
threats, which may include investments to accelerate advanced 
development of investigational vaccines, therapeutics and 
diagnostics; support emergency manufacturing of critical MCMs 
and ancillary supplies; and, to the extent feasible, invest in 
the expansion of the domestic medical supply chain.
    The Committee recognizes that deployment of cutting-edge 
manufacturing technology is an essential component of a 
feasible pathway toward a resilient domestic manufacturing base 
for medicines, active pharmaceutical ingredients, and 
diagnostics. The Committee directs that this funding shall be 
used to continue and expand ongoing work to build and validate 
advanced manufacturing processes and facilities capable of 
storing, producing, and deploying essential medicines and 
diagnostics in the event of a national health emergency.
    Diagnostic Manufacturing.--The Committee remains concerned 
investments made by U.S. headquartered diagnostic companies for 
end-to-end domestic manufacturing during the COVID-19 pandemic 
are being undone without warm-base investment. Therefore, the 
Committee directs the ASPR to invest in public-private 
partnerships and create policies for flexible contracting with 
U.S. diagnostic test manufacturers to create a sustainable 
warm-base and supply chain for end-to-end domestic 
manufacturing.
    Improving Biomanufacturing Capabilities.--The Committee 
urges ASPR to increase coordination with relevant Manufacturing 
USA institutes to address pandemic preparedness, CBRN defense, 
and emerging biopharmaceutical manufacturing strategies.
    Industrial Base Manufacturing and Supply Chain.--The 
Committee urges ASPR to prioritize the development of new 
Abbreviated New Drug Application [ANDA] by a domestic 
manufacturer for priority essential drugs in shortage or at 
risk of shortage to have domestic manufacturers able to produce 
a drug if it goes into shortage.
    Prioritizing Domestic Producers of Essential Medicines.--
The Committee is concerned about drug shortages of essential 
medicines. Therefore, the Committee urges ASPR to utilize U.S. 
manufactures that are producing critical medicines, like the 
antibiotic amoxicillin, over non-U.S. producers.
    Rapid Detection of Bioterrorism Agents.--The Committee is 
concerned that the Nation is not prepared to rapidly detect 
biological agents, such as anthrax, tularemia, melioidosis, 
glanders, and plague, even though BARDA has successfully 
supported development of diagnostic technologies that detect 
such biothreats, in some cases simultaneously. The Committee 
strongly urges ASPR to prioritize partnerships with domestic 
manufacturers capable of producing rapid diagnostics that can 
detect such threats and develop a diagnostic testing 
preparedness plan for use during public health emergencies, 
disasters, and other serious public health threats.
    Strengthening Domestic Manufacturing and Production.--The 
Committee commends ASPR for its support of industrial base 
management capabilities launched during the COVID-19 pandemic, 
including global supply chain situational awareness, market 
capabilities, rapid acquisition execution, and coordination of 
Defense Production Act [DPA] and Emergency Support Function 
[ESF]-8 authorities. This work has been essential to creating a 
secure and resilient domestic supply of quality and affordable 
essential medicines and PPE. These strategic investments in 
domestic technologies and industries ensure our Nation's health 
and biosecurity. However, the Committee remains concerned about 
the Nation's limited infrastructure to produce essential 
products such as medical devices, equipment, pharmaceuticals, 
and PPE. The Committee supports efforts by ASPR to expand upon 
the domestic industrial base to end the reliance on foreign 
sourced medical equipment, PPE, diagnostic tests, medical 
devices, and to secure the pipeline for critical medicines, 
including antibiotics. The Committee directs IBMSC to use 
available funds to continue and expand ongoing work to build 
and validate advanced manufacturing processes and facilities 
capable of storing, producing, and deploying essential 
medicines in the event of a national health emergency. IBMSC 
should seek opportunities to expand domestic manufacturing 
facilities with end-to-end capabilities to produce bulk drug 
substance, support platform technologies for MCMs, and provide 
fill-finish capacity. The Committee urges ASPR to use available 
funds to support manufacturers in building, expanding, 
upgrading, modifying, and/or recommissioning facilities in the 
U.S. to increase manufacturing capacity of critical medicines 
or their active pharmaceutical ingredients.
    Trusted Domestic Vaccine Supplier Capability.--The 
Committee continues to recognize the need for domestic 
manufacturing of key biological starting materials [KSM], 
including plasmid DNA and mRNA, antibodies, and other MCMs, to 
ensure timely response to unanticipated health emergencies. 
Therefore, the Committee encourages ASPR to expand domestic 
manufacturing of KSMs and collaborate with U.S. companies that 
have pharmaceutical capabilities to ensure the development and 
stockpiling of synthesized medicines for future pandemics and 
biothreats.
    Warm-Base Manufacturing.--The Committee supports warm-base 
surge production capacity contracts with domestic 
manufacturers, including NIOSH-approved N95 respirators and 
other domestic PPE manufacturers who received Federal funding 
to expand manufacturing capacity during the COVID-19 pandemic. 
ASPR is encouraged to maintain domestic manufacturing surge 
capacity and capabilities to prepare for, or respond to, an 
existing or potential public health emergency or otherwise 
address threats that pose a significant level of risk to 
national security.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2024....................................    $710,955,000
Budget estimate, 2025...................................     762,917,000
Committee recommendation................................     727,964,000

    The Committee recommends $727,964,000 for General 
Departmental Management [GDM]. The recommendation includes 
$64,828,000 in transfers available under section 241 of the PHS 
Act (Public Law 78-410 as amended).
    This appropriation includes an increase of $10,000,000 for 
cybersecurity and supports activities that are associated with 
the Secretary's role as policy officer and general manager of 
the Department. It supports health activities performed by the 
Office of the Assistant Secretary for Health [OASH], including 
the Office of the Surgeon General. GDM funds also support the 
Department's centralized services carried out by several Office 
of the Secretary staff divisions, including personnel 
management, administrative and management services, information 
resources management, intergovernmental relations, legal 
services, planning and evaluation, finance and accounting, and 
external affairs.
    Adult Cellular Therapies.--The Committee encourages the 
Department to support collaborative evidence development in 
coordination with FDA, NIH, and HRSA. Such efforts should 
include a focus on enhancing transparency regarding outcomes 
from somatic cellular based 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. The Committee 
also encourages engagement of experts and stakeholders to 
advance awareness, understanding, and utilization of existing 
databases to promote research and development.
    AD/RD Early Intervention.--The Committee encourages the 
Department to prioritize early interventions for Alzheimer's 
disease and related dementias, and to identify and implement a 
comprehensive set of actions to assess risk factors for 
cognitive decline and dementia. Such an assessment should 
emphasize historically underserved communities. Actions should 
include: conducting health risk assessments; identifying 
opportunities to address known risk factors; examining 
incentives to promote brain health; providing payments for 
prevention and care delivery models that incorporate brain 
health as part of care and treatment of other conditions; and 
examining the development and implementation of quality 
measures specifically related to brain health.
    Alzheimer's Advisory Council.--The Committee is encouraged 
by the Department's leadership to ensure that risk reduction is 
part of our Nation's plan to end Alzheimer's disease. More than 
2 years ago, the Secretary announced that the 2021 plan update 
would include a sixth goal (Goal Six) of reducing risk factors 
for Alzheimer's disease. The Committee requests a briefing 
within 180 days of enactment of this act on progress made 
toward meeting that goal. The briefing should include 
information on funding allocated toward achieving Goal Six; how 
progress is being measured and tracked; and an overview of how 
HHS and other Federal agencies are implementing prevention 
strategies and working with non-governmental organizations to 
meet Goal Six.
    Antimicrobial Resistance [AMR].--The Committee continues to 
support the Administration's proposal to combat antibiotic-
resistant infections by strengthening national One Health 
surveillance efforts, encouraging the development of innovative 
diagnostic tests for resistant bacteria, and accelerating the 
development of new antibiotics, other therapeutics, and 
vaccines. The Committee requests an update in the fiscal year 
2026 CJ detailing how HHS and its agencies are coordinating 
their AMR-related efforts, as well as domestic and 
international AMR trends.
    Benzathine Penicillin G L-A [Bicillin L-A].--The Committee 
is concerned that Bicillin L-A, the only FDA-approved treatment 
for syphilis in pregnant women and infants, has frequently been 
in short supply over the last two decades. The Committee 
requests a briefing within 180 days of enactment of this act on 
HHS efforts to coordinate with CDC and FDA to develop a plan to 
ensure an adequate, uninterrupted drug supply and to prevent 
future shortages as well as steps to use agency-generated data, 
including other drug shortages that may impact Bicillin L-A.
    Bereavement Care.--The Committee is concerned that 
individuals and families often suffer severe health, social, 
and economic declines following the death of a loved one, be it 
a child, sibling, spouse, or parent. The Committee encourages 
the Secretary to coordinate efforts across HHS to advance 
bereavement care for families, including interventions or 
programs that could help coping or adaptive processing.
    Biotech Reagents.--The Committee is concerned by the 
increased reliance on foreign imports of active pharmaceutical 
ingredients, which are often made from U.S. exports of basic 
organic chemicals and biochemical reagents. The committee 
encourages the Secretary to consult with drug manufacturers, 
scientific experts, and across Federal agencies to compile a 
list of organic chemicals and biochemical reagents required to 
produce active pharmaceutical ingredients, biopharmaceutical 
treatments, and other medicines listed on the World Health 
Organization's essential medicines list. Further, the Secretary 
should examine, to the extent possible, additional medical and 
non-medical industrial uses of such identified reagents.
    Children's Interagency Coordinating Council.--The Committee 
is pleased that the Secretary has assigned the Assistant 
Secretary for Planning and Evaluation [ASPE] the responsibility 
for establishing the Children's Interagency Coordinating 
Council. The Committee continues current funding at $3,000,000 
for the interagency council's activities. The Committee 
requests a briefing within 180 days of enactment of this act on 
the interagency council's activities, including efforts to 
establish a permanent leadership structure and identify 
officials from key agencies across the government who will 
participate as members of the council.
    Chronic Numbness and Pain after Mastectomy.--The Committee 
recognizes research demonstrating that long-term impacts after 
mastectomy can lead to significant functional impairment and 
quality of life issues for breast cancer survivors. The 
Committee is aware of technological procedure advancements that 
can restore normal breast functions, such as sensation, and 
improve functional impairment, physical safety, and quality of 
life for breast cancer survivors. The Committee encourages the 
Secretary, in collaboration with other relevant HHS agencies, 
to explore technological advances impacting health outcomes 
after mastectomy and requests an update in the fiscal year 2026 
CJ about this issue.
    Confidentiality of Substance Use Disorder Patient 
Records.--The Committee recognizes the Department's issuance of 
a final rule entitled ``Confidentiality of Substance Use 
Disorder [SUD] Patient Records'' and directs HHS to ensure that 
providers are informed of the changes made and the impact of 
the rule, including through public meetings, webinars, and 
guidance. The Committee further directs HHS to clarify how the 
Center of Excellence for Protected Health Information will work 
to educate providers, including by providing more educational 
opportunities through webinars, resources, and other means. 
Within 180 days of enactment of this act, the Committee 
requests a briefing on efforts to educate providers and 
implementation of Subtitle F, Section 7051 of Public Law 115-
271.
    Dietary Guidelines.--The Committee recognizes that existing 
research has shown that ultra-processed plant-based 
alternatives to dairy are not nutritionally equivalent, and 
that consumers may not fully understand the nutritional 
differences between dairy and plant-based alternatives. The 
Committee expects the Secretary of HHS to ensure that the 
process for developing the 2025 Dietary Guidelines includes 
recommendations that are based on the preponderance of 
scientific and medical evidence consistent with section 5341 of 
title 7 of the U.S. Code, and that it is fully transparent and 
includes a balanced representation of individuals who are 
unbiased and free from conflicts of interest.
    Embryo Adoption Awareness Campaign.--The Committee includes 
funding 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.
    Ending the HIV Epidemic.--The Committee continues support 
for this initiative but is concerned by a lack of quantifiable 
data showing outcomes of a program started in 2019. Therefore, 
the Committee directs HHS to: (1) provide a spend plan to the 
Committees no later than 60 days after enactment of this act, 
to include resource allocation by State; (2) brief the 
Committees on the fiscal year 2025 plans no later than 90 days 
after enactment of this act; (3) provide the Committees an 
update on the program's performance data since the beginning of 
the initiative through the latest available data, making sure 
to address each of the initiative's goals and performance 
metrics, no later than 180 days after enactment of this act and 
updated annually throughout the life of the initiative.
    Gene Synthesis Screening and Procurement.--The Committee 
recognizes the potential benefits and risks associated with 
advances in gene synthesis technology. Given the rapidly 
evolving nature of the field, it is critical that adequate 
safeguards and oversight mechanisms be in place to ensure the 
responsible use of this technology. The Committee encourages 
HHS to closely examine agency procurement of gene synthesis 
products and equipment, as well as the funding of entities that 
purchase gene synthesis products and equipment.
    Global Health Research.--The Committee requests an update 
in the fiscal year 2026 CJ on how CDC, FDA, BARDA, NIH, 
including the Fogarty International Center, and other agencies 
jointly coordinate global health research activities with 
specific metrics to track progress and collaboration toward 
agreed upon health goals.
    Hepatitis B Public Health Initiatives.--The Committee 
encourages OASH to lead the development of a government wide 
coordinated effort to ensure the implementation of the Advisory 
Committee on Immunization Practices [ACIP] recommendation that 
all adults in the U.S. between 19 and 59 be vaccinated for 
hepatitis B and the CDC recommendation that all adults be 
screened for hepatitis B. While the vaccination recommendation 
was made in November 2021, progress toward implementation has 
been slow. Challenges to implementing the screening 
recommendations are also emerging. The Committee requests a 
briefing in partnership with the CDC within 180 days of 
enactment of this act on efforts to implement vaccination and 
screening recommendations and urges HHS to take action on its 
Viral Hepatitis National Strategic Plan.
    Hepatitis C.--The Committee recognizes that millions of 
Americans suffer from chronic hepatitis C, which remains the 
leading cause of liver cancer and liver transplantation. More 
than two thirds of those with hepatitis C, which is curable, 
are unaware of their infection. The Committee supports efforts 
to increase access to diagnostic testing, including rapid 
diagnostics; expand the availability of treatment; and bolster 
public health strategies to prevent hepatitis C.
    Hospital Cybersecurity Infrastructure.--The Committee 
recognizes that cybersecurity has been one of the most 
significant investments hospitals have had to make in the past 
decade in terms of technology, workforce, and insurance. As the 
number of health-related cyber-attacks increase, hospitals are 
reporting that cyber insurance premiums are increasing at a 
rate of 20-50 percent per year. The Committee encourages the 
Administration to work with hospitals, especially small and 
rural providers, and other healthcare stakeholders prior to 
finalizing any new cybersecurity standards.
    Housing-Related Supportive Services.--Individuals who have 
serious and complex health challenges, including mental health 
and substance use disorders, and chronic medical conditions, 
require additional supports to maintain stable housing. The 
Committee supports the effort underway in partnership with the 
Department of Housing and Urban Development [HUD], CMS, SAMHSA, 
ACL, and ASPE to provide direct technical assistance to 
communities leveraging existing programs, like Medicaid, to 
cover and provide housing-related supportive services and 
behavioral healthcare. The Committee directs HHS and HUD to 
jointly brief the House and Senate Committees on Appropriations 
on this effort within 180 days of enactment of this act.
    Liver Disease.--The Committee recognizes that liver disease 
is the ninth leading cause of death in the U.S. Metabolic 
dysfunction-associated steatotic liver disease [MASLD], 
formerly known as nonalcoholic fatty liver disease [NAFLD], is 
the most common cause of liver-related morbidity and mortality. 
The Committee recommends agencies implement recently updated 
nomenclature for MASLD throughout their programs to 
appropriately identify, diagnose and treat this deadly disease. 
The Committee encourages agencies to build upon and expand 
current activities related to MASLD, with a focus on research, 
therapeutic development, and public health interventions
    Maternal Health.--Research continues to demonstrate that 
the United States has higher rates of maternal mortality and 
adverse maternal health outcomes than peer countries. The 
Committee remains concerned by these findings, and directs HHS 
to prioritize efforts to improve maternal health outcomes and 
reduce maternal mortality by expanding the maternity care 
workforce, advancing equity through the development of a 
maternal health quality outcomes measure, and enhancing 
postpartum social supports for families. Further, the Committee 
directs HHS to focus on efforts to improve coordination across 
maternal health programs and requests a report within 180 days 
of enactment of this act detailing plans to further such 
collaboration and leverage agency expertise.
    Medically-Complex and Special Needs Adolescents Aging Out 
of the Pediatric Care System.--The Committee recognizes the 
importance of continuity of care for medically-complex and 
special needs adolescents. The Committee encourages the 
Department to examine the challenges associated with 
adolescents aging out of the pediatric care system.
    National Integrated Heat Health Information System.--The 
Committee is encouraged by the Office of the Assistant 
Secretary for Health's participation in the interagency efforts 
to stand up the National Integrated Heat Health Information 
System. The Committee encourages continued collaboration 
between HHS and other Federal agencies to inform research 
products, services and related projects.
    National Parkinson's Project.--The Committee urges the 
Secretary to begin implementation of the National Parkinson's 
Project, as created by the Dr. Emmanuel Bilirakis and Honorable 
Jennifer Wexton National Plan to End Parkinson's Act (Public 
Law 118-66). Within 90 days of enactment of this act, the 
Department shall provide a report on the projected costs of 
full implementation of the act and describe steps the agency 
will take to implement the act until full funding is received.
    Neglected Tropical Diseases.--The Committee is encouraged 
by the use of priority review vouchers for neglected tropical 
diseases [NTD] and requests a briefing within 180 days of 
enactment of this act on the Department's progress to safeguard 
and improve global health, including efforts to promote 
research and investment in NTD.
    Mental Health Parity.--The Committee encourages the 
Secretary to support State insurance departments for the 
implementation of mental health parity as authorized in Public 
Law 117-328.
    Neurodegenerative Disease Diagnostics.--The Committee 
supports the efforts of the Department to prevent and 
effectively treat neurodegenerative diseases, including 
Parkinson's disease, Lewy body dementia, and other related 
disorders. The Committee also recognizes that early detection 
is imperative to improving health outcomes and patient quality 
of life by delaying or halting the progression of such 
diseases. To improve the ability of healthcare providers to 
diagnose and treat neurodegenerative diseases at an earlier 
onset, the Committee encourages HHS to work with stakeholders 
to research, develop, and improve access to novel diagnostic 
testing for neurodegenerative diseases.
    Nonrecurring Expenses Fund [NEF].--The Committee directs 
the Secretary to prioritize obligations from resources in the 
NEF for projects currently underway, including the CDC NIOSH 
facility in Cincinnati, Ohio. The Secretary should complete 
outstanding projects in a timely manner and prior to funding 
new projects.
    Obesity.--The Committee notes that the CDC formally 
recognizes obesity as a disease and recommends that it should 
be treated with evidence-based therapies. Intensive behavioral 
therapy, improved diet and nutrition, and medication, in 
addition to surgical procedures, can lead to weight loss and 
have the potential to improve health outcomes for those with 
obesity-related health conditions including diabetes, coronary 
heart disease, and hypertension. Additionally, evidence points 
to rural areas and communities of color as having a higher rate 
of disease burden. Obesity is a preventable condition with a 
significant potential for reduction in burden of disease with 
adequate investment in proven prevention measures. The 
Committee encourages HHS to take a comprehensive approach to 
preventing and treating obesity as a chronic disease, including 
collaborating with other Federal agencies and conducting an 
evaluation of the work and research being done across HHS 
agencies on the costs, risks, and benefits of preventive 
measures and treatments, and uptake of medications such as GLP-
1 agonists. The Committee requests a briefing on this effort 
within 180 days of enactment of this act.
    Obligation Reports.--The Committee directs the Secretary to 
submit electronically to the Committees an Excel table 
detailing the obligations made in the most recent quarter for 
each office and activity funded under this appropriation not 
later than 30 days after the end of each quarter.
    Pharmaceutical Supply Chain Risk Assessment.--The Committee 
directs the Secretary, in consultation with the Secretaries of 
Defense and Homeland Security, as well as with the Director of 
the Office of Pandemic Preparedness and Response Policy, to 
provide a risk assessment of the pharmaceutical supply chain 
within 18 months of enactment of this act. The assessment shall 
be done in coordination with the private sector and examine 
drugs, including generic drugs, to identify a list of 
medicines: (1) that are reasonably likely to be required to 
respond to a public health emergency or chemical, biological, 
radiological, or nuclear [CBRN] threat; (2) whose shortage 
would pose a significant threat to the U.S. healthcare system 
or at-risk populations; and (3) whose shortage would pose a 
risk to national security. The assessment shall also assess and 
identify: (1) key starting materials and excipients used in 
manufacturing the active pharmaceutical ingredients and drugs 
on the list; (2) current domestic manufacturing capabilities; 
(3) critical vulnerabilities, including cybersecurity threats; 
and (4) any deficiencies, lack of authorities, or limitations 
in policy or process that limit the ability of the Departments 
of Health and Human Services, Defense, or Homeland Security to 
address vulnerabilities in the pharmaceutical supply chain and 
how it will mitigate such vulnerabilities.
    Programs of All-Inclusive Care for the Elderly.--The 
Committee notes that before the COVID-19 pandemic and during 
the COVID-19 Public Health Emergency, Programs of All-Inclusive 
Care for the Elderly [PACE] were effective in keeping their 
medically complex, nursing home eligible population safe at 
home. Given the increasing demand for home and community based 
services by older adults and those living with disabilities, 
within 120 days of enactment of this act, the Committee directs 
the Secretary to submit a report providing details of an 
implementation plan for PACE-specific model tests that examine 
methods of increasing access and affordability for Medicare and 
Medicaid beneficiaries.
    Rare Diseases.--The Committee recognizes that multiple 
Federal departments, agencies and programs exist to address the 
needs of people impacted by rare diseases and improve the lives 
of members of the rare diseases community. The Committee 
recognizes the importance of enhanced coordination and 
collaboration across the Federal Government and encourages the 
Secretary to initiate efforts to focus on optimizing rare 
disease activities across the Federal Government and assess all 
Federal agency activities concerning rare diseases.
    Rare Kidney Disease Diagnostic Issues.--The Committee 
encourages the Secretary to convene a conference focused on 
rare kidney disease diagnostic issues. The Committee notes the 
need to analyze the impact of the decline of routine urinalysis 
on the timely diagnosis of rare kidney disease and on the 
quality of patient care as well as the quality and reliability 
of kidney biopsy in the diagnosis of rare kidney disease. The 
Committee further encourages the Secretary to report to 
Congress on whether genetic and genomic testing may improve 
preventative care, precision medicine and health outcomes.
    Rare Kidney Disease Transplant and Dialysis.--The Committee 
notes the high costs of dialysis and transplant associated with 
rare kidney disease. The Committee encourages the Secretary to 
conduct experiments to evaluate methods for treating rare 
kidney disease, particularly those that would delay or 
eliminate the need for dialysis and transplant through a 
comprehensive study of methods to increase public awareness of 
rare kidney disease, including in communities of color. The 
Committee requests an update on these activities as part of the 
fiscal year 2026 CJ.
    Rural News Media and Advertising Campaigns.--The Committee 
continues to recognize the critical role local media plays in 
delivering public health messages to small or rural 
communities. Therefore, the Committee directs the Secretary to 
ensure that local media in small or rural markets are part of 
Federal public health advertising campaigns. To further this 
goal, the Committee directs the Secretary, in coordination with 
the Assistant Secretary for Public Affairs and the Department's 
media buyer contractors, to utilize local news media in small 
or rural areas for HHS and its related agencies' public 
advertising campaigns to reach citizens with key health 
messages. Local media includes newspapers, including non-daily 
newspapers; television; and radio. Within 90 days of enactment 
of this act, the Committee directs the Office of the Secretary 
to provide a briefing on the efforts of the Department in its 
utilization of local media in small and rural areas as part of 
the Department's public health advertising campaigns for fiscal 
year 2025 and future fiscal years, and the amount of money 
allocated to local media in small and rural areas for fiscal 
year 2024 broken down by Statewide newspapers, non-daily 
newspapers, TV and radio. The Committee also directs the 
Assistant Secretary for Public Affairs in consultation with the 
CDC's Office of Rural Health to undertake a review of the use 
of local media in small and rural communities in an HHS public 
health advertising campaign in fiscal year 2025 in several 
States to better understand the role of local media as a key 
delivery system to reach small and rural communities with 
important health messages. The Committee requests a report 
detailing this review within 1 year of enactment of this act.
    Staffing Reports.--The Committee includes a general 
provision requiring the Department to submit a biannual 
staffing report to the Committees. The Excel table shall 
include: the names, titles, grades, agencies, and divisions of 
all of the political appointees, special government employees, 
and detailees that were employed by or assigned to the 
Department during the previous 180 days.
    Substance Use Disorder Treatment Outcomes.--The Committee 
recognizes that long-term, evidence-based outcomes research on 
various treatment modalities for substance use disorder is 
limited. The Committee directs the Department to expand and 
coordinate evidence-based, long-term outcomes research for 
different modalities of treatment and recovery support for 
substance use disorder treatment. Such research should consider 
measures of mortality, morbidity, and physical health, as well 
as quality-of-life measures, such as employment, criminal 
justice involvement, family relationships, and stable housing. 
The Department is further directed to conduct research across 
the demographic populations of people with substance use 
disorders, including those that have historically been under-
researched.
    Transparency for Imaging Technology.--Foreign adversaries 
are pursuing the collection and exploitation of Americans' 
sensitive health data through medical equipment. Therefore, the 
Committee directs HHS to provide a report regarding the 
procurement of all medical imaging technology by HHS and its 
sub agencies from entities that are based in a territory of a 
foreign adversary, as defined in 15 CFR section 7.4, or under 
the jurisdiction of a foreign adversaries' laws or regulations. 
``Medical imaging technology'' refers to any device, software, 
or other technology intended for use in medical imaging, 
including but not limited to X-ray, MRI, CT, ultrasound, and 
other diagnostic or therapeutic imaging modalities.
    Vector Borne Diseases.--The Committee commends the 
Department for the 2024 release of the National Public Health 
Strategy to Prevent and Control Vector Borne Diseases in People 
and encourages continued collaboration and innovation to reach 
targeted public health outcomes for the United States, 
including the target of reducing the number of Lyme disease 
cases (laboratory confirmed) 25 percent by 2035.
    Wuhan Institute of Virology.--The Committee is encouraged 
by the actions taken to debar the Wuhan Institute of Virology, 
Chinese Academy of Sciences Capital Construction and EcoHealth 
Alliance, Inc. from participating in United States Federal 
Government programs and ensure that they are unable to receive 
Federal Government funding, pursuant to 42 CFR 180.800. 
Accordingly, this bill does not include funding for either 
entity. The Committee directs the Department to provide a 
report to the Committee within 30 days of enactment of this act 
regarding compliance with the debarment, any updates on 
debarment proceedings, as appropriate, and ways the Department 
is ensuring that Federal funds are not awarded to entities 
based on evidence that provides cause for suspension under 2 
CFR 180.700 and 180.800.

Teen Pregnancy Prevention

    The Committee recommendation includes $101,000,000 for the 
Teen Pregnancy Prevention Program [TPPP]. This program supports 
competitive grants to public and private entities to replicate 
evidence-based teen pregnancy prevention approaches and develop 
and evaluate new and innovative approaches to prevent teen 
pregnancy and STIs among adolescents. In addition, the 
recommendation includes $6,800,000 in transfers available under 
section 241 of the PHS Act.
    TPPP.--The Committee includes $900,000 for ASPE to support 
the TPPP Evidence Review. The Evidence Review is an 
independent, systematic, rigorous review of evaluation studies 
that informs grant making and provides a clearinghouse of 
evidence-based programs for other Federal, State, and community 
initiatives.

Office of Minority Health

    The Committee recommends $74,835,000 for the Office of 
Minority Health [OMH]. The Office focuses on strategies 
designed to decrease health disparities and to improve the 
health status of racial and ethnic minority populations in the 
United States. OMH establishes goals and coordinates all 
departmental activity related to identifying and disseminating 
innovative and effective approaches for improving health 
outcomes for racial and ethnic minority individuals.
    Achieving Equitable Maternal Health Outcomes.--The 
Committee continues to provide $7,000,000 to support community-
based and other eligible organizations located in geographic 
areas with high rates of adverse maternal health outcomes, 
particularly among racial and ethnic minority families. The 
Department should support activities that include but are not 
limited to identifying evidence-based and evidence-informed 
practices for: addressing social determinants of health; 
promoting evidence-based health literacy, and pregnancy, 
childbirth, and parenting education programs; providing support 
from perinatal health workers; and providing culturally 
congruent, linguistically appropriate, and trauma-informed 
training to perinatal health workers.
    Asian American, Native Hawaiian, and Pacific Islander 
[AANHPI] Youth Mental Health.--The Committee notes with concern 
that suicide has been the leading cause of death for AANHPI 
youth ages 10 through 24 in recent years. The committee 
encourages the Department to examine the prevalence and causes 
of behavioral health conditions among AANHPI youth, including 
by identifying ways the Department can address this disparity 
and improve access to behavioral healthcare for AANHPI youth.
    Center for Indigenous Innovation and Health Equity.--The 
Committee recognizes the importance of promoting Indigenous 
solutions to advance health equity, and continues to provide 
$4,000,000 for the Center for Indigenous Innovation and Health 
Equity. The Committee recognizes the Center's efforts to 
partner with institutions of higher education with a focus on 
Indigenous health research, education, and policy among 
American Indians and Alaska Natives, as well as a focus on 
Indigenous health policy and innovation among Native Hawaiians 
and Pacific Islanders. The Committee encourages the Center to 
both continue and expand these efforts, including by focusing 
on improving health outcomes for Indigenous youth.
    Kidney Disease Initiative.--Rates of severe kidney disease 
are significantly higher in Black Americans than in other 
ethnic groups. The Committee encourages OMH to focus on 
activities to reduce genetic kidney disease among populations 
disproportionally affected.
    Middle Eastern and North African [MENA] Communities.--The 
Committee recognizes that accurate and representative health 
data may improve the ability for underserved populations to 
receive greater access to healthcare services. The Committee 
encourages the Department to examine access to its programs and 
initiatives for Middle Eastern and North African [MENA] 
populations, including by assessing gaps in previously 
collected data on race and ethnicity.
    Promoting Language Access Services.--The Committee 
continues no less than $4,000,000 to support the development of 
methods of informing limited English proficient [LEP] 
individuals about their right to and the availability of 
language access services. The Committee supports the 
Department's efforts to improve external communications, which 
should include mediums such as television and radio, to reach 
LEP communities. The Committee encourages the Department to 
review communication practices and create uniform applications 
across all HHS agencies to strengthen communication practices 
to include digital, television, and radio advertising when 
working with LEP communities.

Minority HIV/AIDS

    The Committee includes $60,000,000 for the Secretary's 
Minority HIV/AIDS Fund to strengthen and expand services 
provided by minority-serving community-based organizations 
[CBOs] for HIV education and awareness campaigns, testing, 
prevention, linkage to care, and engagement in care to racial 
and ethnic minority individuals at risk for or living with HIV 
in order to address the decline in HIV testing and the 
challenges with linkage to and retention in care and treatment 
that occurred during the COVID-19 pandemic. Funding may be 
prioritized for minority-serving CBOs in the South, which has 
the highest burden of HIV of any region nationwide.

Office of Women's Health

    The Committee recommends $44,140,000 for the Office of 
Women's Health [OWH]. This office develops, stimulates, and 
coordinates women's health research, healthcare services, and 
public and healthcare professional education across the 
Department. It advances important crosscutting initiatives and 
develops public-private partnerships, providing leadership and 
policy direction to address the disparities in women's health.
    The Committee recommendation includes $10,100,000 to combat 
violence against women through the State partnership 
initiative. This program provides funding to State-level public 
and private health programs to partner with domestic and sexual 
violence organizations to improve healthcare providers' ability 
to help victims of violence and improve prevention programs. 
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.
    Access to Lactation Support Services.--The Committee 
continues to support HHS' initiatives to improve access to 
lactation support services for all individuals who choose to 
breastfeed. The Committee notes that despite guidance from the 
HHS Women's Preventive Services Initiative recommending that 
families receive comprehensive lactation support services to 
optimize the successful initiation and maintenance of 
breastfeeding, many families struggle to gain access to quality 
lactation care. The Consolidated Appropriations Act of 2023 
(Public Law 117-328) included funding for HHS to enter into an 
agreement with the National Academies of Sciences, Engineering, 
and Medicine to provide an evidence-based, non-partisan 
analysis of the macroeconomic, health, and social costs of U.S. 
breastfeeding rates and national breastfeeding goals. The 
Committee expects that this analysis should also examine how 
health insurers have implemented comprehensive lactation 
services, the standards set to determine reimbursement rates 
for breastfeeding supplies and services, and the current best 
practices used to provide coverage to help women breastfeed.
    Eating Disorders.--The Committee remains concerned that 
eating disorders have one of the highest fatality rates of any 
psychiatric illness, with girls and women at heightened risk 
for developing an eating disorder during their lifetime. The 
Committee recognizes the efforts of OWH to address eating 
disorders, and continues to provide $750,000 for such efforts. 
The Committee encourages OWH to address early detection and 
treatment protocols for women and girls with or at-risk of 
developing an eating disorder, and to examine the lack of 
pediatric and adolescent screening in the primary care and 
pediatric settings. Further, the Committee encourages OWH to 
convene with relevant Federal agencies and stakeholders to 
ensure coordination among Federal efforts to address eating 
disorders research, prevention, intervention, and treatment, 
and gather recommendations for better administration of 
existing Federal programs.
    Stillbirth Working Group.--Each year 21,000 infants are 
lost due to stillbirth and the rate of stillbirth has remained 
consistent despite medical advances. Some studies show that one 
in four stillbirths are preventable. The Committee urges the 
Secretary to carry out the Department-wide implementation of 
the Stillbirth Working Group's recommendations and engage in 
efforts to promote evidence-based stillbirth awareness and 
prevention activities. The Department shall report to the 
Committee within 180 days of enactment of this act on progress 
made toward implementation of the Working Group's 
recommendations and make such report available on the agency's 
website.
    Women's Health Research Study.--To address the persistent 
gaps in knowledge of women's health and improve access to care, 
the Committee continues to expect the Secretary to coordinate 
with NIH and NASEM in support of research that explores the 
proportion of research on conditions that are more common or 
unique to women. This research should establish how these 
conditions are defined and ensure that it captures conditions 
across the lifespan, evaluates sex and gender differences and 
racial health disparities, and determine the appropriate level 
of funding that is needed to address gaps in women's health 
research at NIH and submit to Congress a report containing the 
findings and recommendations of the study no later than 18 
months after enactment of this act.
    White House Initiative on Women's Health Research.--The 
Committee supports the Department's work to prioritize and 
integrate women's health research across the Federal 
Government, including efforts to better address diseases and 
conditions that are more likely to occur after menopause, such 
as rheumatoid arthritis, heart attack, and osteoporosis.
            Office of the Assistant Secretary for Administration

Cybersecurity

    The Committee recommends $110,000,000 for information 
technology cybersecurity in the Office of the Chief Information 
Officer and HHS-wide to strengthen the Department's 
cybersecurity posture. These funds provide continuous 
monitoring and security incident response coordination for the 
Department's computer systems and networks.

Office of National Security

    The Committee recommends $8,983,000 for the Office of 
National Security to support strategic all-source information, 
intelligence, defensive counterintelligence, insider threat 
intelligence, enterprise supply chain risk management, security 
for classified information, and communications security support 
across the Department. These funds sustain the Department's 
security and threat awareness and its ability to respond 
swiftly and effectively to national and homeland security 
threats.

Office of Global Affairs

    The Committee recommends $7,009,000 for the HHS Office of 
Global Affairs to support its work to lead global health 
diplomacy and policy coordination efforts for HHS to strengthen 
U.S. health security and pandemic preparedness.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2024....................................    $196,000,000
Budget estimate, 2025...................................     196,000,000
Committee recommendation................................     196,000,000

    The Committee provides $196,000,000 for the Office of 
Medicare Hearings and Appeals [OMHA]. This Office is 
responsible for hearing Medicare appeals at the Administrative 
Law Judge [ALJ] level, which is the third level of Medicare 
claims appeals. OMHA ensures that Medicare beneficiaries who 
are dissatisfied with the initial decisions about their 
benefits or eligibility can appeal and exercise their right to 
a hearing in front of an ALJ.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

Appropriations, 2024....................................     $69,238,000
Budget estimate, 2025...................................      86,000,000
Committee recommendation................................      69,238,000

    The Committee makes available $69,238,000 in transfers 
available under section 241 of the PHS Act, to the Office of 
the National Coordinator for Health Information Technology 
[ONC]. ONC is responsible for coordinating Federal health 
information systems and collaborating with the private sector 
to develop standards for a nationwide interoperable health 
information technology infrastructure.
    Information Blocking Guidance.--The Committee recognizes 
that ONC's rule to implement the interoperability and 
information blocking provisions of the 21st Century Cures Act 
took significant steps forward to give patients greater access 
to and improve the electronic flow of electronic health 
information across care settings. Given the significant 
penalties and other consequences for information blocking, the 
Committee urges ONC to provide regulated entities and other 
affected stakeholders with clear, practical guidance regarding 
foundational concepts in the rule. Guidance should clearly 
outline how regulated entities can evaluate their particular 
circumstances and scenarios against the rule's provisions, 
including how to identify and apply relevant exceptions to the 
information blocking definition.
    Health Information Exchanges [HIE].--The Committee 
recognizes the importance of electronic health data as a 
critical piece to address the health needs and care delivery 
challenges of diverse communities. The Committee strongly 
encourages HHS to work with States to designate existing 
neutral, trusted, and nonprofit HIEs to be the State's health 
data utility [HDU]. HDU models are designed and implemented in 
alignment with States' policies and priorities to address the 
needs of a broader health and healthcare ecosystem. A HDU can 
be defined as one or more entities, guided by a diverse 
stakeholder governance structure, that combine, enhance, and 
exchange disparate electronic health data sets for treatment, 
care coordination, quality improvement, population health, 
public health emergencies, and other public and community 
health purposes. The Committee recognizes that each State 
designated HDU is essential in establishing a national 
framework that fulfills a current gap in healthcare by 
implementing a comprehensive digital health infrastructure as a 
public utility that will support data sharing between public 
and private health data stakeholders. The Committee directs 
HHS, through ONC and other relevant Federal agencies, to 
leverage existing authorities, funds, and other resources to 
construct policy and regulations that strengthen existing HIE 
infrastructure to facilitate their transition into HDUs. If 
necessary, the Committee encourages the Secretary to issue 
policy guidelines, or best practices, to encourage each State 
to designate a HIE or HIEs to be a State's HDU.
    Standards for Interoperability.--The Committee continues to 
include not less than $5,000,000 to support interoperability 
and information sharing efforts related to the implementation 
of Fast Healthcare Interoperability Resources standards or 
associated implementation standards. Additionally, within 30 
days of enactment of this act, the Committee directs ONC to 
provide an update on the status of the report requested in 
fiscal year 2024 detailing the progress made in implementing 
the interoperability provisions of the 21st Century Cures Act 
and gaps that remain for full implementation, including the 
status of the public release of the report.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2024....................................     $87,000,000
Budget estimate, 2025...................................      97,384,000
Committee recommendation................................      87,000,000

    The Committee recommends $87,000,000 for the HHS Office of 
Inspector General [OIG].
    OIG conducts audits, investigations, and evaluations of the 
programs administered by the Department's operating and staff 
divisions, including the recipients of the Department's grant 
and contract funds. In doing so, OIG addresses issues of waste, 
fraud, and abuse and makes recommendations to improve the 
efficiency and effectiveness of the Department's programs and 
operations.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2024....................................     $39,798,000
Budget estimate, 2025...................................      56,798,000
Committee recommendation................................      39,798,000

    The Committee recommends $39,798,000 for the Office for 
Civil Rights [OCR] in budget authority. OCR is responsible for 
enforcing civil rights-related statutes in healthcare and human 
services programs. To enforce these statutes, OCR investigates 
complaints of discrimination, conducts program reviews to 
correct discriminatory practices, and implements programs to 
generate voluntary compliance among providers and constituency 
groups of health and human services.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 2024....................................    $792,691,000
Budget estimate, 2025...................................     894,795,000
Committee recommendation................................     894,795,000

    The Committee provides an estimated $894,795,000 in 
mandatory funds for Retirement Pay and Medical Benefits for 
Commissioned Officers of the U.S. Public Health Service. This 
account provides for retirement payments to PHS officers who 
are retired due to age, disability, or length of service; 
payments to survivors of deceased officers; and medical care to 
Active Duty and retired officers, as well as their dependents.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriations, 2024....................................................
Budget estimate, 2025...................................    $172,492,000
Committee recommendation................................................

    The Committee recommendation does not include funding for 
the Public Health and Social Services Emergency Fund [PHSSEF]. 
Funding for activities previously funded within PHSSEF were 
reorganized in fiscal year 2024 and funded within the 
Administration for Strategic Preparedness and Response and 
Office of the Secretary, General Departmental Management. The 
Committee recommendation maintains that structure in fiscal 
year 2025. In addition, the Committee provides funding for the 
Office of Global Affairs [OGA] within the Office of the 
Secretary, General Departmental Management.

                   PREVENTION AND PUBLIC HEALTH FUND

    In fiscal year 2025, the level transferred from the PPH 
Fund after accounting for sequestration is $1,225,900,000. The 
Committee includes bill language in section 222 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:

------------------------------------------------------------------------
                                                            Committee
             Account                      Program         recommendation
------------------------------------------------------------------------
Aging and Disability Services      Alzheimer's Disease       $14,700,000
 Programs.                          Prevention
                                    Education and
                                    Outreach.
Aging and Disability Services      Chronic Disease Self-       8,000,000
 Programs.                          Management.
Aging and Disability Services      Falls Prevention....        5,000,000
 Programs.
Immunization and Respiratory       Section 317               469,350,000
 Diseases.                          Immunization Grants.
Emerging and Zoonotic Infectious   Epidemiology and           40,000,000
 Diseases.                          Laboratory Capacity
                                    Grants.
Emerging and Zoonotic Infectious   Healthcare                 12,000,000
 Diseases.                          Associated
                                    Infections.
Chronic Disease Prevention and     Office of Smoking         141,850,000
 Health Promotion.                  and Health (Tobacco
                                    Prevention/Media &
                                    Quit Lines).
Chronic Disease Prevention and     Breast Feeding              9,750,000
 Health Promotion.                  Grants (Hospitals
                                    Promoting
                                    Breastfeeding).
Chronic Disease Prevention and     Million Hearts              5,000,000
 Health Promotion.                  Program.
Chronic Disease Prevention and     Heart Disease &            57,075,000
 Health Promotion.                  Stroke Prevention
                                    Program.
Chronic Disease Prevention and     Diabetes............       52,275,000
 Health Promotion.
Chronic Disease Prevention and     Early Care                  5,000,000
 Health Promotion.                  Collaboratives.
Public Health and Scientific       Data Modernization        182,900,000
 Services.                          Initiative.
Environmental Health.............  Lead Poisoning             51,000,000
                                    Prevention.
CDC-Wide Activities..............  Preventive Health         160,000,000
                                    and Health Services
                                    Block Grants.
Mental Health....................  Suicide Prevention         12,000,000
                                    (Garrett Lee Smith).
------------------------------------------------------------------------

                           General Provisions

    Section 201. The bill continues a provision placing a 
$50,000 ceiling on official representation expenses.
    Section 202. The bill continues a provision limiting the 
use of certain grant funds to pay individuals more than an 
annual rate of Executive Level II or capping NIH investigator 
salaries.
    Section 203. The bill continues a provision restricting the 
Secretary's use of taps for program evaluation activities 
unless a report is submitted to the Committees on 
Appropriations of the House of Representatives and the Senate 
on the proposed use of funds.
    Section 204. The bill continues a provision authorizing the 
transfer of up to 2.5 percent of PHS Act (Public Law 78-410) 
funds for evaluation activities.
    Section 205. The bill continues a provision restricting 
transfers of appropriated funds and requires a 15-day 
notification to the Committees on Appropriations of the House 
of Representatives and the Senate.
    Section 206. The bill continues a general provision 
allowing National Health Service Corps contracts to be canceled 
up to 60 days after award.
    Section 207. The bill continues a provision regarding 
requirements for family planning applicants.
    Section 208. The bill continues language which States that 
no provider of services under title X of the PHS Act (Public 
Law 78-410) may be exempt from State laws regarding child 
abuse.
    Section 209. The bill continues language that restricts the 
use of funds to carry out the Medicare Advantage Program if the 
Secretary denies participation to an otherwise eligible entity.
    Section 210. The bill continues a provision prohibiting the 
use of funds for lobbying activities related to gun control.
    Section 211. The bill continues a provision that limits the 
assignment of certain public health personnel.
    Section 212. The bill continues a provision that 
facilitates the expenditure of funds for international health 
activities.
    Section 213. The bill continues a provision permitting the 
transfer of up to 3 percent of AIDS funds among ICs by the 
Director of NIH and the Director of the Office of AIDS Research 
at NIH.
    Section 214. The bill continues language that requires that 
the use of AIDS research funds be determined jointly by the 
Director of NIH and the Director of the Office of AIDS Research 
and that those funds be allocated directly to the Office of 
AIDS Research for distribution to the ICs consistent with the 
AIDS research plan.
    Section 215. The bill continues a provision authorizing the 
Director of NIH to enter into certain transactions to carry out 
research in support of the NIH Common Fund.
    Section 216. The bill continues a provision permitting NIH 
to use up to $100,000,000 of IC funding for construction, 
improvements, and repairs of facilities.
    Section 217. The bill continues a provision that transfers 
funds from NIH to HRSA and AHRQ, to be used for National 
Research Service Awards.
    Section 218. The bill continues a provision that provides 
BARDA with authority to enter into a multiyear contract for up 
to 10 years and to repurpose unused termination costs to pay 
contract invoices.
    Sections 219. The bill continues a provision requiring the 
CJ to include certain FTE information with respect to the ACA.
    Section 220. The bill continues a provision related to ACA 
exchange funding transparency.
    Section 221. The bill continues a provision prohibiting 
funds for the Risk Corridor program.
    Section 222. The bill continues a provision requiring the 
Secretary to transfer Prevention and Public Health Fund 
resources within 45 days.
    Section 223. The bill continues a provision related to 
breast cancer screening recommendations.
    Section 224. The bill continues a provision on NIH indirect 
costs.
    Section 225. The bill continues a provision requiring 
Congressional notification prior to NIH transfers of opioid 
funds internally.
    Section 226. The bill continues a provision related to 
notifications for ACA enrollment and Community Health Centers 
awards.
    Section 227. The bill continues a provision related to 
Medicare administrative funds.
    Section 228. The bill continues a provision requiring 
staffing reports.
    Section 229. The bill continues a provision on HHS staff 
travel for medical care.
    Section 230. The bill continues a provision allowing 
private donations for the care of unaccompanied children.
    Section 231. The bill continues a provision limiting the 
use of funds for unlicensed shelters for unaccompanied 
children.
    Section 232. The bill continues a provision requiring 
Congressional notification prior to the use of influx 
facilities as shelters for unaccompanied children.
    Section 233. The bill continues a provision regarding 
Member access to unaccompanied children facilities.
    Section 234. The bill continues a provision requiring 
monthly reporting of unaccompanied children.
    Section 235. The bill continues a provision for CDC 
employees dependents' schooling of CDC employees stationed in a 
U.S. territory.
    Section 236. The bill continues a provision rescinding 
funding from the Nonrecurring Expenses Fund.
    Section 237. The bill includes a new provision regarding 
investigations into harassment, bullying, retaliation or 
hostile working conditions at NIH-funded grantees.

                               TITLE III

                        DEPARTMENT OF EDUCATION

    Any references in this title of the Committee Report to the 
``Secretary'' or the ``Department'' shall be interpreted to 
mean the Secretary of Education or the Department of Education, 
respectively, unless otherwise noted.

                    Education for the Disadvantaged

Appropriations, 2024.................................... $19,107,790,000
Budget estimate, 2025...................................  19,287,790,000
Committee recommendation................................  19,387,790,000

    The Committee recommends $19,387,790,000, for programs in 
the Education for the Disadvantaged account. Funds appropriated 
in this account primarily support activities in the 2025-2026 
school year.

Grants to Local Educational Agencies

    The Committee recommends $18,686,802,000, for the title I-A 
grants to local educational agencies [LEAs] program. Title I-A 
grants to LEAs provide supplemental education funding, 
especially in high-poverty areas, for LEAs to provide extra 
academic support to help raise the achievement of eligible 
students or, in the case of school-wide programs in which the 
vast majority of students participate in title I-A programs, 
help all students in high-poverty schools meet challenging 
State academic standards. Title I-A grants are distributed 
through four ESEA formulas in amounts provided by this act: 
basic, concentration, targeted, and the education finance 
incentive grant [EFIG].
    Of the funds available for title I-A grants to LEAs, up to 
$5,000,000 shall be available on October 1, 2024, for transfer 
to the Census Bureau for poverty updates; $7,840,625,000 will 
become available on July 1, 2025; and $10,841,177,000 will 
become available on October 1, 2025. The funds that become 
available on July 1, 2025, and October 1, 2025, will remain 
available for obligation through September 30, 2026.
    The fiscal year 2025 President's budget also proposes to 
reserve up to $10,000,000 from amounts available for EFIG and 
targeted grants to support voluntary activities to help school 
systems address inequities in school funding through voluntary 
State school funding equity commissions and voluntary local 
educational agency equity reviews. Given the limited allocation 
and necessity to invest in formula allocations needed to 
sustain investments that assist with academic recovery and 
student well-being, the Committee recommendation does not 
include this requested authority.
    School Support and Improvement.--The Committee appreciates 
steps the Department has taken to improve compliance with ESEA 
requirements for school support and improvement. These include 
the targeted monitoring of ESEA provisions and related July 
2023 Dear Colleague on recommendations for implementing related 
resource equity provisions of ESEA; additional rounds of 
targeted monitoring on school improvement requirements; and 
planned issuance of comprehensive guidance on school support 
and improvement requirements. The Department must continue to 
increase its efforts on ensuring compliance of these 
requirements at all levels, including through additional 
monitoring directed in the 2024 explanatory statement or its 
equivalent, technical assistance, and support. This should also 
include consideration of the least burdensome ways to monitor, 
support and ensure compliance of SEA, LEA, and school support 
and improvement requirements.
    The Committee also believes more transparency is needed 
around findings and implementation of corrective actions from 
comprehensive and targeted monitoring of ESEA school support 
and improvement requirements. While the Department's website 
has information on its monitoring protocol and reports, it 
lacks transparency on all of its monitoring activity and 
implementation of corrective actions. The Committee directs the 
Department to produce a report that summarizes the Department's 
findings and actions it is requiring or recommending SEAs to 
take in response to all monitoring and performance reviews of 
State implementation of title I-A of the ESEA, including 
findings from both comprehensive and targeted program 
monitoring, and the implementation of corrective actions and 
recommendations from such monitoring. This report must be 
provided to the committees of jurisdiction and made publicly 
available on the Department's website no later than September 
1. Further, the Committee directs the Department to publish the 
results of targeted monitoring of State compliance with 
provisions under title I-A, including report cards, for 
individual States on its website within 30 days of providing 
such findings to SEAs. Finally, the Committee requests a 
briefing not later than 60 days after enactment on the 
Department's completed actions and plans to continue making 
progress toward improved SEA, LEA and school implementation of 
related requirements and the additional high-quality 
educational opportunities being made available to students for 
whom such opportunities are not currently available.
    GAO Report on School Support and Improvement.--The 
Committee appreciates that GAO is ready to initiate the next 
report in its body of work on ESEA school support and 
improvement requirements. The Committee is particularly 
interested in a deeper review of areas where SEA, LEA, and 
school implementation and compliance were found to be lacking 
in prior studies conducted by GAO, particularly, but not 
limited to, implementation of provisions related to 
identification of resource inequities. That deeper review 
should probe whether any comprehensive support and improvement 
[CSI] school improvement plans examined real building-level, 
per-pupil spending at the CSI schools compared to other schools 
in the LEA and the State and the extent to which the required 
needs analyses conducted aligned with best practice, 
particularly in measuring the resources provided in relation to 
the needs of the students in the CSI schools.
    The next report should also include new analysis of the 
extent to which and characteristics of schools initially 
identified for comprehensive support and improvement have 
subsequently been required to implement more rigorous State-
determined actions; the extent to which and characteristics of 
schools initially identified for additional targeted support 
and improvement have been escalated to comprehensive support 
and improvement; and the extent to which and characteristics of 
schools identified for comprehensive support and improvement 
have subsequently improved performance to exit identification 
status and the enabling conditions and types of resources that 
contributed to improved school performance. This analysis 
should also evaluate the strength and characteristics of the 
State exit criteria used to determine whether these additional 
targeted and comprehensive support and improvement schools 
exited status or faced escalating interventions.
    Required Reservation for Students Experiencing 
Homelessness.--The Committee reiterates its strong support for 
and interest in effective implementation of ESEA's requirement 
for LEAs to reserve sufficient title I-A funds to provide 
comparable services to students experiencing homelessness, 
including by providing educationally related support services 
to children in shelters and other locations where children may 
live. The Committee appreciates the initial steps the 
Department has taken to increase collaboration between State 
and local title I-A directors and Education for Homeless 
Children and Youth State and local coordinators on determining, 
reserving, and using sufficient amounts from the title I-A 
program and increasing public transparency of such amounts. 
Such services include those not ordinarily provided with title 
I-A funds to other students served by title I-A programs such 
as all or part of the homeless liaison's salary, education-
related fees, and other necessary items or services.
    However, there is concern that LEAs can avoid reserving 
funds by stating no students experiencing homelessness are 
enrolled. The Committee directs the Department to clarify that 
title I-A funds must be reserved to enable LEAs to identify and 
support students experiencing homelessness. The Committee looks 
forward to seeing the changes that result from these and other 
efforts and directs the Department to report in its fiscal year 
2026 CJ the specific State policy changes resulting from these 
efforts. In addition, the Department should widely disseminate 
specific State policy changes resulting from monitoring 
findings and recommendations that produce more collaborative 
and transparent approaches to the determination of set-aside 
amounts under such section providing necessary resources to 
fulfill needs assessments conducted for students experiencing 
homelessness to meet State challenging academic standards and 
effectively take advantage of educational opportunities.
    In addition, as was noted in the explanatory statement 
accompanying the fiscal year 2023 appropriations act, more must 
be done to improve transparency on amounts reserved by LEAs 
under section 1113(c)(3)(A). The Committee understands the 
Department is planning to analyze the variation of per-
homeless-pupil amounts across LEAs within a State and take 
other steps to improve the quality of reported data. However, 
this must be accompanied with actions to provide transparency 
on amounts reserved and spent with funds available under such 
section, including effective technical assistance and support 
being provided to title I SEA and LEA leaders and McKinney-
Vento staff on the wide variety of services supported by these 
funds, implementation of an adequate needs assessment, and 
determination of a sufficient reservation under such section. 
The Committee requests a briefing on actions taken and planned 
on these issues not later than 45 days after enactment of this 
act.
    State Reservation for Administration of Title I.--The 
Committee bill includes new language proposed in the 
President's budget that increases the amount of title I-A funds 
States reserve for administration of parts A, C, and D of title 
I of the ESEA. The new language provides each State with 
administrative resources of the greater of $800,000 or 1 
percent of its allotment under such parts of title I and each 
outlying area with a reservation of $100,000. In addition, the 
new language requires the 1 percent reservation to be 
calculated based on fiscal year 2023 enacted appropriations for 
such programs. The Committee expects the additional State 
capacity enabled by this increase to support improved 
implementation of ESEA requirements, particularly school 
support and improvement requirements.
    Advanced Coursework.--The Committee is aware that the 
National Center for Education Statistics School Pulse Panel 
reported earlier this year that 84 percent of high schools with 
fewer than 25 percent students of color offered advanced 
academic courses but just 65 percent of high schools serving 75 
percent or more of student of color did the same. This 
disparity means students of color are denied opportunities to 
Advanced Placement, International Baccalaureate, and dual 
enrollment courses that predict more success in college and 
careers. The Committee is heartened by recent State and 
district actions like opt out policies for identified students 
that may help increase equity in advanced course enrollment 
policy and use of more than standardized test scores to 
identify students for automatic enrollment. The Committee notes 
that funds under ESEA may be used to support these and other 
efforts to reduce inequities in access to advanced coursework. 
The Committee also encourages the Department to resume 
collection of pass rates for all Advanced Placement subject 
areas.

Comprehensive Literacy State Development Grants

    The Committee recommendation includes $194,000,000 for the 
Comprehensive Literacy State Development Grants program. This 
program provides competitive grants to SEAs that then subgrant 
at least 95 percent of such funds to eligible entities to 
support efforts to improve the literacy skills of children and 
students from birth through 12th grade in high-need schools and 
early education programs in a State for each of several age 
bands through implementation of evidence-based practices and 
interventions. In fiscal year 2025, the program is expected to 
support approximately 25 State grant awards and funding 
reservations for Bureau of Indian Education schools, the 
outlying areas, and national activities, including evaluation. 
The President's budget proposes to allow SEAs to reserve 10 
percent of its grant funds for evaluation. The Committee bill 
does not include the requested language.
    Evidence-based Instruction for Students with Language-based 
Learning Disabilities.--The Committee is aware ESEA requires 
the Secretary to prioritize applications proposing evidence-
based activities to develop or enhance comprehensive literacy 
instruction plans that ensure high-quality instruction and 
effective strategies in reading and writing for children from 
early childhood education through grade 12. The Committee 
requests the Department to describe in the fiscal year 2026 CJ 
how grantees plan to use fund for activities designed to 
strengthen and enhance teacher training on the identification 
of language-based learning disabilities and evidence-based 
methods of literacy instruction for students with language-
based learning disabilities.

Innovative Approaches to Literacy

    The Committee recommendation includes $30,000,000 for the 
Innovative Approaches to Literacy program. This program 
provides competitive grants to national not-for-profit 
organizations and school libraries for providing books and 
childhood literacy activities to children and families living 
in high-need communities.
    The Committee continues to direct the Department to reserve 
no less than 50 percent of funds under this program for grants 
to develop and enhance effective school library programs, which 
may include providing professional development to school 
librarians, books, and up-to-date materials to high-need 
schools. School library programs increase access to a wide 
range of print and electronic resources and provide learning 
opportunities for all students, particularly those who are less 
likely to have access to such materials at home. The Committee 
also encourages the Department to use a portion of the funds 
under this program for grants to pediatric literacy programs 
that are provided during well-child visits by medical providers 
trained in research-based methods of early language and 
literacy.
    In addition, the Committee directs the Department to ensure 
that grants are distributed among eligible entities that will 
serve geographically diverse areas, including communities that 
are rural, Tribal, or where English is not the primary 
language. The Committee also encourages the Department to 
include a priority for initiatives that support biliteracy and 
multilingual approaches or provide professional development in 
multilingual education for existing school staff and teachers.

Migrant Education Program

    The Committee recommends $375,626,000 for the title I 
Migrant Education program. This funding supports grants to SEAs 
to ensure that migratory children receive full and appropriate 
opportunities to meet the same challenging State academic 
standards that all children are expected to meet and help such 
children overcome educational disruption and other factors that 
inhibit the ability of such children to succeed in school. 
Funding also supports activities to improve interstate and 
intrastate coordination of migrant education programs, as well 
as identify and improve services to the migrant student 
population.
    The President's budget proposes new language that would 
allow the Department to reserve funds from the Migrant 
Education and Neglected and Delinquent programs in this account 
and Education for Homeless Children and Youth program in the 
school improvement account for competitive grants to States to 
improve coordination of services to students eligible for 
multiple Federal programs. The Committee bill does not include 
the requested language.

Neglected and Delinquent

    The Committee recommends $49,239,000 for the Neglected and 
Delinquent program. This program, authorized under subpart 1 of 
title I-D of the ESEA, provides financial assistance to SEAs 
for education services to neglected and delinquent children and 
youth in State-run institutions and for juveniles in adult 
correctional institutions. States are authorized to set aside 
at least 15 percent, but not more than 30 percent, of their 
Neglected and Delinquent program funds to help students in 
State-operated institutions make the transition into locally 
operated programs and to support the successful reentry of 
youth offenders who are age 20 or younger and have received a 
secondary school diploma or its recognized equivalent. The 
Department is authorized to reserve up to 2.5 percent of the 
appropriation for national activities, including technical 
assistance. The Committee continues to urge the Department to 
increase its direct and technical assistance support to further 
assist grantees in their efforts to improve and report on 
program outcomes.
    The President's budget proposes new language that would 
allow the Department to reserve funds from the Migrant 
Education and Neglected and Delinquent programs in this account 
and Education for Homeless Children and Youth program in the 
school improvement account for competitive grants to States to 
improve coordination of services to students eligible for 
multiple Federal programs. The Committee bill does not include 
the requested language.

Special Programs for Migrant Students

    The Committee recommends $52,123,000 for Special Programs 
for Migrant Students, which consist of the High School 
Equivalency Program [HEP] and the College Assistance Migrant 
Program [CAMP]. HEP projects are 5-year grants to institutions 
of higher education and other nonprofit organizations to 
recruit migrant students ages 16 and older and provide the 
academic and support services needed to help them obtain a high 
school equivalency credential and subsequently gain employment, 
attain admission to a postsecondary institution or a job 
training program, or join the military. CAMP projects are 5-
year grants to institutions of higher education and nonprofit 
organizations to provide tutoring, counseling, and financial 
assistance to migrant students during their first year of 
postsecondary education in order to support postsecondary 
education program completion.
    The bill does not include language proposed in the budget 
which allows the Secretary the ability to fund the highest 
quality HEP and CAMP applications regardless of the allocation 
requirements of the Higher Education Act.

                               Impact Aid

Appropriations, 2024....................................  $1,625,151,000
Budget estimate, 2025...................................   1,618,112,000
Committee recommendation................................   1,645,151,000

    The Committee recommends $1,645,151,000, for the Impact Aid 
program. Impact Aid provides financial assistance to LEAs 
affected by the presence of Federal activities and federally 
owned land. These LEAs face unique challenges because they must 
educate children living on federally owned land, such as 
military bases, while federally owned property is also exempt 
from local taxes, a primary source of revenue for LEAs. LEAs 
also enroll students residing on private property whose parents 
may be exempt from paying sales and income taxes, reducing the 
revenue available to support these LEAs.

Basic Support Payments

    The Committee recommends $1,490,500,000 for the Basic 
Support Payments program. Under this statutory formula, 
payments are made on behalf of all categories of federally-
connected children, with a priority placed on making payments 
first to 23 heavily impacted LEAs and providing any remaining 
funds for regular basic support payments.

Payments for Children With Disabilities

    The Committee bill includes $48,316,000 for Payments for 
Children With Disabilities. Under this program, additional 
payments are made for certain federally connected children 
eligible for services under the Individuals with Disabilities 
Education Act [IDEA].

Facilities Maintenance

    The Committee recommends $4,835,000 for Facilities 
Maintenance. This activity provides funding for emergency 
repairs and comprehensive capital improvements to certain 
school facilities owned by the Department and used by LEAs to 
serve federally connected military dependent students. Funds 
appropriated for this purpose are available until expended.

Construction

    The Committee recommends $20,500,000 for eligible LEAs for 
school construction activities allocated through the authority 
for competitive grants to LEAs under section 7007(b) of the 
ESEA. The bill also allows the funds to be available for 
obligation through September 30, 2026.

Payments for Federal Property

    The Committee recommends $81,000,000 for Payments for 
Federal Property. These payments compensate LEAs specifically 
for revenue lost due to the removal of Federal property from 
local tax rolls, regardless of whether any federally connected 
children attend schools in the LEA.

                      School Improvement Programs

Appropriations, 2024....................................  $5,776,178,000
Budget estimate, 2025...................................   5,781,178,000
Committee recommendation................................   5,796.178.000

    The Committee recommendation includes $5,796,178,000 for 
the School Improvement Programs account.

Supporting Effective Instruction State Grants

    The Committee recommends $2,190,080,000 for Supporting 
Effective Instruction State Grants. States and LEAs may use 
funds for a range of activities related to the certification, 
recruitment, professional development, and support of teachers 
and administrators. Activities may include reforming teacher 
certification and licensure requirements, addressing 
alternative routes to State certification of teachers, 
recruiting teachers and principals, improving equitable access 
to effective teachers, and implementing teacher mentoring 
systems, evaluation and support systems, merit pay, and merit-
based performance systems. These funds may also be used by LEAs 
to hire teachers to reduce class sizes.
    The appropriation for this program primarily supports 
activities associated with the 2025-2026 academic year. Of the 
funds provided, $508,639,000 will become available on July 1, 
2025, and $1,681,441,000 will become available on October 1, 
2025. These funds will remain available for obligation through 
September 30, 2026.
    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 science 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.

Nita M. Lowey 21st Century Community Learning Centers

    The Committee recommends an appropriation of $1,329,673,000 
for the Nita M. Lowey 21st Century Community Learning Centers 
program. Funds are allocated to States by formula, which in 
turn, award at least 95 percent of their allocations to LEAs, 
community-based organizations, and other public and private 
entities. Grantees use these resources to establish or expand 
community learning centers that provide activities offering 
significant extended learning opportunities, such as before and 
after-school programs, recreational activities, drug and 
violence prevention, and family literacy programs for students 
and related services to their families. Centers must target 
their services to students who attend schools that are eligible 
to operate a school-wide program under title I of the ESEA or 
serve high percentages of students from low-income families.

State Assessments Grants

    The Committee recommends $380,000,000 for the State 
Assessments Grants program. This program provides formula 
grants to States for the development and implementation of 
standards and assessments required by the ESEA, including 
improving such assessments through the adoption of through-
course assessments and other innovative assessments that meet 
ESEA's requirements. This program may assist States and LEAs in 
carrying out audits of their assessment systems to eliminate 
low-quality or duplicative assessments. It also provides 
competitive grants to States, including consortia of States, to 
improve the quality, validity, and reliability of academic 
assessments. These competitive grants may also be used to 
support State planning leading to an Innovative Assessment 
Demonstration Authority [IADA] application. The recommendation 
includes nearly $11,000,000 more than the statutorily required 
amount for formula grants that would be available for new 
competitive grants for state assessments.
    Report on Improvements in Assessments.--The Committee 
recognizes that assessments serve different purposes, ranging 
from formative purposes to inform classroom instruction to 
summative purposes to inform school accountability and 
improvement. CGSA was authorized to support grantees seeking to 
improve both formative and summative assessments, depending on 
needs within their States. Not later than 180 days after 
enactment, the Committee directs the Department to report on 
innovative work it has or is supporting on assessments, 
including through awards made through fiscal year 2024 under 
the CGSA program. The report shall include an analysis of the 
assessment work undertaken by recent CGSA grantees, any best 
practices that have emerged from CGSA grantees and how the 
Department has shared and will continue to share those and 
other best practices with other States in order to help all 
States improve their assessments, how CGSA grantees have used 
funds to support IADA work, how CGSA grantees have improved 
assessments for English learners and students with 
disabilities, how CGSA grantees are supporting through-course 
assessments to provide more real time data to educators and 
parents, and how CGSA grantees are developing more culturally 
aware and responsive assessments. Such report shall also 
describe how the Department is supporting, monitoring, and 
evaluating the CGSA program and its grantees, and include 
recommendations for how ongoing innovative assessment work can 
better support learning in classrooms, while maintaining the 
importance of annual, statewide, summative assessment data that 
produces disaggregated results for students and their families.

Education for Homeless Children and Youth

    The Committee recommends $129,000,000 for carrying out 
education activities authorized by title VII, subtitle B of the 
McKinney-Vento Homeless Assistance Act. This program provides 
assistance to each State to support an office of the 
coordinator of education for homeless children and youth to 
develop and implement State plans for educating children and 
youth experiencing homelessness, and to make subgrants to LEAs 
to support the education of those children and youth. Grants 
are made to States based on the total that each State receives 
in title I-A grants to LEAs. States must subgrant not less than 
75 percent of funds received to LEAs and may reserve remaining 
funds for State level activities. Under the McKinney-Vento 
Homeless Children and Youth Program, SEAs must ensure that 
children and youth experiencing homelessness have equal access 
to the same free public education, including a public preschool 
education, as is provided to other children and youth.
    The Committee bill continues to include language providing 
an additional 12 months for educational agencies and 
institutions to obligate and expend EHCY funds.
    The Committee directs the Department to issue guidance 
clarifying that funds provided under title VII, subtitle B of 
the McKinney-Vento Homeless Assistance Act may be used for the 
provision of extraordinary or emergency assistance needed to 
enable homeless children and youths to attend school and 
participate fully in school activities as allowed under law. 
This should include all of the activities and services outlined 
in the Department's September 12, 2023, Dear Colleague Letter 
to the Chief State School Officers on the American Rescue 
Plan--Homeless Children and Youth Funds, including paying for 
short-term, temporary emergency housing (such as a hotel or 
motel room) on a case-by-case basis if reasonable and necessary 
to facilitate school attendance, and as a last resort when 
other funding sources are not readily available.
    The President's budget proposes new language that would 
allow the Department to reserve funds from the Migrant 
Education and Neglected and Delinquent programs in this account 
and Education for Homeless Children and Youth program in the 
school improvement account for competitive grants to States to 
improve coordination of services to students eligible for 
multiple Federal programs. The Committee bill does not include 
the requested language.

Training and Advisory Services

    For Training and Advisory Services authorized by title IV 
of the Civil Rights Act (Public Law 88-352), the Committee 
recommends $6,575,000. The funds provided will support awards 
to operate regional equity assistance centers [EACs]. EACs 
provide services to LEAs, SEAs, and other customers upon 
request. Activities include disseminating information on 
successful practices and legal requirements related to 
nondiscrimination in educational programs on the basis of race, 
sex, religion, or national origin and evidence-based activities 
to improve equity and access to high-quality educational 
settings.

Native Hawaiian Education

    The Committee recommends $45,897,000 for the Education for 
Native Hawaiian program. In addition, the Committee bill 
continues a provision that clarifies the use of funds for 
administrative costs.
    The Committee bill includes $650,000 for the Native 
Hawaiian Education Council, which includes an increase of 
$150,000 for the Council to fulfill the statutory requirement 
for data collection.
    The Committee bill continues the set-aside of funds made 
available for the Education for Native Hawaiians program for 
grants for construction, renovation, and modernization of any 
public elementary school, secondary school, or structure 
related to a public elementary school or secondary school, that 
serves a predominantly Native Hawaiian student body.

Alaska Native Education

    The Committee recommends $44,953,000 for the Alaska Native 
Education. These funds help address the unique educational 
needs of Alaska Native schoolchildren. Funds are used for the 
development of supplemental educational programs to benefit 
Alaska Natives.
    Outreach and Program Responsiveness.--The Committee directs 
the Department to make every effort to ensure that grants are 
awarded well in advance of the school year, to maximize 
grantees' ability to hire the necessary staff and have their 
programs ready to go with the start of Alaska's school year in 
mid-August. The Committee continues to direct the Department to 
ensure that Alaska Native Tribes, Alaska Native regional non-
profits, and Alaska Native corporations, particularly those 
that have received no or few grants under this program, have 
the maximum opportunity to successfully compete for grants 
under this program by providing these entities multiple 
opportunities for technical assistance in developing successful 
applications for these funds, both in Alaska and via various 
forms of telecommunications. The Committee also strongly 
encourages the Department to include as many peer reviewers as 
possible who are Alaska Natives or who have experience with 
Alaska Native education and Alaska generally on each peer 
review panel.
    Use of Funds.--The Committee continues language that allows 
funding provided by this program to be used for construction 
and overrides the authorizing statute's requirement to make 
noncompetitive awards to certain organizations.

Rural Education

    The Committee recommends $230,000,000 for rural education 
programs. The Committee expects that rural education funding 
will be equally divided between the Small, Rural School 
Achievement Program, which provides funds to LEAs that serve a 
small number of students, and the Rural and Low-Income School 
Program, which provides funds to LEAs that serve concentrations 
of poor students, regardless of the number of students served.
    In 2020, the Department announced that some LEAs were using 
alternative poverty data to demonstrate eligibility for the 
Rural and Low-Income School Program in place of the U.S. Census 
Bureau's Small Area Income and Poverty Estimates, as required 
by section 5221(b)(1)(A)(i) of the ESEA. The Department had 
routinely accepted these data since the program was created in 
2002. In fiscal years 2021, 2022, and 2023, those LEAs that 
would have been eliminated abruptly from eligibility were held 
harmless at a declining rate that would have continued to fall 
through fiscal year 2027. In fiscal year 2024, bill language 
was included to hold the affected LEAs harmless at the fiscal 
year 2023 level. The Committee has also increased funding for 
the Rural Education Achievement Program in the fiscal year 2021 
through 2024 bills and recommends an increase of $10,000,000 
for this fiscal year. The Committee understands that changes to 
eligibility for funding received under this program create very 
significant challenges for several LEAs and States, at no fault 
of their own, and therefore continues to include bill language 
that will hold the affected LEAs harmless at the fiscal year 
2023 level during this fiscal year.

Comprehensive Centers

    The Committee recommends $50,000,000 for the Comprehensive 
Centers program. These funds provide support to a network of 
comprehensive centers that are operated by research 
organizations, agencies, institutions of higher education, or 
partnerships thereof. Centers provide training and technical 
assistance identified in annual State service plans to build 
the capacity of SEAs and the Bureau of Indian Education [BIE], 
and through them LEAs, and schools, to provide a high quality 
education to all students.
    The Committee is particularly supportive of the work of the 
centers in supporting SEAs, LEAs, Tribal Education Agencies, 
and schools in selecting, implementing, and sustaining 
evidence-based programs, policies, practices, and interventions 
and addressing corrective actions or results from audit 
findings and ESEA program monitoring. Further, centers play a 
critical role in supporting State and local efforts to close 
opportunity gaps and improve educational outcomes, particularly 
for students attending schools implementing comprehensive 
support and improvement or targeted or additional targeted 
support and improvement activities. The Committee directs the 
Department to brief the Committee not later than 60 days after 
enactment on center annual service plans. In addition, the 
Committee notes SEAs and LEAs seeking to redesign staffing and 
support team-based teaching models can receive technical 
assistance and support through the Strengthening and Supporting 
the Educator Workforce Content Center and Regional Centers.

Student Support and Academic Enrichment Grants

    The Committee recommendation includes $1,390,000,000 for 
Student Support and Academic Enrichment [SSAE] Grants. This 
program provides formula grants to States based on each State's 
share of title I-A grants, which then sub-grant to LEAs, to 
help support activities that provide students with a well-
rounded education, ensure safe and supportive learning 
environments, and use technology to improve instruction.
    Technical Assistance and Capacity Building.--The Committee 
appreciates the information provided in the fiscal year 2025 CJ 
on expenditures for the 2 percent set-aside for technical 
assistance [TA] and capacity building from prior year 
appropriations. The reservation for TA and capacity building 
should be used to support SEAs and LEAs in carrying out 
authorized activities under this program identified by SEAs and 
LEAs, which may include support for fostering school diversity 
efforts across and within school districts. The Committee 
continues to direct the Department to prioritize its TA and 
capacity building support for SEAs and LEAs seeking to address 
school diversity needs. In future CJs, the Department shall 
continue to provide current and planned expenditures for this 
reservation and include a plan for how resources will be spent 
to provide TA and to build the capacity of SEAs and LEAs. 
Further, such information shall also describe how expenditures 
for this reservation have and will build upon efforts to foster 
school diversity across and within school districts, including 
efforts set out by the Department in the May 8, 2023 Notice 
Inviting Applications. The Committee also supports plans to use 
these TA and capacity building funds for continued support of a 
TA center on student attendance and engagement and a new TA 
center on student mental and physical health, which will work 
in close coordination with the CMS technical assistance center 
for school-based services under Medicaid.
    Report on Use of Funds.--The Committee directs the 
Department to obtain and examine data on State and local 
expenditures, outlined by specific authorized activities, and 
provide information about how LEAs plan to evaluate the 
effectiveness of their activities. The Committee directs the 
Department, within 180 days after the enactment of this act, to 
provide a briefing to the Committee on implementation of this 
directive.
    Feminine Hygiene Products.--The Committee notes that SSAE 
funds can be used to create more supportive environments for 
students. The Committee believes that the inability to access 
feminine hygiene products can be a significant barrier to 
learning, but it can be alleviated through education, 
coordination, and cooperation among community stakeholders. 
Therefore, the Committee directs the Departments of Education 
and Health and Human Services to collaborate with stakeholders, 
including corporate and not-for-profit entities, to disseminate 
information regarding the availability of low-cost or donated 
feminine hygiene products for any SEA, LEA, or school to 
access. Such information should be made available to SEA, LEA, 
and school personnel.

                            School Readiness

Appropriations, 2024....................................................
Budget estimate, 2025...................................     $25,000,000
Committee recommendation................................................

    The Committee does not include funds for a newly proposed 
School Readiness account.

Preschool Incentive Demonstration Program

    The Committee recommendation does not include funds for 
this proposed demonstration program. The proposed program is 
intended to expand access to high-quality preschool for 
children eligible to attend title I schools through a mixed-
delivery model.

                            Indian Education

Appropriations, 2024....................................    $194,746,000
Budget estimate, 2025...................................     194,746,000
Committee recommendation................................     194,746,000

    The Committee recommends $194,746,000 for Indian Education 
programs.

Grants to Local Educational Agencies

    For grants to LEAs, the Committee recommends $110,381,000. 
These funds provide financial support to elementary and 
secondary school programs that serve Indian students, including 
preschool children. Funds are awarded on a formula basis to 
LEAs, schools supported and operated by the Department of the 
Interior/Bureau of Indian Education, and in some cases directly 
to Indian Tribes.

Special Programs for Indian Children

    The Committee recommends $72,000,000 for Special Programs 
for Indian Children. Funds are used for demonstration grants to 
improve Indian student achievement from early childhood 
education through college preparation programs, and for 
professional development grants for training Indians who are 
preparing to begin careers in teaching and school 
administration. The Committee strongly supports the budget 
proposal to invest more than $30,000,000 in new grants for 
professional development, including for the teacher retention 
initiative, to assist eligible entities, including Tribal 
colleges and universities, with addressing the need for 
teachers and administrators serving Indian students.
    The Department is directed to use no less than $5,000,000 
of funds available to continue the teacher retention-initiative 
intended to help address the shortage of Indian, Alaska Native, 
and Native Hawaiian educators and to expand their impact on 
students' education. The initiative must support teacher 
leadership models as a method to increase the retention of 
effective, experienced Indian, Alaska Native, and Native 
Hawaiian teachers. Outcomes and models of culturally-responsive 
teacher leaders participating in this program must have their 
growth and effectiveness measured and these findings should 
support the development of evidence-, research- and culturally 
responsive teacher leadership models. The Department is 
directed to publish such findings within a year of enactment of 
this act.

National Activities

    The Committee recommends $12,365,000 for National 
Activities. Funds are used to expand efforts to improve 
research, evaluation, and data collection on the status and 
effectiveness of Indian education programs, and to continue 
grants to Tribal educational departments for education 
administration and planning. The bill includes language 
proposed in the President's budget allowing more than 20 
percent of these funds to be used for grants for Native 
American Language Immersion. The Committee bill also continues 
language from the current appropriations act, which allows the 
Secretary to make such awards for a period not to exceed 5 
years.
    Native American Language Immersion Programs.--The 
recommendation includes not less than $4,500,000 for Native 
American Language Immersion programs. This amount will support 
new and continuation awards in fiscal year 2025. Funds for the 
Native American Language Immersion program should continue to 
be allocated to all types of eligible entities, including both 
new and existing language immersion programs and schools, to 
support the greatest possible geographical distribution and 
language diversity. Further, the Department should continue to 
give the same consideration to applicants that propose to 
provide partial immersion schools and programs as to full 
immersion, as the local Tribes, schools, and other applicants 
know best what type of program will most effectively assist 
their youth to succeed.
    The Committee directs the Department to provide parity in 
the treatment to American Indian, Alaska Native and Native 
Hawaiian language immersion schools and programs, including the 
development of a fair and equitable process to confer with 
Native Hawaiian organizations and Hawaiian language education 
stakeholders regarding implementation of the Native American 
Language program.
    Native American Language Resource Centers.--The Committee 
recognizes the importance of the Native American Languages 
Resource Centers, and that such centers are integral to 
supporting the revitalization of such Native American 
languages, including by encouraging and supporting the use of 
Native American languages as a medium of instruction. In 
addition, the Committee recognizes the need to encourage and 
support early childhood education programs, elementary schools, 
secondary schools, and institutions of higher education to 
include Native American languages in the curriculum as the 
primary mode of instruction, and in the same manner as other 
world languages, including through cooperative agreements and 
distance education, and to grant proficiency in Native American 
languages the same full academic credit as proficiency in other 
world languages. The Committee recommendation includes 
$2,965,000 to continue to carry out the policy set forth in 
Public Law 117-335 and direction provided in prior fiscal years 
to establish Native American Language Resource Centers.

                       Innovation and Improvement

Appropriations, 2024....................................  $1,203,084,000
Budget estimate, 2025...................................   1,208,000,000
Committee recommendation................................   1,231,461,000

    The Committee recommends $1,231,461,000, for programs 
within the Innovation and Improvement account. This amount 
includes an additional $116,461,000 provided by a general 
provision at the end of this title of the bill.

Education Innovation and Research

    The Committee recommendation includes $259,000,000 for the 
Education Innovation and Research [EIR] program. This program 
supports the creation, development, implementation, 
replication, and scaling up of evidence-based, field-initiated 
innovations designed to improve student achievement and 
attainment for high-need students. EIR incorporates a tiered 
evidence framework that provides early-phase, mid-phase, and 
expansion and replication grants. This supports interventions 
throughout the pipeline, from smaller grants for early stage 
projects that are willing to undergo rigorous evaluation to 
test their efficacy to larger grants to scale-up proven-
effective interventions that have demonstrated significant 
impacts through at least one rigorous evaluation.
    Briefing Requirement.--The Committee requests the 
Department brief the Committees on the fiscal year 2025 funding 
opportunities available under this program, including any 
proposed priorities, not less than 14 days prior to publication 
in the Federal Register.
    Social and Emotional Learning.--The Committee expects the 
Department to continue prioritizing and funding quality 
applications for eligible social and emotional learning 
projects within both the early- and mid-phase evidence tiers. 
The Committee strongly encourages EIR funds to be used for 
awards for high-quality applications meeting program 
requirements and planning to support evidence-based, school-
based mentoring programs in communities with high rates of 
violence and for students who experience trauma, low-income 
students, students of color, students academically at-risk, and 
justice-involved youth. Further, such applications could 
include a focus on providing students with life and workforce 
skills and experiences needed to be successful in the 
workplace.
    Data Science Education.--The Committee notes EIR grants in 
prior competitions have been awarded for data science education 
and learning projects. The Committee continues to encourage the 
Department to invite applications that propose the development 
and implementation of effective interventions in data science 
education.
    Grant Priorities.--The Committee notes there is significant 
demand from the field to test many types of strategies and to 
examine promising techniques that can be scaled-up in different 
settings. The Committee expects funds to continue to support 
diverse and field-initiated interventions, rather than a single 
nationwide program or award focused solely on one area of 
educational innovation. The Committee believes the Department 
should continue to support new awards to develop, validate and 
scale up evidence-based strategies that address the impact of 
the COVID-19 pandemic.
    High-dosage Tutoring.--The Committee notes the importance 
of high-dosage tutoring in accelerating student learning and 
supporting student success. As SEAs and LEAs are implementing 
and scaling up tutoring programs aligned with research-based 
components, the Committee encourages the Department to support 
high-dosage tutoring through new awards, particularly expansion 
and replication grants, for high-quality applications that meet 
program requirements.
    Rural Set-Aside.--The Committee supports the required 25 
percent set-aside within EIR for rural areas and encourages the 
Department to take steps necessary to ensure the set-aside is 
met and that EIR funds are awarded to diverse geographic areas. 
The Committee encourages the Department to invest in rural, 
high-need communities by ensuring grants are awarded to a 
diverse set of institutions, affecting varied geographic 
locations, including areas with substantial minority students, 
which have submitted high quality applications meeting EIR 
program requirements.
    Focused Math Instruction.--The Committee notes that more 
effective approaches are needed to improve math achievement and 
outcomes, particularly for students not currently engaged with 
high quality learning opportunities needed to eliminate 
learning gaps. The Committee notes that several EIR grants 
currently are implementing and evaluating project activities 
intended to improve outcomes in math for high need students. 
The Committee intends funds provided to continue to be 
available to support high quality applications focused on 
improving math learning and instruction, including applications 
that use diagnostic tools to match students with the 
appropriate math instruction and learning opportunities needed 
for all students to progress on current grade-level content.

Charter School Program

    The Committee recommends $440,000,000 for the Charter 
School Program [CSP]. This program supports the start-up, 
replication, and expansion of high-quality public charter 
schools prepared to effectively serve all students.
    Program Activities.--The Committee continues last year's 
enacted bill language providing increased flexibility within 
the program to effectively respond to the changing needs of the 
sector and increase the likelihood that Federal funds will be 
invested in high-quality charter schools prepared to serve all 
students effectively. Both the authorizing statute and prior 
year appropriations bills dictated the use of the appropriation 
in ways that prevented the Department from allocating funds 
based on the number of high quality applications in grant 
competitions and emerging needs of the field. To facilitate 
this, the Committee expects the Department to run competitions 
for charter school programs on similar cycles. The language 
will continue to allow the Department to allocate not more than 
$140,000,000 for replication and expansion of high-quality 
charter schools through the Charter Management Organization 
[CMO] program established in ESEA.
    The bill also allocates not less than $60,000,000 for 
Facilities Grants under section 4304, including the Credit 
Enhancement program. The bill also provides not more than 
$16,000,000 for national activities to provide technical 
assistance, disseminate best practices, and evaluate the impact 
of the charter school program. Finally, funds are available for 
use under 4305(a)(2) for Developer grants and under section 
4303 for State Entity grants. The Committee directs the 
Department to provide a briefing on its planned use of 
flexibility provided not later than 14 days prior to the 
announcement of any notice of proposed priorities, notice 
inviting applications for CSP activities, and announcement of 
grant awards.
    The Committee takes no action on additional language 
proposed in the President's budget that would prohibit the 
Secretary from making new awards under Charter Schools Grants 
that support charter schools that are operated or managed by 
for-profit entities, including through contractual 
relationships. CSP applicants for State Entity, CMO, and 
Developer grant competitions must assure a charter school 
supported by CSP funds has not or will not enter into a 
contract with a for-profit management organization, including a 
nonprofit management organization operated by or on behalf of a 
for-profit entity, under which the management organization, or 
its related entities, exercises full or substantial 
administrative control over the charter school and, thereby, 
the CSP project. The Committee expects the Department to 
enforce the assurance and related transparency requirements for 
the reporting of contracts with for-profit entities.
    Technical Assistance.--The Department is directed to 
continue to support and evaluate flexibility in the 
availability and effective use of CSP State Entity technical 
assistance resources; evaluate how such funds are used to 
ensure subgrantees are equipped to meet the needs of all 
students, and specifically students with disabilities and 
English learners as required by law; and, brief the Committees 
not later than 90 days after enactment of this act on its 
actions and continued plans to effectively oversee the CSP 
program.
    State Entity Subgrantees.--Under the CSP, State Entities 
receive competitive grants that are subsequently distributed as 
subgrants to support the opening of new charter schools, the 
replication of high-quality charter schools, and the expansion 
of high-quality charter schools. As required by ESEA, when 
eligible State Entities apply for these grants, they include in 
their applications the projected number of subgrants that they 
expect to make in each of those three categories. After 
completing their subgrant competitions, however, State Entities 
will typically find that they must deviate from their initial 
projections in order to support the highest-quality applicants, 
regardless of category. The Committee notes State Entities 
received awards based on the quality of their applications, 
including projections of schools to be opened. However, if the 
State Entity attempts to but is unable to implement the 
approved plan, the timely approval of amendments to subgrant 
projections could facilitate the most effective use of these 
resources in creating high-quality public educational options 
for students. The Committee directs the Secretary to allow 
State Entities to diverge from their original projections after 
conducting competitions that do not meet subgrant projections 
in their approved application, in order to fund the highest-
quality subgrant applicants that meet all Federal requirements. 
The Committee further directs the Department to report on the 
implementation of this directive in next year's CJ.
    Uses of Funds.--The Committee has become aware that grant 
recipients under the Charter Schools Grants to State Entities 
program encounter delays in their implementation of their 
grants because of uncertainty over whether certain uses of 
funds are allowable under the ESEA. For example, while section 
4303(h) allows funding of ``appropriate, non-sustained 
costs...when such costs cannot be met from other sources'', it 
is often unclear whether specific costs should be considered 
sustained or non-sustained, with the confusion sometimes 
emanating from unclear language in the State statutes that 
provide funding for charter schools. In other situations, a 
funding category such as ``educator compensation'' could 
encompass activities that are either sustained or non-
sustained, depending on the manner in which those activities 
are carried out. When State Entities grantees are delayed in 
making subgrants to charter school developers because the 
Department is going through a lengthy and necessary process of 
determining whether individual costs are allowable, new charter 
schools do not open on schedule, which constrains the ability 
of the program to make available high-quality educational 
options for students and jeopardizes the ability of State 
Entities grantees to use their grant funds in a timely manner.
    The Committee therefore strongly urges the Department to 
resolve these spending issues in a timely manner and in a 
manner that provides grantees with maximum flexibility 
consistent with the statute. The Department should allow State 
Entities to support all activities listed under section 
4303(h), so long as they contribute to the objective of 
developing, implementing, expanding, and replicating high-
quality charter schools. The Committee directs the Department 
to brief the Committee on the Department's response to this 
concern within 90 days of publication of this report and to 
provide an update in the fiscal year 2026 CJ on the 
Department's implementation of any changes in practice related 
to this issue.
    No-Cost Extensions.--The Committee is aware that recipients 
of grants under the CSP are sometimes unable to complete their 
projects within the original project period, often for reasons 
beyond their control (such as lower than anticipated 
subrecipient applications received, trouble obtaining charter 
school authorization, and delays in Department approval of 
charter school authorizers, uses of funds, or the allocation of 
subgrant funds). Yet, in situations in which a new grant has 
been made to an entity in the same State, the Department has 
been unwilling to approve no-cost extensions beyond the 
automatic 12-month period. The Committee understands that the 
Department believes that longer no-cost extensions would 
violate the statutory prohibition on a State receiving more 
than one grant at a time. The Committee strongly urges the 
Department to act favorably on requests for longer extensions 
in these situations, including for States receiving a new award 
in fiscal year 2024, particularly when an extension would 
enable the completion of subgrants made late in the grant 
period or when it is clear that the delays in carrying out 
project activities were largely unavoidable by the grantees 
and, thus, that requests likely meet the requirements of 
section 75.261 of the EDGAR regulations. The Committee directs 
the Department to brief the Committee on the Department's 
response to this concern within 90 days of publication of this 
report and to provide an update in the fiscal year 2026 CJ on 
the Department's implementation of any changes in practice 
related to this issue.

Magnet Schools Assistance

    The Committee recommends $139,000,000 for the Magnet 
Schools Assistance program. This program supports grants to 
LEAs to establish and operate magnet schools that are part of a 
court-ordered or federally approved voluntary desegregation 
plan. Magnet schools are designed to attract substantial 
numbers of students from different social, economic, ethnic, 
and racial backgrounds. Grantees may use funds for planning and 
promotional materials; salaries of instructional staff; 
transportation, as long as such expenses are sustainable beyond 
the grant period and not a significant portion of the grant; 
and the purchase of technology, educational materials, and 
equipment.

Teacher and School Leader Incentive Grants

    The Committee recommendation includes $60,000,000 for 
Teacher and School Leader Incentive Grants. This program 
provides competitive grants to eligible entities to develop, 
implement, improve, or expand human capital management systems 
or performance-based compensation systems in schools. Funds can 
be used for a wide-range of activities, including developing or 
improving evaluation and support systems that are based in part 
on student achievement; providing principals with necessary 
tools to make school-level decisions; implementing a 
differentiated salary structure based on a variety of factors; 
improving the recruitment and retention of effective teachers, 
principals, and other school leaders; and instituting career 
advancement opportunities that reward effective teachers, 
principals and other school leaders.

Ready-To-Learn Television

    The Committee recommendation includes $31,000,000 for the 
Ready-to-Learn Television program. This program is designed to 
facilitate student academic achievement by leveraging the power 
and reach of public television to develop and distribute 
educational video programming, and digital content, for 
preschool and elementary school children and their parents, 
caregivers, and teachers.

Arts in Education

    The Committee recommendation includes $36,500,000 for the 
Arts in Education program. The funding is used for a program of 
competitive awards for assistance for arts education, including 
professional development for arts educators, teachers and 
principals; developing and disseminating accessible 
instructional materials and arts-based educational programming; 
and for national and community outreach activities that 
strengthen relationships among LEAs, schools, communities and 
arts organizations. Funds also are used for evaluation and 
dissemination activities.
    National Program.--The Committee recommendation includes no 
less than $8,000,000 for a national program grant competition. 
The Committee includes bill language intended to ensure the 
Department does not administer the Arts in Education program 
activities in a consolidated grant competition as it did in 
fiscal year 2021. The language further requires the Department 
to use not less than $8,000,000 for an Arts in Education 
National Program competition following priorities and program 
requirements of the fiscal year 2022 competition.

Javits Gifted and Talented Students

    The Committee recommendation includes $16,500,000 for the 
Javits Gifted and Talented Students Education program. Funds 
are used for awards to State and local educational agencies, 
institutions of higher education, and other public and private 
agencies for research, demonstration, and technical assistance 
activities designed to enhance the capability of elementary and 
secondary schools to meet the special educational needs of 
gifted and talented students. Under ESEA, the Department gives 
priority to making awards for projects that include evidence-
based activities or that develop new information to improve the 
capacity of schools to operate gifted and talented education 
programs or to assist schools in identifying and serving 
traditionally underserved students

Supporting Effective Educator Development

    The Committee recommendation includes $90,000,000 for the 
Supporting Effective Educator Development [SEED] program. SEED 
provides competitive grants to improve teacher and principal 
effectiveness by supporting pathways that help teachers, 
principals, or other school leaders with non-traditional 
preparation and certification obtain employment in underserved 
LEAs; providing evidence-based professional development; and 
making services and learning opportunities freely available to 
LEAs.
    Effective School Leaders.--The Committee recognizes the 
significant impact of effective school principals and other 
school leaders on student achievement and other student 
outcomes, and believes the SEED program provides important 
support for helping ensure that more highly trained school 
leaders are available for service in schools that have 
concentrations of students from low-income families. Therefore, 
the Committee directs the Secretary to continue to use a 
portion of funds made available for SEED for new awards 
supporting the preparation of principals and other school 
leaders.

American History and Civics Education

    The Committee recommendation includes $23,000,000 for 
American History and Civics Education, including $3,000,000 for 
Presidential and Congressional Academies for American History 
and Civics and $20,000,000 for American History and Civics 
Education National Activities.
    Presidential Academies for the Teaching of American History 
and Civics offer residential workshops to elementary and 
secondary school teachers to strengthen their knowledge through 
instruction and interaction with primary scholars and 
accomplished teachers in these fields. The Congressional 
Academies for Students of American History and Civics provide 
similar workshops to students to enrich their understanding of 
American history and civics.

Statewide Family Engagement Centers

    The Committee recommendation includes $20,000,000 for 
Statewide Family Engagement Centers. This program provides 
competitive grants to statewide organizations to promote and 
implement evidence-based family engagement activities in 
education programs, and provide training and technical 
assistance to SEAs, LEAs, schools, and other organizations for 
carrying out such activities.

Fostering Diverse Schools

    The budget includes $10,000,000 for the creation of a new 
Fostering Diverse Schools program. This new program would 
support competitive awards to address voluntary efforts to 
increase racial and socioeconomic diversity in preschool 
through 12th grade.
    While the Committee recommendation does not include 
requested bill language and funding for this proposal, the bill 
does include investments through a range of authorized programs 
that may be used to further racial and socioeconomic diversity 
in the Nation's public schools, including capacity building 
grants through the student support and academic enrichment 
grant program.

Fund for the Improvement of Education

    The bill includes a general provision providing an 
additional $116,461,000 for this account for projects and 
associated amounts and purposes identified in the table at the 
end of this Committee Report.

                 Safe Schools and Citizenship Education

Appropriations, 2024....................................    $457,000,000
Budget estimate, 2025...................................     507,000,000
Committee recommendation................................     464,000,000

    The Committee recommends a total of $464,000,000 for 
activities to promote safe schools, healthy students, and 
citizenship education.

Promise Neighborhoods

    The Committee recommendation includes $93,000,000 for the 
Promise Neighborhoods program. This program awards competitive 
grants to not-for-profit, community-based organizations for the 
development of comprehensive neighborhood programs designed to 
combat the effects of poverty and improve educational and life 
outcomes for children and youth, from birth through college. 
Each Promise Neighborhood grantee serves a high-poverty urban 
neighborhood or rural community. Grants are for up to 5 years, 
with the final 2 years of funding contingent on grantee 
performance against program- and project-level performance 
objectives. Further, grants may be extended an additional 2 
years beyond the 5-year project period contingent on grantee 
performance. The bill continues to provide extended 
availability of these funds, to allow the Department more 
flexibility for the timing of new awards and maximize the time 
for grantee planning activities.
    Promise Neighborhoods Extensions.--The Committee is 
disappointed that the Department chose to use available funds 
in fiscal year 2024 for planning grants for new communities. 
The Committee notes with overwhelming concern that planning 
grants have only previously been awarded under an authority 
that no longer exists within the ESEA. The Department could 
have instead used the funds to make statutorily-authorized, 
competitive extension awards to high performing current 
implementation grantees. The Committee directs the Department 
to use any available fiscal year 2025 funds, not being used for 
continuation awards, only for 2-year extension grants to high 
quality Promise Neighborhood grantees that have demonstrated 
improvements in program performance indicators or for new 5-
year implementation awards. If the Departments runs a grant 
competition for new 5-year awards, it is directed to allow 
previously awarded grantees with programs that may have 
recently expired to compete for additional funding for the same 
neighborhood, provided they have at least 5 years of 
successfully submitting GPRA data, demonstrated improvements in 
Promise Neighborhoods indicators, and justify the need for 
additional funding for their continued implementation of high 
quality plans and evidence-based activities.

School Safety National Activities

    The Committee recommendation includes $221,000,000 for 
School Safety National Activities, including up to $5,000,000 
as necessary for Project SERV, which provides assistance to 
schools and institutions of higher education to respond and 
recover in the aftermath of violent or traumatic events 
disrupting the learning environment. School Safety National 
Activities funding also supports several grant and technical 
assistance activities intended to improve the safety, health, 
and well-being of all students. At the recommended funding 
level, sufficient funding is available for continuation grants 
for grantees making substantial progress on their awards, and 
approximately $30,000,000 is available for new awards as 
directed by this Report. The Committee requests a briefing not 
later than 14 days prior to the issuance of any notice inviting 
applications or notice of proposed priorities.
    Mental Health Service Professional Development Grant 
Program and School-Based Mental Health Services Grant 
Program.--The Committee directs the Department to use any 
available funds not needed for continuation awards for grantees 
meeting substantial progress or for necessary Project SERV 
awards to make additional new awards for these mental health 
programs. The Committee encourages the Department to continue 
working to support SEAs, LEAs, and IHEs in addressing the 
shortage of school-based mental health professionals in our 
Nation's K-12 schools by expanding the pipeline of these 
professionals and improving districts' ability to recruit and 
retain these professionals. The Committee recommendation 
includes approximately $80,000,000 for continuation awards for 
current grantees under the Mental Health Services Professional 
Demonstration Grant Program and approximately $80,000,000 for 
continuation awards for current grantees under the School-Based 
Mental Health Services Grant to increase the number of well-
trained school counselors, school social workers, and school 
psychologists, or other mental health professionals qualified 
to provide school-based mental health services. The Bipartisan 
Safer Communities Act also provides $100,000,000 each for these 
programs for additional continuation grants in fiscal year 
2025.
    The Committee also urges the Department to begin planning 
for how to prioritize applications in future grant competitions 
that address the negative effects of social media, problematic 
digital technology use, and online safety. The Committee also 
directs the Department to ensure that, to the greatest extent 
practicable, high-need LEAs and eligible institutions of higher 
education (as defined by FR Doc. 2022-21633) have not less 90 
days to submit an application. The Department should also 
widely publicize to potential applicants the Notice Inviting 
Applications and relevant award deadlines. Additionally, the 
Department should provide robust technical assistance to 
potential applicants, including multiple webinars, and prompt 
responses to questions and concerns regarding the application. 
The Committee directs the Department to continue including high 
rates of substance use and other adverse childhood experiences 
in its definition of LEAs with demonstrated need eligible to 
receive support under the School-Based Mental Health Services 
program. Finally, the Department should consider ways of 
executing the matching requirement that most effectively 
promotes sustainability of activities after grant funds are 
expended.
    The Committee recognizes the significant challenges facing 
some students, including LGBTQ+ students and students of color, 
in regards to bullying and harassment by their peers. The 
Committee understands that LGBTQ+ youth are four times more 
likely to attempt suicide than their peers. These funds can 
help reduce bullying and harassment, improve student well-
being, and ensure every student is able to attend school in a 
safe and welcoming environment.

Full Service Community Schools

    The Committee recommendation includes $150,000,000 for 
Full-Service Community Schools. This program provides support 
for the planning, implementation, and operation of full-service 
community schools that improve the integration, accessibility, 
and effectiveness of services for children and families, 
particularly for children attending high-poverty schools, 
including high-poverty rural schools.
    Equitable Distribution of Awards.--The Full Service 
Community Schools program provides support for the planning, 
implementation, and operation of full-service community schools 
that improve the integration, accessibility, and effectiveness 
of services for children and families, particularly for 
children attending high-poverty schools, including high-poverty 
rural schools. The Committee appreciates the potential of these 
Federal investments to improve student outcomes and school 
performance. However, the Committee is concerned that the 
program is not adequately supporting projects that meet program 
criteria in high-poverty rural areas. Additionally, the 
Department has awarded multiple awards to some entities while 
other entities with qualifying projects have not received 
awards. Therefore, the Department is urged to prioritize the 
equitable distribution of awards to include high-poverty rural 
areas, and to limit granting multiple awards to a single entity 
in a given fiscal year when other high-quality applicants exist 
in that year.
    The Committee bill does not include language proposed in 
the President's budget allowing up to $10,000,000 to be awarded 
as planning grants.

                      English Language Acquisition

Appropriations, 2024....................................    $890,000,000
Budget estimate, 2025...................................     940,000,000
Committee recommendation................................     895,000,000

    The Committee recommends an appropriation of $895,000,000 
for the English Language Acquisition [ELA] program.
    The Department makes formula grants to States based on each 
State's share of the Nation's limited-English-proficient and 
recent immigrant student population. The program is designed to 
increase the capacity of States and school districts to address 
the needs of these students. The authorizing statute requires 
that 6.5 percent of the appropriation be used to support 
national activities, which include professional development 
activities designed to increase the number of highly qualified 
teachers serving limited-English-proficient students; and a 
National Clearinghouse for English Language Acquisition and 
Language Instructional Programs. The Committee does not adopt 
the proposal to increase this reservation to 8 percent. 
National activities funds are available for 2 years.
    National Clearinghouse for English Language Acquisition.--
The Committee does not adopt the President's budget proposal to 
increase to $4,000,000 the amount of funds that may be reserved 
for the National Clearinghouse for English Language Acquisition 
and expand the scope of the National Clearinghouse to include 
technical assistance and capacity building to support SEAs and 
LEAs.
    Multilingualism.--The Committee is concerned that the 
Office of English Language Acquisition has overemphasized 
English-only approaches for the education of English language 
learner students, to the detriment of bilingual and dual 
language approaches. These approaches have proven more 
effective in the teaching of English, as well as academic 
content such as reading, math, science, and social studies. The 
Committee supports initiatives to build multilingual teacher 
pipelines through Grow-Your-Own initiatives and provide 
professional development in multilingual education for existing 
school staff and teachers. The Committee also supports efforts 
for post-secondary fellowships to bolster the multilingual 
educator pipeline.

                           Special Education

Appropriations, 2024.................................... $15,467,264,000
Budget estimate, 2025...................................  15,673,264,000
Committee recommendation................................  15,768,264,000

    The Committee recommends an appropriation of 
$15,768,264,000 for special education programs.

Grants to States

    The Committee recommendation includes $14,508,704,000 for 
IDEA part B Grants to States. This program provides formula 
grants to assist States, outlying areas, and other entities in 
meeting the costs of providing special education and related 
services for children with disabilities. States pass along most 
of these funds to LEAs, but may reserve some for program 
monitoring, enforcement, technical assistance, and other 
activities. The appropriation for this program primarily 
supports activities associated with the 2025-2026 academic 
year. Of the funds available for this program, $5,225,321,000 
will become available on July 1, 2025, and $9,283,383,000 will 
become available on October 1, 2025. These funds will remain 
available for obligation through September 30, 2026.

Preschool Grants

    The Committee recommends $420,000,000 for Preschool Grants. 
This program provides formula grants to States to assist them 
in making available special education and related services for 
children with disabilities aged 3 through 5. States distribute 
the bulk of the funds to LEAs. States must serve all eligible 
children with disabilities aged 3 through 5 and have an 
approved application under the IDEA.

Grants for Infants and Families

    The Committee recommends $545,000,000 for the Grants for 
Infants and Families program under part C of the IDEA. Part C 
of IDEA authorizes formula grants to States, outlying areas, 
and other entities to implement State-wide systems for 
providing early intervention services to all children with 
disabilities, ages 2 and younger, and their families. IDEA also 
gives States the option of extending eligibility for part C 
services to children 3 and older if they were previously served 
under part C and will continue to be served until entrance to 
kindergarten. The Committee bill does not include the new 
policy proposals included in the President's budget.

State Personnel Development

    The Committee recommends $38,630,000 for the State 
Personnel Development program. Ninety percent of funds must be 
used for professional development activities. The program 
supports grants to SEAs to help them reform and improve their 
personnel preparation and professional development related to 
early intervention, educational, and transition services that 
improve outcomes for students with disabilities.

Technical Assistance and Dissemination

    The Committee recommends $76,345,000 for Technical 
Assistance and Dissemination. This program supports awards for 
technical assistance, model demonstration projects, the 
dissemination of useful information, and other activities. 
Funding supports activities that are designed to improve the 
services provided under the IDEA.
    Special Olympics.--Within the total, the Committee 
recommendation includes $37,000,000 to support activities 
authorized by the Special Olympics Sport and Empowerment Act. 
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.

Personnel Preparation

    The Committee recommends $115,000,000 for the Personnel 
Preparation program. Funds support competitive awards to help 
address State-identified needs for personnel who are qualified 
to work with children with disabilities, including special 
education teachers and related services personnel. The program 
is required to fund several other broad areas, including 
training leadership personnel and personnel who work with 
children with low-incidence disabilities, and providing 
enhanced support for beginning special educators.

Parent Information Centers

    The Committee recommends $33,152,000 for Parent Information 
Centers. 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.

Technology and Media Services

    The Committee recommends $31,433,000 for Technology and 
Media Services. This program makes competitive awards to 
support the development, demonstration, and use of technology 
and educational media activities of value to children with 
disabilities.

                        Rehabilitation Services

Appropriations, 2024....................................  $4,092,906,000
Budget estimate, 2025...................................   4,397,033,000
Committee recommendation................................   4,219,297,000

Vocational Rehabilitation State Grants

    The Committee recommends $4,076,098,000 in mandatory 
funding for Vocational Rehabilitation [VR] State Grants. State 
Grants assist States in providing a range of services to help 
persons with physical and mental disabilities prepare for and 
engage in meaningful employment. The Committee provides an 
increase in VR State Grants according to the CPI-U, consistent 
with the authorizing statute.
    Disability Innovation Fund [DIF].--The Committee directs 
the Department to use a portion of DIF funds for competitive 
grants, to be awarded in coordination with the Office of 
Disability Employment Policy, to eligible entities in 
partnership with State VR agencies for innovative strategies 
that significantly increase competitive integrated employment 
of youth and adults with disabilities. The Committee expects 
this will focus on expanding the capacity and the State network 
of eligible entities providing employment supports in States, 
prioritizing States that have returned funds to RSA or States 
from the two lowest quintiles of labor force participation 
rates for people with disabilities.
    The Committee directs the Department to continue to brief 
the Committees on Appropriations; the Committee on Health, 
Education, Labor, and Pensions of the Senate; the Committee on 
Education and Labor of the House of Representatives; the 
Committee on Finance of the Senate; and the Committee on Ways 
and Means of the House of Representatives at least every 6 
months with updates on activities funded within DIF.

Client Assistance State Grants

    The Committee recommends $13,000,000 in discretionary funds 
for Client Assistance State Grants. This program funds State 
formula grants to help VR clients or client applicants 
understand the benefits available to them. States must operate 
client assistance programs to receive VR State Grant funds.

Training

    The Committee recommends $29,388,000 for training 
rehabilitation personnel. This program supports grants to 
provide training to new VR staff or upgrade the qualifications 
of existing staff.

Demonstration and Training Programs

    The Committee recommendation includes $5,796,000 for 
demonstration and training programs. 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 2024 enacted level for parent information and 
training programs.

Protection and Advocacy of Individual Rights

    The Committee recommends $20,150,000 for the Protection and 
Advocacy of Individual Rights program. This program provides 
grants to agencies to protect and advocate for the legal and 
human rights of persons with disabilities who are ineligible 
for the protection and advocacy services available through the 
Developmental Disabilities Assistance and Bill of Rights Act 
(Public Law 106-402) or the Protection and Advocacy for 
Individuals with Mental Illness Act (Public Law 99-319).

Supported Employment State Grants

    The Committee recommendation includes $22,548,000 for the 
Supported Employment State Grants Program. This program 
provides grants to States to provide supported employment 
services for individuals with the most significant 
disabilities, including youth with disabilities.

Independent Living Services for Older Individuals Who Are Blind

    The Committee recommends $33,317,000 for Independent Living 
State Grants. This program supports assistance to individuals 
over age 55 to help them adjust to their blindness and continue 
to live independently, including daily living skills training, 
counseling, community integration information and referral, the 
provision of low-vision and communication devices, and low-
vision screening.

Helen Keller National Center

    The Committee recommends $19,000,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults. The Helen 
Keller National Center consists of a national headquarters in 
Sands Point, New York, with a residential training and 
rehabilitation facility where deaf-blind persons receive 
intensive specialized services; a network of 10 regional field 
offices that provide referral and counseling assistance to 
deaf-blind persons; and an affiliate network of agencies.

           Special Institutions for Persons with Disabilities


                 AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2024....................................     $43,431,000
Budget estimate, 2025...................................      43,431,000
Committee recommendation................................      53,431,000

    The Committee recommends $53,431,000 to help support 
American Printing House for the Blind [APH].
    APH provides educational materials to students who are 
legally blind and enrolled in elementary and secondary 
education programs to help enable such students to fully 
participate in and benefit from education programs. The Federal 
subsidy provides approximately 65 percent of APH's total sales 
income. Materials are distributed free of charge to schools and 
States through per capita allotments based on the total number 
of students who are blind. Materials provided include 
accessible textbooks, assistive technologies and other 
educational aids in Braille, large type, recorded form, and 
computer applications. Appropriated funds may be used for staff 
salaries and expenses, as well as equipment purchases and other 
acquisitions, consistent with the purpose of the act to Promote 
the Education of the Blind (Public Law 45-186).
    The Committee includes funding for APH to develop and 
distribute assistive technologies, books in accessible formats, 
specially designed educational aids, and the training and 
support necessary to assist educators, parents and students who 
are blind or visually impaired to participate in and benefit 
from education programs. In addition, within amounts provided 
for APH, the Committee includes up to $10,000,000 to support 
production and distribution of an innovative braille and 
tactile display product developed by the Printing House and its 
partners. The Committee also includes up to $6,000,000 to 
continue the current Center for Assistive Technology Training 
regional partnership.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2024....................................     $92,500,000
Budget estimate, 2025...................................      92,500,000
Committee recommendation................................      96,500,000

    The Committee recommends $96,500,000 for the National 
Technical Institute for the Deaf [NTID].
    NTID, located on the campus of the Rochester Institute of 
Technology in Rochester, New York, was created by Congress in 
1965 to provide a residential facility for postsecondary 
technical training and education for persons who are deaf. NTID 
also provides support services for students who are deaf, 
trains professionals in the field of deafness, and conducts 
applied research.
    Regional STEM Center.--The Committee recommendation 
includes up to $9,500,000 to continue NTID's current Regional 
STEM Center partnership. The STEM Center program expands NTID's 
geographical reach and improves access to postsecondary STEM 
education and employment for students who are deaf or hard of 
hearing in underserved areas. This has included professional 
development for teachers, developing relationships with 
business and industry to promote employment opportunities, and 
preparing students to be successful in STEM fields.

                          GALLAUDET UNIVERSITY

Appropriations, 2024....................................    $167,361,000
Budget estimate, 2025...................................     165,361,000
Committee recommendation................................     171,361,000

    The Committee recommends $171,361,000 for Gallaudet 
University.
    Gallaudet University is a private, not-for-profit 
institution offering undergraduate and continuing education 
programs for students who are deaf, as well as graduate 
programs in fields related to deafness for students who are 
hearing and deaf. The university conducts basic and applied 
research related to hearing impairments and provides public 
service programs for the deaf community.
    This funding also supports the Model Secondary School for 
the Deaf, which serves as a laboratory for educational 
experimentation and development; disseminates curricula, 
materials, and models of instruction for students who are deaf; 
and prepares adolescents who are deaf for postsecondary 
academic or vocational education or the workplace. The 
university's Kendall Demonstration Elementary School develops 
and provides instruction for children from infancy through age 
15.
    Early Language Acquisition Project [ELAP].--Within the 
total, the Committee recommendation includes $8,500,000 for 
ELAP, with its current partner as the lead agent for program 
expansion. ELAP supports early language acquisition for 
children from birth through age three who are deaf or hard of 
hearing. This program also supports activities to improve early 
language acquisition training for early educators, caretakers, 
and other professionals and allows Gallaudet to expand and 
build on its current research in this area, and test and 
evaluate interventions in diverse geographic areas.

                 Career, Technical, and Adult Education

Appropriations, 2024....................................  $2,181,436,000
Budget estimate, 2025...................................   2,268,436,000
Committee recommendation................................   2,226,436,000

Career and Technical Education

    The Committee recommends $1,497,269,000 for Career and 
Technical Education [CTE] programs.
    State Grants.--The Committee recommends $1,474,848,000 for 
CTE State grants. Funds provided under the State grant program 
assist States, localities, and outlying areas to expand and 
improve their CTE programs and ensure equal access to CTE for 
populations with special needs. Persons assisted range from 
secondary students in pre-vocational courses through adults who 
need retraining to adapt to changing technological and labor 
market conditions. Per the authorization of the program, after 
reservations for required set-asides and small State minimums, 
funds are distributed to a baseline level of the amount awarded 
to each State in fiscal year 2018, with any remaining funds 
allocated according to a formula based on State population and 
State per capita income.
    Under the Indian and Hawaiian Natives programs, competitive 
grants are awarded to federally recognized Indian Tribes or 
Tribal organizations and to organizations primarily serving and 
representing Hawaiian Natives for services that are additional 
to what these groups receive under other provisions of the 
Perkins Act (Public Law 88-210).
    Of the funds available for this program, $683,848,000 will 
become available July 1, 2025, and $791,000,000 will become 
available on October 1, 2025. These funds will remain available 
for obligation until September 30, 2026.
    National Activities.--The Committee recommendation includes 
$22,421,000 for national activities, including up to 
$16,100,000 for Innovation and Modernization grants.
    The Committee continues to encourage the Department to work 
with the Departments of Defense, Labor, and Commerce to develop 
a pilot project to increase the quality of, and participation 
in, CTE programs related to the skills needed for new submarine 
construction.
    The Committee strongly encourages the Department to include 
a priority for projects that include, as a component of an 
innovative career and technical education program, evidence-
based school-based mentoring activities focused on providing 
students with social-emotional and other skills and experiences 
needed to be successful in the workplace in any new 
competitions under the Innovation and Modernization grants 
authority.
    The Committee requests the Department provide a briefing to 
the Committee 180 days after enactment detailing any plans the 
Department has to include a priority for grants that support 
the establishment of online savings accounts as authorized 
under the Innovation and Modernization Grants authority in 
section 114(e) of the Perkins Act.
    The Committee encourages the Department to update and 
reissue the Beyond the Box guidance to support increased access 
to higher education for justice-involved individuals.
    The Committee recognizes the importance of preparing 
students for postsecondary education and the workforce through 
the Career Connected High School Program. This program provides 
students with access to dual enrollment, work-based learning 
opportunities, career navigation systems, and prioritizes 
opportunities for students from families with low incomes and 
students living in rural areas. The Committee directs the 
Department to develop guidance on best practices from grantees 
in this program and ways States can adopt and implement these 
best practices statewide, including policies to align high 
school coursework with postsecondary credit-bearing coursework; 
ensure credit transfer; and develop programs of study that 
allow students to attain an industry recognized credential in 
high school and culminate with an associate, bachelor's or 
advanced degree or completion of a Registered Apprenticeship 
program after high school.

Adult Education

    The Committee recommends $729,167,000 for Adult Education 
programs.
    Adult Education State Grants.--The Committee recommendation 
includes $715,455,000 for Adult Education State Grants which 
provide funding for States for programs that assist adults in 
becoming literate and in obtaining the skills necessary for 
employment and self-sufficiency.
    National Leadership Activities.--The Committee recommends 
$13,712,000 for adult education national leadership activities.
    The Committee encourages the Department to support 
technical assistance that will help build the evidence-base of 
adult education programs, including supporting States in 
prioritizing rigorously evaluated programs and the development 
of rigorous evidence such as funding randomized control trials, 
quasi-experimental studies and other evaluation methods that 
provide for a causal understanding of the effects of programs.
    The Committee also encourages the Department to prioritize 
activities that reengage adults who have dropped out of the 
labor force, with a priority on States that have low labor 
participation rates.

                      Student Financial Assistance

Appropriations, 2024.................................... $24,615,352,000
Budget estimate, 2025...................................  26,716,352,000
Committee recommendation................................  24,615,352,000

    The Committee recommends an appropriation of 
$24,615,352,000 for programs under the Student Financial 
Assistance account.

Federal Pell Grant Program

    The Committee recommends $22,475,352,000 in current year 
discretionary funding for the Pell grant program.
    The Committee recommendation includes $6,435 for the 
discretionary portion of the maximum Pell grant award, an 
increase of $100. Combined with mandatory funding, under 
current law, this would provide a total maximum award of $7,495 
for the 2025-2026 award year.
    Pell Grant Restoration and Prison Education Program.--The 
Committee continues to recognize the significance of restoring 
Pell Grant access for incarcerated individuals and the impact 
that will have on reestablishing effective prison education 
programs across the country, and ultimately reducing recidivism 
rates and saving taxpayer dollars by reducing the overall cost 
of incarceration. The Committee directs the Department to 
continue the Second Chance Pell Pilot program as the Department 
finalizes implementation of the full Pell Grant reinstatement. 
The Committee encourages the Department to use the expertise 
and best practices from the Pilot to develop guidance and 
technical assistance for the new Prison Education Program. The 
Committee further directs the Department to work with Second 
Chance Pell Pilot sites as they transition to the requirements 
under the new Prison Education Program to ensure that 
incarcerated students do not experience a gap in their 
educational programming. In addition, the Committee strongly 
encourages the Department to notify institutions of higher 
education (particularly those that operate Second Chance Pell 
Pilot sites), the Bureau of Prisons, State departments of 
corrections, county and local jail administrators, and 
institutional accrediting agencies about the new Prison 
Education Program. Further, the Committee expects the 
Department will provide technical assistance and guidance to 
Second Chance Pell sites to ensure that they have enough time 
and information to prepare and apply for Prison Education 
Program approval.
    As a part of the new Prison Education Program, the 
Committee encourages the Department, in coordination with the 
Department of Justice, to develop and provide technical 
assistance and guidance to participating institutions of higher 
education on how to support formerly incarcerated students as 
they leave prison, reenter society, and reenroll in 
postsecondary education. This guidance should address evidence-
based strategies for helping formerly incarcerated people to 
secure housing, employment, and other Federal benefits, as well 
as re-enroll in college, access Federal and State financial 
aid, and secure campus housing and student employment. The 
Department should convey to institutions of higher education 
that they should work to ensure that every student who 
participates in the new Prison Education Program is able to 
reenter their communities successfully post-release.
    Experimental Site Initiatives.--The Committee encourages 
the Department to pilot activities to support and encourage 
accelerated, cost-effective, 3-year bachelor's degree programs, 
such as the ``College in 3'' project.

Federal Supplemental Educational Opportunity Grant Program

    The Committee recommends $910,000,000 for the Supplemental 
Educational Opportunity Grant [SEOG] program. The SEOG program 
provides funds to institutions of higher education for need-
based grants to students. Institutions must contribute at least 
25 percent toward SEOG awards.

Federal Work-Study Program

    The Committee bill provides $1,230,000,000 for the Federal 
Work-Study [FWS] program. This program provides grants to 
institutions of higher education to help undergraduate, 
graduate, and professional students meet the costs of 
postsecondary education through part-time employment. 
Institutions must provide at least 25 percent of student 
earnings.
    Within the total for FWS, the Committee recommendation 
includes $11,053,000, for the Work Colleges program authorized 
under section 448 of the Higher Education Act [HEA] (Public Law 
89-329), as amended.

                       Student Aid Administration

Appropriations, 2024....................................  $2,058,943,000
Budget estimate, 2025...................................   2,659,126,000
Committee recommendation................................   2,158,943,000

    The Committee recommends $2,158,943,000 for the Student Aid 
Administration account. These funds are available until 
September 30, 2026, and support the Department's student aid 
management expenses.
    The Committee recommendation includes an increase in 
funding to support increased costs associated with servicing 
Federal student loans, FAFSA Simplification Act implementation, 
and helping support borrowers effectively.
    The Committee directs the Department to provide a detailed 
spend plan of the planned uses of funds in this account within 
45 days of enactment, and to provide quarterly briefings on its 
implementation not later than 10 days prior to the start of the 
quarter. This should continue to include, but not be limited 
to, detailed breakouts by baseline operations and development 
efforts; and servicing, student aid core systems, IT 
activities, and other Federal Student Aid activities. These 
spend plans should also include details on major activities, 
including implementation of the Unified Servicing and Data 
Solution [USDS], FUTURE Act, and FAFSA Simplification Act, and 
other activities as appropriate. Further, the spend plan should 
include a crosswalk to activities funded under administrative 
costs and servicing activities, and any reallocation of funds 
between those two activities should be treated as a 
reprogramming of funds, and the Committees should be notified 
in advance of any such changes.
    The Committee recommendation also continues the requirement 
for the Department to provide quarterly briefings on Federal 
student loan servicing contracts, including the transition to 
USDS. Additionally, the Department is directed to continue to 
notify the Committees of awarded contract Change Requests from 
the preceding month by the 10th day of the next calendar month 
regarding changes to student loan servicing.
    Timely FAFSA Launch.--The Committee is concerned about the 
challenges students and institutions faced due to the difficult 
launch of the Free Application for Federal Student Aid for the 
2024-2025 award year. The Committee strongly recommends that 
the Department ensures that the FAFSA is available on October 1 
and ensures full functionality for the 2025-2026 FAFSA upon 
launch. This shall include FAFSA processing, school receipt of 
processed FAFSAs, processing of paper FAFSAs, and FAFSA 
correction functionality for applicants, institutions of higher 
education, and States. In advance of the October 1st launch, 
the Committee urges a timely release of the Federal student aid 
estimator, the FAFSA demonstration site, communication and 
training materials, a user-friendly Pell look-up table, 
eligibility and technical guides, and a quick, effective, and 
secure process for attaining an FSA ID. Funds provided under 
this account should be allocated to improve customer service, 
including by conducting rigorous consumer testing as required 
by law. The Committee urges the Department to communicate a 
timeline for the complete 2025-2026 FAFSA launch as soon as 
possible and directs the Department to provide weekly briefings 
on the timeline, consumer testing, and bug fixes on the 2025-
2026 FAFSA and related processes, including the creating of the 
FSA ID, transmission of ISIRs, and availability of corrections. 
The Committee remains concerned about the number of students 
whose FAFSA applications remain incomplete after beginning the 
application process due to errors that occurred during the 
launch of the 2024-2025 FAFSA. To address this issue, the 
Department is directed to utilize outreach processes to 
identify and assist students who have begun, but not 
successfully submitted a complete FAFSA application for both 
the 2024-2025 FAFSA and the 2025-2026 FAFSA. The Committee 
further directs the Department to provide a detailed launch 
plan for the FAFSA for the upcoming award year no later than 10 
days after enactment of this act. Should the launch of the form 
be delayed after October 1 of the year prior to the upcoming 
award year, the Department shall provide the Committees, the 
Senate Committee on Health, Education, Labor and Pensions, and 
the House Committee on Education and the Workforce with written 
notification and a written timeline for the upcoming FAFSA 
launch no later than 10 days after enactment of this act and 
continue to update the written notification and written 
timeline every week until complete.
    FAFSA Data.--Not later than 30 days after the date of 
enactment of this act, the Secretary shall report to the 
Committees, the House Committee on Education and Workforce, and 
the Senate Committee on Health, Education, Labor, and Pensions 
relevant data compiled for the 2023-2024 and 2024-2025 award 
years, which shall include, at minimum: (1) The number of FAFSA 
submissions processed by Federal Student Aid; (2) The average 
processing turnaround time from the point of FAFSA submission 
to disbursal of aid; (3) The number of submissions which 
contained inaccuracies thereby requiring resubmission to the 
Department; (4) The amount of Federal student aid awarded 
broken down by type; and (5) The number of submissions from 
students filing during 2023-2024 which resulted in a decrease 
in aid under the Student Aid Index formula for 2024-2025.
    FAFSA Simplification Impact Analysis.--The Committee is 
interested in further analyzing the impact of major formula and 
eligibility changes included in the FAFSA Simplification Act, 
including increases to income protection allowances, the use of 
Federal poverty level for Pell Grant eligibility, receipt of 
public benefits, treatment of family farms, and number of 
students enrolled in college simultaneously. The Committee 
directs the Department to publish a distributional analysis of 
the major changes within 180 days of enactment, and to ensure 
such analysis is disaggregated by family income and dependency 
status, includes estimates of the number of recipients, gains 
and losses in aid, and both average and median changes to the 
Student Aid Index, as applicable. Additionally, the Committee 
encourages the Department to project differences in aid 
recipients over time from such changes and include detailed 
explanations of such projections.
    Unaccompanied Homeless Youth and Other Students Without 
Parent or Family Support.--The Committee is concerned that 
youth who do not have parental support are experiencing 
significant challenges completing the FAFSA and financial aid 
process. Students experiencing, or at risk of, homelessness and 
who do not have documentation have been incorrectly categorized 
as provisionally independent and have been arbitrarily limited 
in how they can document their experience with homelessness. In 
addition, the FAFSA form unnecessarily limits the provisional 
independence options for other students. The Committee directs 
the Department to correct these errors for the 2025-2026 cycle 
and to issue updated guidance within 60 days that clarifies and 
streamlines the ability of unaccompanied homeless youth and 
other students who do not have parental support to access 
Federal financial aid.
    FAFSA Family Farm Impact Study.--The new Student Aid Index 
formula included in the FAFSA Simplification Act (Title VII, 
Division FF of Public Law 116-260) requires students applying 
for Federal student aid to report the net worth of the farms on 
which their family resides, which could impact the eligibility 
of students to qualify for Federal student aid. The Committee 
directs the Department to conduct a study of the 2024-2025 
FAFSA data within 90 days of enactment to thoroughly understand 
the impact of the requirement for students to report the farms 
their families live on as assets for purposes of applying for 
Federal student aid.
    FAFSA Student Support Strategy.--The Committee shares the 
Department's goal of increasing FAFSA completion rates. The 
Committee directs the Department to provide a report within 120 
days on its efforts to boost FAFSA completion rates for the 
2024-2025 award year through the FAFSA Student Support 
Strategy, as managed by ECMC, announced on May 6, 2024. This 
report shall include detailed information on total funding 
obligated from the Federal Student Loan Reserve Fund for ECMC's 
use, funding amounts awarded to each grantee by ECMC, how ECMC 
selected grantees, how much each grantee spent, a summary of 
metrics ECMC and the Department used to measure grantees' 
performance, a summary of the types of activities each grantee 
used, and whether grantees tracked how many more students 
completed the FAFSA as a result of their efforts and if so, the 
number of additional students that completed the FAFSA per 
grantee.
    Interagency Coordination for Benefits Outreach and 
Financial Aid.--The Committee notes that students and families 
would benefit from additional information on public and tax 
benefit programs that can help them meet their basic needs and 
cost of attendance, and that the recipients of public and tax 
benefit programs would benefit from information on financial 
aid to help them enroll in higher education. The FAFSA 
Simplification Act supports data-sharing agreements and 
interagency coordination and outreach plans for such purposes 
under sections 483(c)(3) and 485E(c) of the HEA, respectively. 
Within 60 days of enactment, the Committee directs the 
Department to provide a briefing on the status of 
implementation of these provisions, including the establishment 
of data sharing and interagency agreements with Federal 
agencies, and other efforts to expand notifications to students 
about public and tax benefit programs. Further, the Committee 
strongly encourages the Department to promote such outreach 
through direct and regular notices to financial aid applicants, 
technical assistance to institutions, grant priorities, and 
communications with States.
    Maintaining Higher Education Transparency and Research.--
The Committee is concerned by reports that existing higher 
education research, data collection, reporting, and secure 
data-sharing organizations are being limited contrary to 
Congressional intent under the FAFSA Simplification Act. 
Collecting and publishing timely and relevant student access 
and outcome data that does not publicly release personally 
identifiable information and related analyses through 
mechanisms such as third-party research agreements, agency 
surveys, and administrative data collections with strong 
privacy protections have been and continue to be essential for 
the planning, administration, operation, and evaluation of the 
student aid programs and higher education grant programs. 
Additionally, students and their families benefit from targeted 
outreach and enrollment into public and tax benefit benefits 
for which they may be eligible and which help them afford the 
cost of college. Such data uses do not result in publicly 
disclosing personally identifiable information. The Committee 
urges the Department to maintain secure data collection, 
reporting that does not publicly release personally 
identifiable information, privacy-protected research, and 
interagency data-sharing, including tax information such as 
income and family size, as part of the administration of the 
Federal student aid programs under the HEA. Further, the 
Committee directs the Department to reaffirm such data uses in 
agency guidance to further transparency, research, evaluation, 
and accountability in higher education while still ensuring 
student privacy. Further, the Committee directs the Department 
to permit the secure use of student and family tax data, in 
accordance with Internal Revenue Service guidelines, to satisfy 
Federal data collection and reporting requirements.
    Return of Title IV Funds.--The Committee continues to 
encourage the Department to pursue efforts to simplify and 
streamline the Return of Title IV Funds process for 
institutions of higher education and students.
    Return to Repayment.--The Committee directs the Secretary 
to provide monthly briefings and reports to the Committees and 
to the Committees on Education and the Workforce of the House 
of Representatives and on Health, Education, Labor, and 
Pensions of the Senate on student aid administrative activities 
and data for Federal student loans during fiscal year 2025. 
Information should include, but not be limited to, borrower 
status, including the percentage of total borrowers and the 
percentage of at-risk borrowers (defined as borrowers who have 
one or more of the following risk factors: a previous history 
of default, missing a payment in the first 3 months of entering 
repayment, not completing their degree program, or pausing 
payments multiple times) in repayment in repayment by repayment 
plan; the percentage of borrowers and the percentage of at-risk 
borrowers who are delinquent or not making payments; share of 
borrowers at-risk of defaulting on their student loans 
currently in active repayment, by repayment plan; average and 
median amount repaid through the duration of repayment by 
repayment plan; average and median income of borrowers who 
receive forgiveness through IDR; share of borrowers making $0 
payments; metrics on communications with borrowers in the 
Targeted Early Delinquency Intervention [TEDI] program and 
equivalent programs and Fresh Start segment or equivalent 
support program such as open and click through rates for emails 
and repayment actions; and any changes to communications with 
borrowers based on data or behavioral economics assumptions 
gathered during communications campaigns. The Committee also 
directs the Department to produce and broadly disseminate an 
accessible public report that summarizes this data on an annual 
basis.
    College Scorecard.--The Committee recognizes the value of 
institution-level outcomes data, including graduation rates, 
student loan repayment rates, and post-college earnings data 
for higher education accountability and directs the Department 
to update the College Scorecard's data annually. The Committee 
also encourages the Department to continue refining the 
existing measures on the College Scorecard and examining new 
measures to add to maximize transparency about postsecondary 
educational opportunities and outcomes for students.
    State-Based and Non-Profit Servicing Organizations.--The 
Committee continues to note that many State-based and non-
profit servicing organizations have demonstrated and 
specialized experience in helping struggling borrowers, and 
continues to encourage the Department and Federal student loan 
servicers to work with state and nonprofit organizations to 
help student and parent borrowers repay their Federal student 
loans.
    Federal Fund, Operating Fund, and Guaranty Agency 
Reporting.--Not later than 180 days after enactment, the 
Department is directed to produce and make publicly available 
on the FSA Data Center, a report regarding the Federal Funds 
authorized under section 422A of the HEA and the Operating 
Funds authorized under section 422B of the HEA. The Committee 
directs such report to include the following for each guaranty 
agency: total amount in the Federal Fund and total amount in 
the Operating Fund available for obligation, a list of 
obligations (detailed by amount, recipient, and purpose) from 
the previous fiscal year from each of the Federal Fund and the 
Operating Fund, the total amount the Secretary transferred to 
the Operating Fund in the previous fiscal year, changes in the 
Federal Fund and Operating Fund and forecasted performance of 
the guaranty agencies, and how the Department ensures effective 
oversight of both the Federal Fund and any transfers into the 
Operating Fund. The report shall also include, for each 
guaranty agency, how much from the Federal Fund was obligated 
to Project Success for the previous fiscal year, a list of 
Project Success partner institutions for that fiscal year, a 
summary by partner institution of what Project Success funds 
were spent on in that fiscal year, and for each guaranty agency 
and partner institution (as applicable), the metrics the 
Department is using to evaluate the effectiveness of the 
Project Success funds, how the Department selected current 
Project Success partner entities, and how many students were 
served by each Project Success partner entity. Finally, the 
report should include what is communicated to Guaranty Agencies 
when Federal funds are released for any grantmaking or 
programmatic purposes, including about the duration of project 
performance, the timely outlaying of funds for agreed upon 
activities, what percent of funds are allowed be held onto by 
Guaranty Agencies for administrative or indirect costs, and how 
the Department ensures Guaranty Agencies are adhering to basic 
grantmaking standards and requirements such as the standards 
and requirements other entities are required to adhere to in 
EDGAR.
    Promoting Safe Campuses.--The Committee is concerned by 
reports of increased discrimination on college campuses, 
including hate crimes motivated by anti-Semitic and anti-Muslim 
prejudice. As Federal Student Aid conducts its fiscal year 2025 
work on enforcement of the Jeanne Clery Disclosure of Campus 
Security Policy and Campus Crime Statistics Act [Clery Act], 
including complaint assessments, media assessments, and program 
reviews, the Committee encourages Federal Student Aid to 
include institutions where known anti-Semitic or anti-Muslim 
hate crimes have occurred during the 2023-2024 academic year in 
such assessments and reviews. The Committee further encourages 
the Department to issue appropriate and timely fines for 
violations of the Clery Act.
    Student Loan Dashboard.--The Committee directs the 
Department to study the best way to create a government-wide 
student loan dashboard that provides prospective students and 
their families with comprehensive and easy to understand 
information about the availability of Federal student loans and 
Federal student loan repayment programs across the Federal 
Government, including eligibility requirements, application 
information, loan type, and repayment terms. In conducting this 
study, the Department shall examine how existing government-
wide resources could be updated and shall consult with the 
relevant Federal agencies that administer Federal student loans 
and Federal student loan repayment programs, as the Department 
determines appropriate. The study shall also include a plan for 
how a government-wide student loan dashboard could be 
implemented within 180 days of completion of the study. The 
Department shall share this study with the Committees, the 
Senate Committee on Health, Education, Labor and Pensions, and 
the House Committee on Education and the Workforce within 1 
year of enactment of this bill.

                            Higher Education

Appropriations, 2024....................................  $3,283,296,000
Budget estimate, 2025...................................   3,343,247,000
Committee recommendation................................   3,352,102,000

    The Committee recommends an appropriation of $3,352,102,000 
for higher education programs.

Aid for Institutional Development

    The Committee recommends $1,034,618,000 for Aid for 
Institutional Development. These totals do not include 
separately authorized and appropriated mandatory funding.
    Strengthening Institutions.--The Committee recommends 
$113,719,000 to provide competitive, 1-year planning and 5-year 
development grants for institutions with a significant 
percentage of students with financial need and with low 
educational and general expenditures per student in comparison 
with similar institutions. Applicants may use these funds to 
develop faculty, strengthen academic programs, improve 
institutional management, and expand student services.
    Hispanic-Serving Institutions [HSIs].--The Committee 
recommends $232,257,000 for competitive grants to institutions 
at which Hispanic students make up at least 25 percent of 
enrollment. Funds may be used for acquisition, rental, or lease 
of scientific or laboratory equipment; renovation of 
instructional facilities; development of faculty; support for 
academic programs; institutional management; and purchase of 
educational materials.
    The Committee continues to support funding for programs 
that promote and support collaboration between Hispanic-serving 
institutions and LEAs that serve a significant number or 
percentage of Hispanic or Latino students for the purpose of 
improving educational attainment, including increasing high 
school graduation rates and postsecondary enrollment, transfer, 
and completion rates among Hispanic or Latino students, such as 
by strengthening pathways to postsecondary and workforce 
development programs.
    Promoting Postbaccalaureate Opportunities for Hispanic 
Americans.--The Committee recommends $27,855,000 for 
competitive, 5-year grants to HSIs to help Hispanic Americans 
gain entry into and succeed in graduate study. Institutions may 
use funding to support low-income students through outreach 
programs; academic support services; mentoring and financial 
assistance; acquisition, rental, or lease of scientific or 
laboratory equipment; construction and other facilities 
improvements; and purchase of educational materials.
    The Committee continues to encourage the Department to 
prioritize awards for projects that support consortiums of HSIs 
that award PhDs to develop and test new models of cross-
institutional partnerships that facilitate mutually reinforcing 
activities, such as resource-sharing learning communities, 
mentorship programs for PhD students, graduate research 
experiences, faculty mentor capacity-building, and other uses 
associated with the pursuit and completion of PhDs by Hispanic 
students.
    Strengthening Historically Black Colleges and Universities 
[HBCUs].--The Committee recommends $406,865,000 for the 
Strengthening HBCUs program. The program makes formula grants 
to HBCUs that may be used to purchase equipment; construct and 
renovate facilities; develop faculty; support academic 
programs; strengthen institutional management; enhance 
fundraising activities; provide tutoring and counseling 
services to students; and conduct outreach to elementary and 
secondary school students.
    Strengthening Historically Black Graduate Institutions 
[HBGIs].--The Committee recommends $102,776,000 for the 
Strengthening HBGIs program. This program provides 5-year 
grants to provide scholarships for low-income students and 
academic and counseling services to improve student success. 
Funds may also be used for construction, maintenance, and 
renovation activities; the purchase or lease of scientific and 
laboratory equipment; and the establishment of an endowment.
    Strengthening Predominantly Black Institutions [PBIs].--The 
Committee recommends $22,742,000 for the Strengthening PBIs 
program. This program provides 5-year grants to PBIs to plan 
and implement programs to enhance their capacity to serve more 
low- and middle-income students.
    Strengthening Asian American and Native American Pacific 
Islander-Serving Institutions [AANAPISIs].--The Committee 
recommends $18,957,000 for competitive grants to AANAPISIs that 
have an enrollment of undergraduate students that is at least 
10 percent Asian American or Native American Pacific Islander 
students. Grants may be used to improve their capacity to serve 
Asian American and Native American Pacific Islander students 
and low-income individuals.
    Strengthening Alaska Native and Native Hawaiian-Serving 
Institutions [ANNHs].--The Committee recommends $24,916,000 for 
the Strengthening ANNHs program. The purpose of this program is 
to improve and expand the capacity of institutions serving 
Alaska Native and Native Hawaiian students and low-income 
individuals. Funds may be used to plan, develop, and implement 
activities that encourage faculty and curriculum development; 
improve administrative management; renovate educational 
facilities; enhance student services; purchase library and 
other educational materials; and provide education or 
counseling services designed to improve the financial and 
economic literacy of students or their families. The Committee 
includes new bill language that will permit ANNH grantees to 
use funding for construction and maintenance of classrooms, 
libraries, and other instructional facilities.
    Strengthening Native American-Serving Non-Tribal 
Institutions.--The Committee recommends $11,630,000 for this 
program, which serves institutions that enroll at least 10 
percent Native American students and at least 50 percent low-
income students. This program helps institutions plan, develop, 
and implement activities that encourage faculty and curriculum 
development; improve administrative management; renovate 
educational facilities; enhance student services; and purchase 
library and other educational materials. The Committee includes 
new bill language that will permit grantees to use funding for 
construction and maintenance of classrooms, libraries, and 
other instructional facilities.
    Strengthening Tribally Controlled Colleges and Universities 
[TCCUs].--The Committee recommends $52,569,000 for this 
program. Tribal colleges and universities rely on a portion of 
the funds provided to address developmental needs, including 
faculty development, curriculum, and student services. Funds 
can also be used for construction and renovation. The Committee 
notes that our Nation's Tribal colleges and universities have 
significant unmet infrastructure needs. Tribal colleges are 
also uniquely situated--they often lack access to State funding 
and other resources available to other public institutions of 
higher education. The GAO is directed to conduct a study on the 
infrastructure and construction needs of Tribal colleges and 
universities, including access to broadband, and include 
recommendations for how the Federal Government can best address 
the unique needs and treaty obligations of Tribal colleges and 
universities.
    Strengthening Master's Degree Programs at Historically 
Black Colleges and Universities.--The Committee recommends 
$20,332,000 for this program, authorized by section 723 of the 
HEA. This program provides grants to specified colleges and 
universities making a substantial contribution to graduate 
education opportunities at the master's level in mathematics, 
engineering, the physical or natural sciences, computer 
science, information technology, nursing, allied health, or 
other scientific disciplines.

International Education and Foreign Language Studies

    The bill includes a total of $85,664,000 for International 
Education and Foreign Language Studies programs. Funds are used 
to increase the number of experts in foreign languages and area 
or international studies to meet national security needs 
through visits and study in foreign countries.
    Domestic Programs.--The Committee recommends $75,353,000 
for domestic program activities related to international 
education and foreign language studies under title VI of the 
HEA. Funds are used to support centers, programs, and 
fellowships. The Committee urges the Secretary to preserve the 
program's longstanding focus on activities and institutions 
that address the Nation's need for a strong training and 
research capacity in foreign languages and international 
studies, including increasing the pool of international experts 
in areas that are essential to national security and economic 
competitiveness.
    Overseas Programs.--The Committee recommends $10,311,000 
for overseas programs authorized under the Mutual Educational 
and Cultural Exchange Act of 1961 (Public Law 87-256), 
popularly known as the Fulbright-Hays Act. Funding is provided 
for group, faculty, or doctoral dissertation research abroad, 
as well as special bilateral projects. Grants focus on training 
American instructors and students to improve foreign language 
and area studies education in the United States.
    Institute for International Public Policy [IIPP].--The 
Committee recognizes the important role played by institutions 
of higher education, particularly HBCUs and other minority-
serving institutions [MSIs], in educating future cohorts of 
foreign service professionals representing of our Nation. Title 
VI of the HEA authorizes grants to establish an IIPP. This 
funding supports consortium of one or more HBCUs or MSIs to 
develop career pathways for students from underrepresented 
backgrounds to develop language competence, engage in overseas 
study, participate in foreign policy seminars, and acquire 
internship experiences. The Committee supports a relaunch of 
this program to assist the State Department, USAID, and other 
international affairs agencies in recruiting top talent at a 
time when complex global challenges are on the rise amidst 
ongoing staffing shortages. The Committee requests the 
Department to provide a briefing to the Committees within 120 
days of enactment about how the Department could support 
efforts to strengthen the pipeline of individuals into foreign 
policy careers and include options for how IIPP could be 
relaunched in its fiscal year 2026 CJs.

Model Transition Programs for Students With Intellectual Disabilities 
        into Higher Education

    The Committee recommendation includes $13,800,000 for the 
Model Transition Programs for Students with Intellectual 
Disabilities into Higher Education [TPSID] program. The TPSID 
program provides competitive grants to institutions of higher 
education or consortia of institutions of higher education to 
enable them to create or expand high quality, inclusive model 
comprehensive transition and postsecondary programs for 
students with intellectual disabilities. The TPSID program also 
supports a national Coordinating Center and a technical 
assistance center to translate and disseminate research and 
best practices to IHEs more broadly.

Minority Science and Engineering Improvement

    The Committee recommends $16,370,000 for the Minority 
Science and Engineering Improvement program. Funds are used to 
provide discretionary grants to institutions with minority 
enrollments greater than 50 percent to purchase equipment, 
develop curricula, and support advanced faculty training. 
Grants are intended to improve science and engineering 
education programs and increase the number of minority students 
in the fields of science, mathematics, and engineering.

Tribally Controlled Postsecondary Career and Technical Institutions

    The Committee recommends $11,953,000 for tribally 
controlled postsecondary vocational institutions. This program 
provides grants for the operation and improvement of tribally 
controlled postsecondary vocational institutions to ensure 
continued and expanding opportunities for Indian students.

Federal TRIO Programs

    The Committee recommends $1,211,000,000 for Federal TRIO 
programs, which provide a variety of services to improve 
postsecondary education opportunities for low-income 
individuals and first-generation college students. This 
includes: Upward Bound which offers disadvantaged high school 
students academic services to develop the skills and motivation 
needed to pursue and complete a postsecondary education; 
Student Support Services which provides developmental 
instruction, counseling, summer programs, and grant aid to 
disadvantaged college students to help them complete their 
postsecondary education; Talent Search which identifies and 
counsels individuals between ages 11 and 27 regarding 
opportunities for completing high school and enrolling in 
postsecondary education; Educational Opportunity Centers [EOC] 
which provide information and counseling on available financial 
and academic assistance to low-income adults who are first-
generation college students; and the Ronald E. McNair 
Postbaccalaureate Achievement Program which supports research 
internships, seminars, tutoring, and other activities to 
encourage disadvantaged college students to enroll in doctoral 
programs.
    The Committee continues to direct the Department to include 
estimated funding for each TRIO program in the operating plan 
required under section 516 of this act.
    TRIO and Justice-Impacted Students.--The Committee 
recognizes that EOCs have a long history of helping justice-
impacted adults to enroll in college. The restoration of Pell 
Grants for people in prison presents an opportunity for EOCs to 
reach more students. The Committee encourages the Department to 
provide technical assistance and guidance to EOCs on best 
practices for supporting justice-impacted students, including 
examples of programs that can serve as models to others. In 
addition, the Committee encourages the Department to consider 
how other TRIO programs can support justice-impacted students 
and provide guidance to institutions of higher education.

Gaining Early Awareness and Readiness for Undergraduate Programs [GEAR 
        UP]

    The Committee recommends $393,000,000 for GEAR UP, which 
provides grants to States and partnerships of colleges, middle 
and high schools, and community organizations to assist cohorts 
or students in middle and high schools serving a high 
percentage of low-income students. Services provided help 
students prepare for and pursue a postsecondary education.
    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 longstanding 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, 2025 will be eligible 
to receive a new State GEAR UP award funded in whole or in part 
by this appropriation. In making new awards, the Department 
shall ensure that not less than 33 percent of the new award 
funds are allocated to State awards, and that not less than 33 
percent of the new award funds are allocated to Partnerships 
awards, as described in section 404(b) of the HEA. The 
Secretary is further directed to ensure that no request from a 
State Grant applicant to receive an exception to the GEAR UP 
scholarship 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 $23,547,000 to support the 
Graduate Assistance in Areas of National Need [GAANN] program. 
GAANN supports fellowships through 3-year competitive grants to 
graduate academic departments and programs in scientific and 
technical fields and other areas of national need as determined 
by the Secretary. Fellowship recipients must have excellent 
academic records and high financial need and must be pursuing 
doctoral degrees or the highest graduate degrees in their 
academic field. Each fellowship consists of a student stipend 
to cover living costs and an institutional payment to cover 
each fellow's tuition and other expenses. Institutions of 
higher education must match 25 percent of the grant amount.

Teacher Quality Partnership Program

    The Committee recommends $70,000,000 for the Teacher 
Quality Partnership [TQP] program. The TQP program helps 
improve the quality of teachers working in high-need schools 
and early childhood education programs by supporting teacher 
preparation and residency programs.
    The Committee recognizes the increasing number of and 
demand for ``Grow Your Own'' teacher preparation programs in 
our Nation. The Committee urges the Department to continue to 
support ``Grow Your Own'' teacher preparation programs, with a 
focus on programs that increase recruitment efforts in local 
communities, provide high quality pathways into the profession, 
improve teacher retention, and improve student outcomes.
    The Committee also notes the need to ensure future teachers 
are well trained in data literacy, including how to use data in 
the classroom to differentiate instruction and improve student 
outcomes. The Committee urges the Department to prioritize TQP 
funding for applicants that seek to develop data literacy 
skills in future teachers.
    Educator Specialization.--The Committee encourages the 
Department to add a new priority in future competitions for 
projects that support the development of new systems of 
workforce development for teachers that include supports, clear 
pathways to advancement, and promote teacher retention.

Child Care Access Means Parents in Schools

    The Committee recommendation includes $80,000,000 for the 
Child Care Access Means Parents in Schools [CCAMPIS] program. 
This program provides competitive grants to institutions of 
higher education to establish or support campus-based child 
care programs, to help support needs and participation of low-
income parents in post-secondary education.
    The Committee directs the Department to prioritize grants 
to eligible entities serving a significant percentage of Pell-
eligible or other low-income students. The Committee urges the 
Department to prioritize grants to eligible entities that 
propose flexible child care arrangements (such as evening, 
weekend, and drop-in child care) in any future competition. The 
Committee further urges the Department to prioritize grantees 
who will conduct direct outreach to parenting students 
regarding State and Federal public benefits, the Child Tax 
Credit, and education tax benefits for which the student parent 
may be eligible. The Committee also urges the Department to 
require new grantees to collect data on the total number of 
parenting students enrolled at the institution and the number 
of parenting students served by CCAMPIS grant funds. 
Additionally, the Committee strongly encourages the Department 
to assist grantees in leveraging other funding opportunities to 
help parenting students afford child care, by providing 
technical assistance and other support to grantees.

Fund for the Improvement of Post-Secondary Education

    The Committee recommendation includes $191,000,000 for the 
Fund for the Improvement of Post-Secondary Education.
    Basic Needs Systems Grants.--The Committee recommendation 
includes $15,000,000 for competitive grants to IHEs (as defined 
in section 101 of the HEA), consortia of such IHEs, systems of 
higher education, or States to advance systemic solutions to 
student basic needs insecurity. Such grants shall include one 
or more of the following activities: establishing processes to 
automatically identify and conduct outreach students who may be 
eligible for public and tax benefit programs; conducting 
surveys or assessments of student basic needs security, 
including surveys of student needs conducted upon enrollment; 
providing referrals or case management to students to enroll in 
local, State, and Federal public and tax benefit programs; or 
coordinating and collaborating with government and community-
based organizations to execute such activities. Activities may 
also include providing direct services such as temporary or 
affordable housing, free or subsidized food, access to on-
campus childcare, and connecting students to mental and 
behavioral health services, so long as such activities are part 
of systemic plan to address and prevent student basic needs 
insecurity. The Committee directs the Department to prioritize 
eligible entities enrolling or serving a significant percentage 
of Pell-eligible or other low-income students, including 
community colleges, HBCUs, and other MSIs.
    Centers of Excellence for Veteran Student Success 
Program.--The Committee recommendation includes $9,000,000 for 
the Centers of Excellence for Veteran Student Success Program.
    Open Textbook Pilot.--The Committee recommendation includes 
$9,000,000 for the Open Textbook Pilot program. The Committee 
directs the Department to issue a notice inviting applications, 
allow for a 60-day application period, and make a significant 
number of grant awards under the same terms and conditions as 
in prior years.
    National Center for Information and Technical Support for 
Postsecondary Students with Disabilities.--The Committee 
recommendation includes $2,000,000 for the continued operation 
of the National Center for Information and Technical Support 
for Postsecondary Students with Disabilities, also known as the 
National Center for College Students with Disabilities, as 
authorized under section 777(a) of the HEA.
    Postsecondary Student Success Grants.--The Committee 
recommendation includes $50,000,000 for Postsecondary Student 
Success Grants, to scale evidence-based practices and reforms 
to improve postsecondary retention and completion rates among 
underserved students. These funds support grants to States, 
TCCUs, and systems of institutions of higher education to 
implement or expand evidence-based, statewide, and 
institutional level practices and reforms that improve student 
outcomes, including enrollment, retention, transfer, and 
completion among underserved students including students of 
color, low-income students, students with disabilities, 
students in need of remediation, first generation college 
students, homeless youth, foster youth, and student parents. 
The Committee directs the Department continue to carry out this 
program as a tiered-evidence competition, and require rigorous 
independent evaluations of grantee projects. The Committee 
further directs the Secretary to prioritize the awarding of 
Postsecondary Student Success grants to institutions of higher 
education that serve a significant percentage of Pell-eligible 
or other low-income students and that have a demonstrated 
commitment to implementing evidence-based strategies to improve 
student outcomes for such underserved students.
    Research and Development Infrastructure Investments at 
HBCUs, TCCUs, and MSIs.--The Committee recommendation includes 
$51,000,000 to increase the capacity of HBCUs, TCCUs, and MSIs 
to conduct innovative research in emerging technology and 
industries. These funds support planning and implementation 
grants designed to promote transformational investments in 
research infrastructure, such as physical infrastructure, 
capital improvement, research-related equipment, and hiring and 
retaining of faculty and research-related staff.
    Rural Postsecondary and Economic Development Grant 
Program.--The Committee recommendation includes $50,000,000 for 
the Rural Postsecondary and Economic Development [RPED] Grant 
Program. The Committee recognizes that rural-serving 
institutions and communities face unique challenges and 
barriers. In particular, smaller, rural-serving colleges, 
universities and non-profit organizations may have 
significantly fewer staff, and less experience, in preparing to 
respond to Federal grant opportunities. The Committee 
encourages the Department to consider ways to better support 
rural applicants by recognizing the unique challenges facing 
rural communities, including but not limited to providing 
greater flexibility, longer application timelines, and targeted 
technical assistance for RPED grants.
    Transitioning Gang Involved Youth.--The Committee 
recommendation includes $5,000,000 for the Transitioning Gang 
Involved Youth program.

Congressionally Directed Spending

    The Committee recommendation includes $206,150,000 for the 
projects, and in the amounts, specified in the table at the end 
of this Committee Report.

Hawkins Centers of Excellence

    The Committee recommendation includes $15,000,000 for 
Hawkins Centers of Excellence. This program supports the 
expansion and improvement of teacher education programs at 
HBCUs and other MSIs in order to support diverse, well-
prepared, and effective educators.
    The Committee recognizes the importance of high-quality 
teacher preparation on student learning and teacher retention, 
and therefore directs the Secretary to prioritize grants to 
eligible institutions that propose to establish or scale up 
high-quality teacher preparation pathways that offer extensive 
preservice clinical training and mentoring by exemplary 
teachers in grade and subject areas deemed high need by their 
state. The Committee also recognizes the value of a diverse 
teacher workforce and directs the Secretary to prioritize 
grants to eligible institutions that commit to providing 
scholarships or grants, based on financial need, as well as 
academic supports to help teacher candidates successfully 
complete the preparation program and state licensure 
requirements, and to publicly report on these efforts and 
outcomes.

                           Howard University

Appropriations, 2024....................................    $304,018,000
Budget estimate, 2025...................................     297,018,000
Committee recommendation................................     297,018,000

    The Committee recommends an appropriation of $297,018,000 
for Howard University. Located in the District of Columbia, 
Howard offers undergraduate, graduate, and professional degrees 
through 12 schools and colleges. The university also 
administers the Howard University Hospital. The Committee 
recommends, within the funds provided, not less than $3,405,000 
for the endowment program.
    Howard University Hospital.--Within the funds provided, the 
Committee recommendation includes $70,325,000 for Howard 
University Hospital. The hospital provides inpatient and 
outpatient care, as well as training in the health professions. 
It also serves as a major acute and ambulatory care center for 
the District of Columbia and functions as a major teaching 
facility attached to the university. The Federal appropriation 
provides partial funding for the hospital's operations.
    Within the Committee's recommendation for the Howard 
University Hospital, the Committee includes $43,000,000 to 
support continued construction of a new Howard University 
Hospital. The new hospital will provide inpatient and 
outpatient care, as well as health professional training and 
other necessary services and will continue to serve as a major 
acute and ambulatory care center for the District of Columbia. 
As a condition of receiving these funds, the Hospital must 
continue to be maintained as the teaching hospital for Howard 
University and continue succession agreements with its union. 
The Committee recommended funding level fulfills the remaining 
planned Federal contribution to support construction of the new 
hospital.

         College Housing and Academic Facilities Loans Program

Appropriations, 2024....................................        $298,000
Budget estimate, 2025...................................         328,000
Committee recommendation................................         298,000

    The Committee recommends $298,000 for Federal 
administration of the CHAFL, College Housing Loans, and Higher 
Education Facilities Loans programs. Prior to fiscal year 1994, 
these programs provided financing for the construction, 
reconstruction, and renovation of housing, academic, and other 
educational facilities. While no new loans have been awarded 
since fiscal year 1993, costs for administering the outstanding 
loans will continue through 2030. These funds will be used to 
reimburse the Department for administrative expenses incurred 
in managing the existing loan portfolio.

  HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING PROGRAM 
                                ACCOUNT

Appropriations, 2024....................................     $20,678,000
Budget estimate, 2025...................................      20,731,000
Committee recommendation................................      20,678,000

    The Committee recommends $20,678,000 for the HBCU Capital 
Financing Program. The HBCU Capital Financing Program makes 
capital available to HBCUs for construction, renovation, and 
repair of academic facilities by providing a Federal guarantee 
for private sector construction bonds. Construction loans will 
be made from the proceeds of the sale of the bonds.
    The Committee recommendation includes $20,150,000 for loan 
subsidy costs in guaranteed loan authority under this program. 
This will support an estimated $344,444,444 in new loan volume 
in fiscal year 2025. In addition, the Committee recommendations 
includes $528,000 for administrative expenses.

                    Institute of Education Sciences

Appropriations, 2024....................................    $793,106,000
Budget estimate, 2025...................................     815,455,000
Committee recommendation................................     798,106,000

    The Committee recommends $798,106,000 for the IES. This 
amount includes $73,500,000 for administrative expenses and 
centralized support costs for the Institute of Education 
Sciences.
    This account supports education research, development, 
dissemination, utilization and evaluation; data collection and 
analysis activities; the assessment of student progress; and 
administrative expenses related to such activities. Funds 
provided to IES are available for obligation for 2 fiscal 
years.
    Under the Education Sciences Reform Act of 2002 [ESRA], 
Congress established IES to provide national leadership in 
expanding fundamental knowledge and understanding of education 
from early childhood through postsecondary study. ESRA required 
IES, in carrying out its mission, ``to compile statistics, 
develop products, and conduct research, evaluations, and wide 
dissemination activities in areas of demonstrated national need 
and ensure that such activities conform to high standards of 
quality, integrity, and accuracy and are objective, secular, 
neutral, and nonideological and are free of partisan political 
influence.''
    Program Administration.--The Committee recommendation 
includes $73,500,000 for administrative expenses and 
centralized support costs. Section 312 of this act ensures 
sufficient funding for centralized support costs is available 
and properly charged to this appropriation. The Committee 
directs the Department, IES and NCES to work together to 
provide in the fiscal year 2026 and future CJs, as well as the 
fiscal year 2025 operating plan the amount for NCES 
administrative expenses supported by this program 
administration appropriation.
    Not later than 30 days after enactment of this act and each 
quarter thereafter, the Committee directs the IES Director and 
NCES Commissioner to submit administrative and staffing plans 
for their respective centers outlining staffing ceilings by 
national center, the factors considered in allocating staffing 
ceilings by national center, actual FTE by national center, and 
an explanation by national center for FTE changes from the 
preceding quarter.

                RESEARCH, DEVELOPMENT, AND DISSEMINATION

    The Committee recommends $245,000,000 for education 
research, development, evaluation, and national dissemination 
activities. These funds support 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 outcomes for students.
    Accelerate, Transform, and Scale Initiative.--The Committee 
supports steps IES has taken to use funds for creating 
scalable, high impact solutions to improve education outcomes 
for all learners and eliminate persistent achievement and 
attainment gaps, including through pilot efforts modeled on 
Federal advanced research projects agencies. This includes the 
updated Transformative Research in the Education Sciences 
program, which is supporting partnerships between researchers, 
industry professionals, and education agencies to propose 
transformative solutions to intractable education problems 
leveraging advances in technology combined with research 
insights from the learning sciences. The Committee requests 
quarterly updates on progress on the initiative including the 
Seedlings to Scale program.
    Data Sciences.--The Committee notes NCER established three 
Methods Training programs in Data Science through the fiscal 
year 2023 appropriation. The Committee continues to make 
funding available that may support research, development, and 
training in data science education to support the expansion of 
and capacity for instruction needed for students to compete in 
the changing economy. The Committee believes the IES should 
continue to make funds available to identify and scale 
research-based interventions to support data science and data 
literacy development among teachers and students, especially 
among underserved populations. The Committee requests an update 
on such plans in both the fiscal year 2025 operating plan and 
fiscal year 2026 CJ.
    Collaborative Education Research.--The Committee recognizes 
the ongoing collaborative efforts between IES and the National 
Science Foundation [NSF], including through the resources 
provided to the IES via the American Rescue Plan that support 
two NSF National Artificial Intelligence [AI] Research 
Institutes focused on education. The Committee encourages IES 
to pursue additional collaborative efforts with NSF and 
expedite the identification of evidence-based innovations in 
education.
    The Future of Education Research at IES.--The Committee is 
aware IES sought expert assistance in requesting the National 
Academies of Sciences, Engineering and Medicine [NASEM] provide 
guidance on the future of education research, which resulted in 
the publication of the ``The Future of Education Research at 
IES''. The Committee encourages IES to continue implementation 
of recommendations made in the report and requests the fiscal 
year 2025 operating plan include a discussion of actions taken 
and planned.

                               STATISTICS

    The Committee recommends $121,500,000 for data gathering 
and statistical analysis activities at the National Center for 
Education Statistics [NCES].
    NCES is headed by a Commissioner appointed by the President 
and has statutory authority without supervision or approval of 
the Director for carrying out the work of NCES. The 
Commissioner also serves as the Department's Chief Statistical 
Officer under the Foundations for Evidence-Based Policymaking 
Act of 2018. NCES collects data on educational institutions at 
all levels, longitudinal data on student progress, and data 
relevant to public policy. NCES also provides technical 
assistance to SEAs, LEAs, and postsecondary institutions. 
Activities are carried out directly and through grants and 
contracts.
    A Vision and Roadmap for Education Statistics.--The 
Committee is aware IES sought expert assistance in requesting 
NASEM to ``recommend a portfolio of activities and products for 
NCES, review developments in the acquisition and use of data, 
consider current and future priorities, and suggest desirable 
changes'', which resulted in the publication of the ``A Vision 
and Roadmap for Education Statistics''. The Committee believes 
the Secretary, Commissioner and Director of IES should continue 
to support NCES in independently developing, producing, and 
disseminating statistics pursuant to recommendations of the 
NASEM report. The Commissioner, and, as applicable, Secretary 
and Director are directed to include in the required operating 
plan actions taken since the report's release and future 
actions and associated timeline to fully implement related 
recommendations. The Committee also encourages NCES to continue 
implementation of other recommendations made in the report and 
requests the fiscal year 2025 operating plan include a 
discussion of actions taken and planned.
    Information on College Admissions.--The Committee is aware 
of the lack of data available demonstrating how legacy status, 
or relationship to alumni of the institution, factors in first-
time, first-year, degree-seeking admissions decisions. Starting 
with the 2022-2023 IPEDS admission surveys, NCES began to ask 
if IHEs consider legacy status. The Committee understands that 
NCES is planning to continue to ask if IHEs consider legacy 
status in the 2025-2026 and 2026-2027 IPEDS admissions surveys, 
and believes this will provide important information about 
considerations for admissions. The Committee also understands 
that in the 2025-2026 and 2026-2027 admissions surveys, NCES 
has proposed to collect data on applications, admissions, and 
subsequent enrollment for early decision and early action as 
well as data on applications and admissions that can be 
disaggregated by race, gender, enrollment type and ethnicity. 
The Committee believes this data will be beneficial to multiple 
stakeholders. The Committee also believes data on applications 
from, admission of, and enrollments by applicants with legacy 
status at any institutions that provide legacy preferences and 
data on early action, early decision, and legacy admissions 
disaggregated by race and ethnicity would be beneficial.
    Rural Statistics.--The Committee recognizes NCES's role in 
collecting statistical information on school districts and 
education activities, and its use of locale codes for 
determining rural districts. However, these current 
classifications do not properly measure rurality in mountainous 
regions, such as the Appalachian Mountains. The Committee urges 
NCES to adopt the Road Ruggedness Scale, as defined in the 
United States Department of Agriculture Economic Research 
Service's published Characterizing Rugged Terrain in the United 
States report, into their definition of rural. The Committee 
requests a description of the work, timeline and resource needs 
to implement such adoption in the NCES operating plan for 
fiscal year 2025.
    National Postsecondary Student Aid Study [NPSAS].--The 
Committee is extremely concerned about NCES's continued plan to 
revise the NPSAS data collection schedule without sufficient 
stakeholder engagement and consideration of the important 
information NPSAS provides to researchers, policymakers, and 
the public. The Committee believes that NPSAS plays a vital 
role in postsecondary empirical research and analysis and 
reiterates the directive in the explanatory statement 
accompanying Public Law 118-47 to restore the study's 
traditional data collection schedule to every two years, for 
NPSAS 2024 and NPSAS 2026, with a student interview included 
every four years, for NPSAS 2024 and NPSAS 2028. NCES is 
directed to brief the Committee not later than 60 days after 
enactment of this act on how they intend to come into 
compliance with this directive.

                   REGIONAL EDUCATIONAL LABORATORIES

    The Committee recommends $53,733,000 to continue support 
for the Regional Educational Laboratories [REL] program.
    The laboratories are responsible for promoting the 
effective use and development of knowledge and evidence in 
broad-based systemic strategies to increase student learning 
and well-being and further school improvement efforts. The 
Committee urges IES to continue its efforts to strengthen the 
connections between practitioners and the research community, 
so that federally supported research is timely, relevant, and 
responsive to the needs of the field, helps build capacity of 
LEAs and SEAs to effectively integrate evidence use in 
decision-making and is effectively utilized in education policy 
and practice.
    The Committee does not adopt the proposal to rescind 
$15,000,000 from the prior year appropriation, noting the IES' 
fiscal year 2024 operating plan indicated that the enactment of 
this proposal would prevent IES from being able to meet 
continuation costs for existing REL activities should IES 
continue to receive the fiscal year 2024 enacted level through 
fiscal year 2027.

              RESEARCH AND INNOVATION IN SPECIAL EDUCATION

    The Committee recommends $64,255,000 for research and 
innovation in special education conducted by the National 
Center for Special Education Research.
    The Center addresses gaps in scientific knowledge to 
improve policies and practices in special education and early 
intervention services and outcomes for infants, toddlers, and 
children with disabilities.

               SPECIAL EDUCATION STUDIES AND EVALUATIONS

    The Committee recommends $13,318,000 for special education 
studies and evaluations.
    This program supports competitive grants, contracts, and 
cooperative agreements to assess the implementation of IDEA. 
Funds are also used to evaluate the effectiveness of State and 
local efforts to deliver special education services and early 
intervention programs.

                         STATEWIDE DATA SYSTEMS

    The Committee recommendation includes $33,500,000 for the 
Statewide Data Systems program.
    This program supports competitive grants to SEAs to support 
the development, maintenance, and expansion of State 
longitudinal data systems. Support for these systems will 
further strengthen State data infrastructure and linkages; 
contribute to improved data access, and use for evidence-based 
policymaking; and build capacity in States to secure and 
protect data. Early childhood, postsecondary, and workforce 
information systems may be linked to such systems or developed 
with program funds. The bill also continues to allow up to 
$6,000,000 to be used for awards to improve data coordination, 
quality, and use, including support for the Privacy Technical 
Assistance Center that serves as a resource on privacy issues 
for SEAs and LEAs, the postsecondary education community, and 
others engaged in building and using education data systems.
    The Committee does not adopt the proposal to rescind 
$10,000,000 from the prior year appropriation, noting the IES' 
fiscal year 2024 operating plan indicated that the enactment of 
this proposal would prevent IES from being able to meet 
continuation costs for current grants and activities should IES 
continue to receive the fiscal year 2024 enacted level through 
fiscal year 2027.

                               ASSESSMENT

    The Committee recommends $193,300,000 to provide support 
for the National Assessment of Educational Progress [NAEP], a 
congressionally mandated assessment created to measure and 
report the educational achievement of American students in a 
range of subjects and analyze trends over time.
    Within the funds appropriated, the Committee recommends 
$8,300,000 for the National Assessment Governing Board [NAGB], 
which is responsible for formulating policy for NAEP.
    The Committee recommendation continues support of 
$10,000,000 for research and development investments activities 
to modernize and innovate assessments while reducing future 
program costs. NAGB and NCES should continue to consult with 
the authorizing and appropriations committees of Congress as it 
considers strategies, including those identified by NASEM, in 
achieving cost efficiencies in and upgrades of its assessment 
program. Further, the Committee requests that the fiscal year 
2026 CJ and fiscal year 2025 operating plan describe 
implemented and planned strategies for cost efficiencies and 
necessary research and development projects.
    Family Structure and NAEP Scores.--The Committee recognizes 
the importance of a child's home environment in shaping that 
child's development and key outcomes later in life, including 
educational progress. Recognizing this critical importance, the 
Committee urges NAGB to work with NCES to collect and report 
student data, such as attendance, grade point average, and 
performance on the National Assessment of Educational Progress. 
To the fullest extent possible, reporting should be 
disaggregated by family structure, socioeconomic status, 
gender, race/ethnicity as well as the intersection of these 
characteristics.
    The Committee is aware that reporting for NAEP 2024 will 
include a new index measure of socioeconomic status to 
supplement data collected on eligibility for the National 
School Lunch Program, and the NCES online achievement gap 
dashboard allows analyses of race/ethnicity gaps by other 
demographic characteristics. The Committee urges the NAGB to 
explore collecting richer data about family background on NAEP 
and should describe in its fiscal year 2025 operating plan 
options for doing so.

                        Departmental Management


                         PROGRAM ADMINISTRATION

Appropriations, 2024....................................    $419,907,000
Budget estimate, 2025...................................     476,846,000
Committee recommendation................................     419,907,000

    The Committee recommends $419,907,000 for program 
administration.
    Funds support personnel compensation and benefits, travel, 
rent, communications, utilities, printing, equipment and 
supplies, automated data processing, and other services 
required to award, administer, and monitor Federal education 
programs. Support for program evaluation and studies and 
advisory councils is also provided under this account.
    Campus Antisemitism.--The Committee is deeply concerned 
with reports of increased discrimination and harassment on 
college campuses, including incidences of antisemitic 
discrimination and harassment. The Committee encourages the 
Department to offer guidance to institutions of higher 
education for the development of campus policies to combat 
religiously-based discrimination, harassment, and other 
incidents. The Committee also encourages the Department to 
offer guidance to institutions of higher education to encourage 
the prompt reporting of instances in which a member of the 
University community violates the institution's policies 
regarding discrimination and harassment, any disciplinary 
actions taken by the institution in response to such 
violations, and how the reporting of such violations and 
disciplinary actions is conducted in a manner that complies 
with all applicable privacy laws and policies.
    Campus Climate Surveys.--The Committee remains interested 
in the Department's work to develop a Federal campus climate 
survey on sexual misconduct, which would be administered in 
accordance with the Violence Against Women Act of 2022 (Public 
Law 117-103). The Committee directs the Department to brief the 
Committees on the Department's survey as well as the plans to 
pilot and evaluate the survey instrument, including its plans 
to consult with stakeholders and provide an analysis of the 
campus climate survey landscape and the appropriateness of the 
Federal survey interval, based on the results of the campus 
climate survey landscape assessment, peer-review research, 
consultation with survey experts, and other considerations, 
such as the length of the survey and differences in campus 
communities and available resources.
    Collaboration Between Airport Authorities and Educational 
Institutions.--Airport authorities can play an important role 
in providing economic development, workforce development, and 
educational opportunities. The Committee encourages the 
Department to consider actions that could support greater 
collaboration between airport authorities and educational 
institutions that helps engage and support students and create 
and improve pathways into high-quality jobs.
    College Costs.--The Committee is concerned by the increase 
in college costs over the past 20 years and how those increases 
have contributed to growing student loan debt. The Committee 
notes that the Department annually publishes the College 
Affordability and Transparency List as required by the HEA. The 
College Affordability and Transparency List provides valuable 
information for students and families on the most and least 
expensive IHEs by both published tuition and net price. The 
Committee directs the Department to ensure that this important 
resource is prominently displayed on the Department's website, 
including on the College Scorecard website. The Committee also 
encourages the Department to note on the College Scorecard 
profile of any IHE, such IHE's inclusion on the College 
Affordability and Transparency List, if applicable.
    Competitive Grant Priorities for Rural Areas.--The 
Committee continues to encourage the Department to continue 
efforts to ensure competitive grants are reaching rural areas 
so that support and solutions developed with Federal funding 
are relevant to and available in such areas.
    Comprehensive Literacy Resources.--The Committee believes 
it is important for all educators to be prepared to provide 
high-quality comprehensive literacy instruction for students. 
Free online comprehensive literacy resources with a specific 
focus on children in kindergarten through sixth grade that are 
evidence-based and build upon existing programs that leverage 
public partnerships and multidisciplinary tools could assist 
educators with being more prepared to provide such instruction.
    Consultation and Briefing Requirement.--The Committee is 
disappointed with the Department's compliance with the 
consultation and briefing requirement included in the 2024 
explanatory statement. The Committee believes the Department 
can plan its program development activities in such a way to 
allow meaningful consultation with the Committee. The Committee 
directs the Department to consult with the Committee on any 
Department action expected to significantly increase or 
decrease current or future costs of programs it administers. In 
addition, the Committee directs the Department to consult with 
the Committee on any execution action related to any program or 
activity for which a directive is included in this report not 
later than 4 weeks prior to a public announcement related to 
such action. Further, the Committee directs the Department to 
brief the Committee on any action covered by this consultation 
requirement, including consideration and incorporation of 
feedback during such initial consultation, not later than 1 
week prior to a public announcement related to such action. 
This paragraph does not replace a more specific directive for a 
program or activity included in this report.
    Cybersecurity Education.--The Committee recognizes the 
rapid changes involved in cybersecurity secondary and 
postsecondary educational opportunities. The Committee 
encourages the Department to support efforts to improve 
educational offerings for cybersecurity education.
    Discretionary Grant Program Management.--There continues to 
be a concern that the Department's late publication of notices 
inviting applications and awarding of discretionary grant 
program funds late in the fiscal year limits the use of Federal 
funds toward timely and maximal achievement of grantee 
performance and program objectives. The Department is directed 
to develop and implement a plan to execute its discretionary 
grant programs in a timely way, through publication of notices 
inviting applications and obligation of grant funds earlier in 
the fiscal year. The Department shall also provide the 
Committee with an update on accelerated execution timelines for 
its discretionary grant programs within 120 days of enactment 
of this act, as well as in the Forecast of Funding 
Opportunities under the Department of Education Grant Programs 
for fiscal year 2026.
    Educator Equity Reporting.--The Committee commends the 
Department's work to support implementation of and enforce the 
educator equity requirements in section 1111(g)(1)(B) of the 
ESEA. The Committee directs continued efforts by the Department 
to work with each State to publicly report in an accessible 
manner not less than every 2 years progress made to ensure low-
income and minority children enrolled in public schools are not 
served at disproportionate rates by ineffective, out-of-field, 
or inexperienced teachers. The Committee requests a briefing 
not later than 60 days after enactment of this act on the 
Department's planned support and monitoring efforts and 
corrective actions and recommendations implemented by States.
    Evidence-Based Grant Making.--The Committee directs the 
Department to use demonstrated evidence of effectiveness as 
part of the selection criteria through its Education Department 
General Administrative Regulations, consistent with 
authorizations, for all competitive grant programs. Further, 
non-competitive formula grant funds have a range of evidence 
requirements and preferences and the Committee directs the 
Department to support entities receiving funding through those 
programs through enhancements to its technical assistance and 
support activities.
    Foreign Influence.--Under section 117 of the HEA, 
institutions of higher education receiving Federal financial 
assistance are required to disclose gifts from, or contracts 
with, foreign sources if the value is $250,000 or more. They 
must also disclose ownership or control by a foreign source. 
The Committee strongly urges the Department to work with IHEs 
to ensure they are fully complying with this statutory 
requirement. The Department shall report to the Committee on 
any steps that it has taken to address undue foreign influence 
within IHEs and K-12 schools and any actions that it has taken 
to ensure IHEs are fully complying with section 117 of the HEA. 
The Department shall also report to the Committee on the 
presence and influence of Confucius Institutes and Confucius 
Classrooms and their successor programs as well as the amount 
of Federal funding for foreign language studies that IHEs with 
a Confucius Institute or a successor program have received in 
the last decade and whether such Federal funding was utilized 
by the Confucius Institute or successor program.
    Foundation for Evidence-Based Policymaking Act.--The 
Committee continues to believe that the execution of the 
Foundations for Evidence-Based Policymaking Act will enhance 
the evidence-building capacity of Federal agencies, strengthen 
privacy protections, improve secure access to data, and provide 
more and higher quality evidence to policymakers. Therefore, 
the Committee directs the Department to continue to include in 
the fiscal year 2026 and future CJs updates on the 
implementation and planned implementation of such act for the 
current and future budget years.
    GAO Report.--The Committee notes that the conditions 
identified in GAO's 2020 report on school facilities remain a 
challenge for under-resourced LEAs, including small and rural 
LEAs, and high-need urban LEAs. The deteriorated conditions 
described in the GAO 2020 report, natural disasters, and 
extreme weather have put additional strains on school 
facilities, costing students valuable instructional time. The 
Committee directs GAO to conduct a study on the impact of the 
physical state of school facilities on instructional time, 
including the number of instructional days lost due to facility 
issues, and the barriers under-resources LEAs face in accessing 
Federal, State, local, and other resources to address facility 
challenges. The GAO study shall also examine effective 
practices to assist under-resourced LEAs in accessing Federal, 
State, local, and other resources to address facility 
challenges and State and local efforts to provide such 
assistance and support to under-resourced LEAs in meeting 
modern standards for health, safety, and educational 
suitability.
    ``Grow Your Own'' Teacher Development.--The Committee 
recognizes the potential efficacy and increasing presence of 
``Grow Your Own'' teacher development programs, including 
through the use of funds under the Teacher Quality Partnerships 
and other Federal education funding streams. The Committee 
looks forward to receiving the report requested last year on 
best practices for ``Grow Your Own'' programs in increasing 
teacher diversity, recruitment efforts within local 
communities, access to high-quality pathways into the 
profession, and teacher retention, and reducing teacher 
shortages. The report should identify current opportunities to 
use funds available from the Department to support ``Grow Your 
Own'' programs and additional Federal opportunities for 
consideration.
    High-Quality Tutoring/Title I Evidence-Based 
Interventions.--The Committee notes that to remediate 
significant learning disparities from longstanding inequities 
in access to high-quality instruction, particularly among 
historically disadvantaged students, many LEAs have dedicated 
title I and other Federal resources to support academic 
tutoring. Research shows that using high-quality, evidence-
based tutoring programs with evidence of effectiveness as 
defined in the 2015 reauthorization of the ESEA can 
significantly improve achievement levels in reading and math. 
These proven systems include three to five sessions a week, 
integrated as part of the school day, delivered by a human 
tutor in person or virtually to a group of one to not more than 
four students at a time; and use a well-structured process, 
high-quality materials designed for tutoring during the school 
day, ongoing professional development and coaching for tutors, 
and assessment tools to benchmark student achievement. Proven 
tutoring models can bring struggling students up to the 
achievement level of their peers. The Committee encourages the 
Department to promote and provide technical assistance to LEAs 
and support partnerships between LEAs and education-related 
community-based organizations to implement evidence-based 
tutoring models.
    Integrating Data and Strengthening Data Privacy.--The 
Committee urges the Secretary in conjunction with the Secretary 
of Labor to provide guidance and technical assistance on 
integrated data systems, including acceptable methods for 
sharing wage record and confidential unemployment compensation 
information with such data systems, while protecting student 
and worker privacy. This guidance should build on and expand 
the guidance issued by the Privacy Technical Assistance Center 
in January 2017 (PTAC-IB-4).
    Late Liquidation.--The Committee emphasizes that Office of 
Management and Budget regulation 2 CFR 200.344(b) gives the 
Department broad flexibility to extend the period for 
liquidating financial obligations incurred under grants awarded 
by the Department. The Committee appreciates that the 
Department has announced a policy and process for ESSER 
liquidation extensions for ARP well in advance of the 
obligation and liquidation deadlines. The Committee continues 
to emphasize the importance of the Department minimizing the 
administrative burden of ARP ESSER late liquidation requests on 
SEAs and LEAs to the extent practicable, including by not 
requiring excessive documentation. The Department shall provide 
sufficient clarity in its guidance, and predictability in its 
process, in order to ensure that LEAs are able to enter into 
contracts for allowable costs as reasonable and necessary 
during the obligation period regardless of the contract's 
liquidation end date, as long as it is within the authorized 
late liquidation period and the LEA intends to submit an 
appropriate late liquidation request to the SEA. Given the 
number of transactions potentially eligible for liquidation 
extension, and the varying needs of SEAs and subgrantees across 
the country, the Committee encourages the Department to permit 
SEAs to submit multiple requests and amend liquidation 
extension requests as often as reasonably necessary to add and 
subtract transactions and subgrantees as circumstances and 
extension needs change related to an allowable, reasonable, 
necessary, and timely obligation. The Committee also 
appreciates the Department' work to educate auditors about the 
late liquidation process.
    Nonrecurring Expenses Fund.--As part of the annual CJ, the 
Department is directed to include the anticipated balances 
available for transfer into and uses of the Nonrecurring 
Expenses Fund [NEF] for the current and budget fiscal years. 
Additionally, the Department is directed to provide the 
Committees quarterly reports for all ongoing projects. The 
report shall include the following for each project: a 
description and timeline for each project; the date the project 
was notified to the Committees; total obligations to date; 
obligations for the prior fiscal year; anticipated obligations 
for current fiscal year; any expected future obligations; and 
the total unobligated balance in the Fund. In addition, the 
Committee requests biannual reports on expired balances that 
are eligible for transfer to the NEF. Such report shall include 
the Treasury Account Fund Symbol, program name, unobligated 
balance, and unexpended balance. Such report shall be 
transmitted 30 days after the close of the second quarter and 
within 45 days after the close of the fourth quarter of the 
fiscal year.
    Nursing Instructor Workforce.--The Committee is concerned 
with the shortages in the nursing educator workforce, which 
leads to fewer qualified nurses in the workforce. Graduating 
more nursing students will improve health outcomes and increase 
access to high-quality healthcare. The Committee supports 
funding to IHEs to increase the number of qualified faculty to 
teach students wanting to enroll in nursing programs.
    Pooled Evaluation Authority.--The Committee requests that 
the Department provide a report to the Committee on the planned 
use of pooled evaluation funds under section 8601 of the ESEA, 
consistent with the required plan under such section, not later 
than 15 days prior to any transfer of funds.
    Post-Secondary Transfer Articulation Agreements.--Transfer 
articulation agreements between community colleges and 4-year 
IHEs can play an important role in promoting access, 
affordability, and completion in higher education. The 
Committee encourages the Department to gather input from States 
that have implemented comprehensive statewide programs to 
determine best practices for implementation, enhancement, or 
scaling-up of agreements. The Department should also seek input 
from States that do not have comprehensive statewide programs 
to identify barriers to scaling-up agreements. This information 
should be disseminated to States by the Department with the 
goal of further enhancing or implementing statewide transfer 
articulation agreements.
    Program Administration.--The Committee remains concerned 
about the Department's prioritization of staff resources in the 
Program Administration account. The fiscal year 2023 agreement 
directed the Department to begin rebalancing the agency's ratio 
of career staff to non-career staff, to prioritize career staff 
for executing core programs at the Department, and not to 
expand its non-career staff on board above the December 2022 
levels. Despite the clear Congressional directive, the level of 
non-career staff remained above the December 2022 level for all 
of fiscal year 2023. For this reason, the fiscal year 2024 bill 
included new language prohibiting funds from being used on or 
after August 15, 2024, to support a non-career employee number 
that is more than the number of non-career employees as of 
December 31, 2022. The Committee looks forward to the 
Department coming into compliance with the fiscal year 2024 
requirement and continues to include bill language for fiscal 
year 2025 prohibiting funds from being used to support a number 
of non-career employees that is above the number of non-career 
employees as of December 31, 2022.
    Protecting Personally-Identifiable Information.--The 
Committee continues to direct the Department to ensure that its 
employees, contractors, and grantees, including States that 
receive funds from Statewide Longitudinal Data System grants, 
adhere to the strictest and highest standards for protecting 
personally identifiable information.
    Reporting and Data Collection on Professional 
Qualifications of Educators.--The Committee is aware that the 
Department, National Center for Education Statistics, and 
Office for Civil Rights each collect data on the 
characteristics and qualifications of teachers, principals, and 
other school leaders. This includes required State plan and 
reporting requirements under section 1111 of the ESEA for 
States to report on professional qualifications of teachers in 
the State, including information on inexperienced teachers, 
teachers teaching with emergency or provisional credentials, 
and teachers who are not teaching in the subject or field for 
which the teacher is certified or licensed. It also includes 
information collected through the National Teacher and 
Principal Survey and Civil Rights Data Collection. The 
Committee requests a briefing not later than 90 days after 
enactment on planned collections, including on the extent to 
which planned collections will include information in the 
aggregate, and disaggregated by high poverty and low poverty 
schools, on the number of teachers, principals and other school 
leaders employed, demographic characteristics, experience, and 
the number of full-time teachers employed who meet and don't 
meet all State license, certificate, and endorsement 
requirements including specifically by mathematics, science, 
English as a second language, and special education.
    Reports to Congress.--The Department is directed to provide 
5 business days' notice to the Committee before release of any 
congressionally directed report.
    Responsiveness to GAO.--The Committee notes that there have 
been prior engagements where the Department unnecessarily 
delayed in providing GAO with timely and complete information 
in response to GAO requests. The Committee directs the 
Department to provide timely and complete information to GAO on 
its engagements within timeframes as GAO may specify. The 
Committee further directs GAO to develop timeliness criteria to 
measure the Department's responsiveness to GAO requests for 
information. GAO activities are crucial to Congressional 
oversight, and the development of such criteria will assist GAO 
in the timely completion of work. GAO should consult with the 
Department, as GAO determines appropriate, in developing such 
criteria.
    Staffing Report.--Consistent with the fiscal year 2024 
explanatory statement, not later than 30 days after enactment, 
the Department is directed to provide the Committee an 
operating plan identifying the total FTE and non-personnel 
allocations supported by the program administration 
appropriation in total for the Department, and FTE and non-
personnel allocations for each program office supported by the 
program administration appropriation provided in this act. In 
addition, the Department shall provide on a monthly basis the 
number of on-board staff, attrition, approved hires not yet on-
boarded and projected full-year FTE usage, including approved 
hires, and actual non-personnel expenses, for each program 
office supported by, and in total for, the program 
administration appropriation provided in this act. The monthly 
reports should be detailed by career and non-career staff. In 
addition, the Department shall separately identify in such 
plans and reports total FTE allocations supported by other 
funding sources. The Department shall also provide the 
Committee on a biannual basis an excel file which includes the 
names, titles, grades, program office, and date of hire of all 
of the political appointees that were employed by the 
Department during the previous 180 days.
    State and Local Report Cards.--The Committee is 
disappointed the Department has yet to provide the required 
briefing on monitoring and support intended to ensure SEA and 
LEA compliance with report card requirements of ESEA. The 
Committee looks forward to the briefing and the Department's 
continued reviews of all State report cards, monitoring, and 
support intended to achieve compliance with the law and 
information being available in accessible and understandable 
formats for parents, caregivers, policymakers, and communities. 
Further, the Committee looks forward to increased transparency 
related to monitoring and review findings and corrective 
actions implemented on report card requirements as directed in 
the Education for the Disadvantaged account of this Report.
    Supporting Principals and School Leaders.--Principals and 
school leaders are critical to both student outcomes and 
teacher retention. The Committee notes the Department's stated 
intent to comply with fiscal year 2023 explanatory statement 
language and reiterates the directive that the Department issue 
guidance to SEAs and LEAs on the use of Federal funds across 
various programs, including title I-A and title II-A of the 
ESEA, for implementing evidence-based strategies to recruit, 
prepare, support, and retain strong principals and school 
leaders.
    Team-Based Models of Instruction.--The Committee encourages 
the Department to support the expansion of team teaching and 
projects that would promote educator specialization and 
differentiated educator roles in the classroom. This would 
support innovative work taking place nationwide to design new 
systems of workforce development for teachers that include 
supports, clear pathways to advancement, and promote teacher 
retention.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2024....................................    $140,000,000
Budget estimate, 2025...................................     162,359,000
Committee recommendation................................     150,000,000

    The Committee recommends $150,000,000 for the Office for 
Civil Rights [OCR].
    OCR is responsible for the enforcement of laws that 
prohibit discrimination on the basis of race, color, national 
origin, sex, disability, and age in all programs and 
institutions that receive financial assistance from the 
Department. To carry out this responsibility, OCR investigates 
and resolves discrimination complaints, monitors desegregation 
and equal educational opportunity plans, reviews possible 
discriminatory practices by recipients of Federal education 
funds, and provides technical assistance to recipients of funds 
to help them meet these civil rights requirements.
    Combatting Antisemitism.--The Committee is concerned by 
reports of increased discrimination, including antisemitic 
harassment, in our Nation's education system. The Committee 
appreciates the administration's development of the first-ever 
U.S. National Strategy to Counter Antisemitism and OCR's 
release of a Dear Colleague letter reminding schools of their 
legal obligations under title VI to provide all students, 
including Jewish students, an environment free from 
discrimination. OCR complaints regarding shared ancestry 
represent less than 1 percent of outstanding cases. The 
Committee recognizes OCR's need for additional resources and 
provides OCR an increase of $10,000,000 for combatting 
antisemitism and helping schools understand and comply with 
their legal obligations under title VI. The Committee directs 
OCR to use funds for timely processing of all current and 
incoming shared ancestry complaints and directed 
investigations, including those relating to antisemitism. The 
Committee further directs the Department to provide the 
Committees and the Senate Committee on Health, Education, Labor 
and Pensions and the House Committee on Education and the 
Workforce with quarterly reports on the status of OCR shared 
ancestry investigations, including those related to 
antisemitism, and an initial report no later than 30 days after 
enactment of this act. Such reports should include a brief 
overview, including timeline, status of the investigation, and 
any actions taken by OCR.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2024....................................     $67,500,000
Budget estimate, 2025...................................      77,497,000
Committee recommendation................................      67,500,000

    The Committee recommends $67,500,00 for OIG. Of this 
amount, $3,000,000 is available until expended to provide 
flexibility for hiring delays and the year-end return of funds 
for common support provided by the Department that may turn out 
costing less than anticipated.
    OIG has the authority to investigate all departmental 
programs and administrative activities, including those under 
contract or grant, to prevent and detect fraud and abuse, and 
to ensure the quality and integrity of those programs. The 
Office investigates alleged misuse of Federal funds and 
conducts audits to determine compliance with laws and 
regulations, efficiency of operations, and effectiveness in 
achieving program goals.
    Higher Education.--The Committee is concerned by the 
challenges and delays faced by students in receiving student 
aid and IHEs in processing financial aid requests due to the 
challenges, errors, and delays in the Department's 
implementation of changes to the Free Application for Federal 
Student Aid through the Student Aid and Borrower Eligibility 
Reform [SABER] Initiative required by the FAFSA Simplification 
Act and the FUTURE Act. The Committee directs OIG to prioritize 
management and systems evaluations of the Office of Federal 
Student Aid and the Office of Postsecondary Education that are 
underway and fast track newly opened investigations. The 
Committee further directs OIG to fully brief the Committees, 
the Senate Committee on Health, Education, Labor and Pensions, 
and the House Committee on Education and the Workforce on 
findings and recommendations from such evaluations and 
investigations no later than 90 days after enactment of this 
act.

                           General Provisions

    Section 301. The bill continues a provision prohibiting the 
use of funds to prevent the implementation of programs of 
voluntary prayer and meditation in public schools.
    Section 302. The bill continues a provision giving the 
Secretary authority to transfer up to 1 percent of any 
discretionary funds between appropriations.
    Section 303. The bill continues a provision making 
evaluation funds pooled under section 8601 of the ESEA 
available for obligation on a forward-funded basis.
    Section 304. The bill continues a general provision 
allowing certain institutions to continue to use endowment 
income for student scholarships.
    Section 305. The bill continues a provision extending 
authorization of the National Advisory Committee on 
Institutional Quality and Integrity.
    Section 306. The bill continues a provision extending 
authority to provide account maintenance fees to guarantee 
agencies.
    Section 307. The bill continues a provision regarding 
servicing of Federal Perkins Loans.
    Section 308. The bill includes a provision rescinding 
mandatory funding to pay for mandatory costs of increasing the 
maximum discretionary Pell award.
    Section. 309. The bill continues a provision regarding 
administrative costs for Public Service Loan Forgiveness.
    Section. 310. The bill continues a provision allowing up to 
0.5 percent of funds appropriated in this act for programs 
authorized under the HEA, except for the Pell Grant program, to 
be used for evaluation of any HEA program.
    Section 311. The bill modifies a provision regarding 
Congressionally Directed Spending within the Innovation and 
Improvement account.
    Section 312. The bill continues a provision regarding 
centralized support services for IES.

                                TITLE IV


                            RELATED AGENCIES


 Committee for Purchase From People who are Blind or Severely Disabled


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $13,124,000
Budget estimate, 2025...................................      14,800,000
Committee recommendation................................      13,124,000

    The Committee recommends $13,124,000 for the Committee for 
Purchase from People Who Are Blind or Severely Disabled 
[Commission], of which no less than $3,150,000 shall be made 
available for the Office of Inspector General.
    The Commission provides employment opportunities to 
approximately 40,000 Americans who are blind or severely 
disabled each year. The primary purpose of this program is to 
increase the employment opportunities for people who are blind 
or have other severe disabilities and, whenever possible, to 
prepare them to engage in competitive employment. Encompassing 
nearly $4,000,000,000 in products and services procured, it is 
the Federal Government's largest employment program for the 
severely disabled.
    Reports.--The Committee continues to request the reports 
listed under this heading in the explanatory statement 
accompanying Public Law 118-47.

             Corporation for National and Community Service

    The Corporation for National and Community Service [CNCS] 
was established to enhance opportunities for national and 
community service. CNCS administers programs authorized under 
the Domestic Volunteer Service Act (Public Law 93-113), the 
National and Community Service Trust Act (Public Law 103-82), 
and the SERVE America Act (Public Law 111-13). Grants are 
awarded to States, public and private nonprofit organizations, 
and other entities to create service opportunities for 
students, out-of-school youth, adults, and seniors.
    The Committee recommendation for CNCS provides a total 
program level of $1,277,806,000.

                           OPERATING EXPENSES

Appropriations, 2024....................................    $975,525,000
Budget estimate, 2025...................................   1,046,276,000
Committee recommendation................................   1,010,525,000

    The Committee recommends $1,010,525,000 for the operating 
expenses of CNCS.

Volunteers in Service to America [VISTA]

    The Committee recommends $103,285,000 for VISTA. This 
program provides capacity building for small, community-based 
organizations with a mission of combating poverty. VISTA 
members raise resources, recruit and organize volunteers, and 
establish and expand programs in housing, employment, health, 
and economic development activities.

National Senior Volunteer Corps

    The Committee recommends $236,917,000 for the National 
Senior Volunteer Corps programs, a collection of programs that 
connect Americans older than the age of 55 with opportunities 
to contribute their job skills and expertise to community 
projects and organizations. These programs include the Retired 
Senior Volunteer Program, the Foster Grandparent Program, and 
the Senior Companion Program.

AmeriCorps State and National Grants

    The Committee recommends $592,094,000 for AmeriCorps State 
and National Grants, which provide funds to local and national 
organizations and agencies to address community needs in 
education, public safety, health, and the environment. Each of 
these organizations and agencies, in turn, uses its AmeriCorps 
funding to recruit, place, and supervise AmeriCorps members. 
AmeriCorps members receive a modest living allowance and other 
benefits proportional to their level of time commitment.
    Alumni Engagement Activities.--The Committee commends CNCS 
for its current comprehensive planning process on service 
alumni engagement and its prioritization of the post-service 
member and volunteer experience in its 2022-2026 annual plan, 
including objectives 2.3 and 3.4. The Committee notes 
significant Congressional and stakeholder interest in those 
activities, including strengthening identification with the 
AmeriCorps brand; expanding education and workforce pipelines; 
soliciting feedback from alumni on member experience; directory 
data sharing; and interagency collaboration on national, 
public, and military service. The Committee encourages CNCS to 
support these and other alumni engagement activities.
    Civic Bridge Building.--The Committee supports CNCS' goal 
of uniting Americans through national service and recognizes 
that service is a proven model of civic bridge building. To 
advance these shared goals, the Committee continues to 
encourage CNCS to consider awarding grants, within existing 
competitions, to: (1) support civic bridge building programs 
and projects to reduce polarization and community divisions; 
and (2) provide training in civic bridge building skills and 
techniques to CNCS members and host sites and provide resources 
that can be publicly disseminated to support local civic bridge 
building efforts, among other activities.
    Collaboration on Outreach and Recruitment.--The Committee 
commends recent collaboration among the Department of Defense, 
CNCS, the Selective Service System, Peace Corps, and the Office 
of Personnel Management on raising public awareness about 
military and national service opportunities. The Committee 
directs these agencies to continue exploring mutually 
beneficial ways to promote each agency's service opportunities, 
including sharing market research, providing ineligible or non-
selected applicants with information about other forms of 
service, piloting joint recruitment efforts, and providing 
information to individuals transitioning out of military and 
national service about other opportunities to serve. The 
Committee requests a briefing from CNCS no later than 60 days 
after enactment that provides an update on these collaboration 
efforts.
    Commission Investment Fund [CIF].--The Committee 
recommendation includes no less than the fiscal year 2024 level 
for the CIF, which provides funds to State commissions for 
training and technical assistance activities to expand the 
capacity of current and potential AmeriCorps programs, 
particularly in underserved areas.
    Fixed Price Grant Program.--The Committee believes the 
fixed amount AmeriCorps State and National grant is a flexible, 
useful grant vehicle that helps minimize risk and lowers 
administrative burden on grantees. Section 129(l) of the 
National and Community Service Act of 1990, as amended by 
Public Law 111-13, provides the agency with the authority to 
adopt other terms and conditions based on the risks associated 
with the Fixed Price grant program. The Committee encourages 
CNCS to review the risks associated with the current drawdown 
formula that only allows recipients to incrementally receive 
awarded grant funds as service hours are recorded by enrolled 
members. The Committee notes that this formula may not always 
account for the many start-of-service program costs and the 
expenses grantees incur, regardless of whether a member serves 
a full term. The Committee urges CNCS to review, and if 
appropriate, modify the drawdown formula to cover allowable 
grant expenses that occur at the start of year and to minimize 
the impact that under-enrollment, attrition, and service hour 
disruptions can have on grantee operations. CNCS should report 
to the Committees, in the fiscal year 2026 CJ, on the 
modifications CNCS may make and if any congressional action is 
required to authorize or help implement the changes.
    Impact in Communities.--The Committee notes that for the 
past 3 years, CNCS has used supplemental funds from the 
American Rescue Plan Act to invest in AmeriCorps member living 
allowances, as directed by Congress. Now, CNCS must balance 
those increases amid relatively constrained program funding. 
This has placed additional pressure on AmeriCorps programs 
around the country and resulted in fewer slots and some 
programs no longer operating. The Committee urges CNCS to take 
a balanced approach when assessing the impacts of increasing 
living allowances and protecting service opportunities. 
Additionally, the Committee encourages CNCS to pursue any 
flexibilities to support programs. The Committee notes it 
provided CNCS with the authority to fund certain member service 
positions under 1,700 hours to help provide flexibility for 
programs to continue to operate and best meet the needs of 
their local communities.

National Civilian Community Corps [NCCC]

    The Committee recommendation includes $37,735,000 for NCCC, 
a full-time, team-based residential program for men and women 
ages 18 to 24. Members are assigned to one of five campuses for 
a 10-month service commitment.

Innovation, Demonstration, and Assistance Activities

    The Committee recommendation includes $14,706,000 for 
innovation, demonstration, and assistance activities.
    Volunteer Generation Fund.--Within the total, the Committee 
recommendation includes $8,558,000 for the Volunteer Generation 
Fund authorized under section 198P of the SERVE America Act 
(Public Law 111-13).
    National Days of Service.--The Committee recommendation 
includes $6,148,000 for National Days of Service including the 
September 11th National Day of Service and Remembrance and the 
Martin Luther King, Jr. National Day of Service. CNCS may give 
priority to making grants, entering into Cooperative 
Agreements, or providing other forms of support to eligible 
organizations with expertise in: representing families of 
victims of the September 11, 2001 terrorist attacks and other 
impacted constituencies; promoting the establishment of 
September 11 as an annually recognized National Day of Service 
and Remembrance; and organizing volunteers to engage in service 
to meet community needs and advance the life and teachings of 
Dr. Martin Luther King, Jr.
    Service Learning.--The Committee encourages CNCS to 
continue to be a convener of the important work surrounding 
service learning, including programs in public schools and 
institutions of higher education.

Evaluation

    The Committee recommendation includes $6,250,000 for CNCS 
evaluation activities.
    Effective Interventions.--The Committee is aware of CNCS 
initiatives to help service providers apply scientific 
evaluation methods to better understand interventions and 
encourages CNCS to continue its use of randomized control 
trials to build causal evidence for effective interventions.

State Commission Grants

    The Committee recommendation includes $19,538,000 for State 
Commission Grants.

                       THE NATIONAL SERVICE TRUST

Appropriations, 2024....................................    $180,000,000
Budget estimate, 2025...................................     159,951,000
Committee recommendation................................     160,000,000

    The Committee recommends an appropriation of $160,000,000 
for the National Service Trust.
    The National Service Trust makes payments of 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 CNCS.

                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $99,686,000
Budget estimate, 2025...................................     127,104,000
Committee recommendation................................      99,686,000

    The Committee recommends an appropriation of $99,686,000 
for CNCS salaries and expenses. The salaries and expenses 
appropriation provides funds for staff salaries, benefits, 
travel, training, rent, equipment, and other operating expenses 
necessary for management of CNCS programs and activities.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2024....................................      $7,595,000
Budget estimate, 2025...................................       8,762,000
Committee recommendation................................       7,595,000

    The Committee recommends an appropriation of $7,595,000 for 
the CNCS OIG. The OIG's goals are to increase organizational 
efficiency and effectiveness within the Corporation and to 
prevent fraud, waste, and abuse.

                       ADMINISTRATIVE PROVISIONS

    The Committee recommendation includes the following general 
provisions for CNCS: requiring CNCS to make any significant 
changes to program requirements or policy through rule making 
(section 401); stipulating minimum share requirements (section 
402); requiring that donations supplement and not supplant 
operations (section 403); aligning requirements regarding the 
use of Education Awards at GI bill-eligible institutions 
(section 404); allowing the required background check of 
certain applicants to be processed by States under terms of the 
National Child Protection Act (Public Law103-209) (section 
405); allowing CNCS to fund certain member service positions 
under 1,700 hours (section 406); and modifying VISTA members' 
education awards (section 407).

                  Corporation for Public Broadcasting

Appropriations, 2024....................................    $595,000,000
Budget estimate, 2025/2027..............................     655,000,000
Committee recommendation................................     595,000,000

    The Committee recommends $595,000,000 for the Corporation 
for Public Broadcasting [CPB]. This includes $535,000,000 as a 
2-year advance appropriation for fiscal year 2027 for CPB to 
carry out its statutory mission of sustaining the public-
private partnership underpinning public media and $60,000,000 
for fiscal year 2025 for continued support of CPB in replacing, 
upgrading, and maintaining the public broadcasting 
interconnection system and further investing in system-wide 
infrastructure and services.
    The majority of the advance appropriation goes directly to 
local public television and radio stations to support their 
programming. CPB funds also support the creation of content for 
radio, television, and other platforms; system support 
activities that benefit the entire public broadcasting 
community; and CPB's administrative costs. This funding 
supports America's local public television and radio stations 
and their mission of developing and ensuring universal access 
to noncommercial, high-quality programming and 
telecommunications services for the American public.
    Interconnection.--Recognizing technology's power to create 
further cost efficiencies across the public media system, the 
Committee recommendation maintains an investment of $60,000,000 
in current year funds for continued support of CPB's efforts to 
replace and upgrade the public broadcasting interconnection 
system and invest in system-wide infrastructure and services 
that benefit the American people. The bill does not include 
proposed language that would allow operational expenses for 
interconnection currently paid out of the six percent system 
support fund to instead be paid using the interconnection 
appropriation.
    Programming.--The Committee supports section 396(g)(1)(A) 
of the Communications Act of 1934, as amended, which authorizes 
CPB to ``facilitate the full development of public 
telecommunications in which programs of high quality, 
diversity, creativity, excellence, and innovation, which are 
obtained from diverse sources, will be made available to public 
telecommunications entities,'' and reminds the CPB that it is 
to maintain a ``strict adherence to objectivity and balance in 
all programs or series of programs of a controversial nature.'' 
The Committee further underscores the importance of 
incorporating diverse points of view throughout public media 
programming, consistent with editorial standards of balance, 
objectivity, fairness, accuracy, and transparency. Including 
diverse points of view is essential to maintaining the trust 
that the American public has placed in public broadcasting and 
the bipartisan support of Congress for public broadcasting.

               Federal Mediation and Conciliation Service


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $53,705,000
Budget estimate, 2025...................................      53,705,000
Committee recommendation................................      53,705,000

    The Committee recommends $53,705,000 for the Federal 
Mediation and Conciliation Service [FMCS]. FMCS provides 
mediation, conciliation, and arbitration services to labor and 
management organizations to prevent and minimize work stoppages 
and promote stable labor-management relationships. FMCS is also 
authorized to provide dispute resolution consultation and 
training to all Federal agencies.

            Federal Mine Safety and Health Review Commission


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $18,012,000
Budget estimate, 2025...................................      17,572,000
Committee recommendation................................      17,572,000

    The Committee recommends $17,572,000 for the Federal Mine 
Safety and Health Review Commission [FMSHRC], which provides 
administrative trial and appellate review of legal disputes 
under the Federal Mine Safety and Health Act of 1977 (Public 
Law 91-173). Most cases involve civil penalties proposed by 
MSHA. FMSHRC's administrative law judges [ALJs] decide cases at 
the trial level and the five-member Commission provides review 
of the ALJ's decisions.

                Institute of Museum and Library Services


       OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2024....................................    $294,800,000
Budget estimate, 2025...................................     280,000,000
Committee recommendation................................     294,800,000

    The Committee recommends $294,800,000 for the Institute of 
Museum and Library Services [IMLS]. This agency supports 
programs for museums and libraries that encourage innovation, 
provide lifelong learning opportunities, promote cultural and 
civic engagement, and improve access to a variety of services 
and information.
    Information Literacy Task Force.--The Committee 
recommendation includes $2,000,000 to continue work on 
information literacy, including the continuation and expansion 
of the Information Literacy Taskforce in accordance with the 
priorities and guidelines described in the explanatory 
statement accompanying Public Law 117-103 and Public Law 117-
328. The Committee also notes the recent launch of the 
Information Literacy website and urges IMLS to further develop 
the portal of resources bridging information literacy research 
and best practices for advancing information literacy within 
communities. Similarly, the Committee directs the IMLS to 
submit a report to the Committees on information literacy 
activities implemented, including any outreach to, and 
engagement with, adult education stakeholders and entities 
implementing Taskforce priorities in the Digital Equity Act 
related to digital equity and inclusion within 1 year of the 
date of enactment of this act. Such report should also include 
Task Force recommendations on areas for future research.
    America250.--The Committee recognizes IMLS's commitment to 
the 250th Anniversary of the founding of the United States in 
coordination with the Semiquincentennial Commission Act of 
2016. The Committee continues to recognize the important role 
of IMLS in supporting existing activities and pilot projects 
that will enhance civic engagement, innovation, and community 
collaboration by convening museum and library professionals, 
facilitating community-driven discussions, and supporting 
partnership grants to museums and libraries in preparation for 
the 250th Anniversary.
    Tribal Consortia Eligibility.--The Committee continues to 
instruct IMLS to issue guidance on how consortia of Indian 
tribes or Tribal organizations could be eligible to apply for 
Tribal library and related grants.
    Museum and Library Facilities.--The Committee continues to 
be concerned about the physical condition of library and museum 
facilities. The Committee looks forward to receiving the GAO 
report required in Senate Report 118-84 on this issue. In 
addition, the Committee appreciates IMLS's work to conduct a 
study on this issue and looks forward to the publication of the 
resulting report.
    Within the total for IMLS, the Committee recommendation 
includes the amounts below:

----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2024         Fiscal year      Committee
                                                                   appropriation   2025 request   recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act [LSTA]:
    Grants to States............................................     180,000,000     177,200,000     183,000,000
    Native American Library Services............................       5,763,000       5,263,000       5,763,000
    National Leadership: Libraries..............................      15,287,000      12,787,000      15,287,000
    Laura Bush 21st Century Librarian...........................      10,000,000       8,000,000      10,000,000
                                                                 -----------------------------------------------
      Subtotal, LSTA............................................     211,050,000     203,250,000     214,050,000
                                                                 ===============================================
Museum Services Act:
    Museums for America.........................................      27,330,000      26,000,000      28,730,000
    21st Century Museum Professional............................       2,000,000       1,000,000       1,000,000
    Native American/Hawaiian Museum Services....................       3,772,000       2,772,000       3,772,000
    National Leadership: Museums................................      10,348,000       8,848,000       9,348,000
                                                                 -----------------------------------------------
      Subtotal, MSA.............................................      43,450,000      38,620,000      42,850,000
                                                                 ===============================================
    African American History and Culture Act....................       6,000,000       4,200,000       4,200,000
    National Museum of the American Latino Act..................       6,000,000       3,900,000       4,200,000
    Research, Analysis and Data Collection......................       5,650,000       5,500,000       5,500,000
    Administration..............................................      22,650,000      24,530,000      24,000,000
                                                                 -----------------------------------------------
        IMLS, Total.............................................     294,800,000     280,000,000     294,800,000
----------------------------------------------------------------------------------------------------------------

            Medicaid and Chip Payment and Access Commission


                         SALARIES AND EXPENSES

Appropriations, 2024....................................      $9,405,000
Budget estimate, 2025...................................      10,698,000
Committee recommendation................................      10,000,000

    The Committee recommends $10,000,000 for the Medicaid and 
CHIP Payment and Access Commission [MACPAC]. This commission 
was established in the Children's Health Insurance Program 
Reauthorization Act of 2009 (Public Law 111-3) and is tasked 
with reviewing State and Federal Medicaid and Children's Health 
Insurance Program access and payment policies and making 
recommendations to Congress, the Secretary of HHS, and the 
States on a wide range of issues affecting those programs. The 
Committee recommendation will allow MACPAC to continue to carry 
out these activities.

                  Medicare Payment Advisory Commission


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $13,824,000
Budget estimate, 2025...................................      14,477,000
Committee recommendation................................      14,477,000

    The Committee recommends $14,477,000 for the Medicare 
Payment Advisory Commission, which provides independent policy 
and technical advice on issues affecting the Medicare program.

                     National Council on Disability


                         SALARIES AND EXPENSES

Appropriations, 2024....................................      $3,850,000
Budget estimate, 2025...................................       4,000,000
Committee recommendation................................       4,000,000

    The Committee recommends $4,000,000 for the National 
Council on Disability [NCD]. NCD is mandated to make 
recommendations to the President, Congress, the Rehabilitation 
Services Administration, and the National Institute on 
Disability, Independent Living, and Rehabilitation Research on 
issues of concern to individuals with disabilities. The Council 
gathers information on the implementation, effectiveness, and 
impact of the Americans with Disabilities Act (Public Law 101-
336) and examines emerging policy issues as they affect persons 
with disabilities and their ability to enter or re-enter the 
Nation's workforce and to live independently.

                     National Labor Relations Board


                         SALARIES AND EXPENSES

Appropriations, 2024....................................    $299,224,000
Budget estimate, 2025...................................     320,002,000
Committee recommendation................................     299,224,000

    The Committee recommends $299,224,000 for the National 
Labor Relations Board [NLRB], which administers and enforces 
the National Labor Relations Act of 1935 (Public Law 74-198) 
and protects employee and employer rights provided under that 
act. The Committee maintains language restricting the use of 
electronic voting.

                        National Mediation Board


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $15,113,000
Budget estimate, 2025...................................      15,113,000
Committee recommendation................................      15,113,000

    The Committee recommends $15,113,000 for the National 
Mediation Board [NMB], which mediates labor-management 
relations in the railroad and airline industries under the 
Railway Labor Act (Public Law 88-542). The NMB mediates 
collective bargaining disputes, conducts elections to determine 
the choice of employee bargaining representatives, and 
administers arbitration of employee grievances.

            Occupational Safety and Health Review Commission


                         SALARIES AND EXPENSES

Appropriations, 2024....................................     $15,449,000
Budget estimate, 2025...................................      16,278,000
Committee recommendation................................      15,449,000

    The Committee recommends $15,449,000 for the Occupational 
Safety and Health Review Commission [OSHRC]. OSHRC serves as a 
court to resolve disputes between OSHA and employers charged 
with violations of health and safety standards enforced by 
OSHA.

                       Railroad Retirement Board

    The Railroad Retirement Board [RRB] administers the 
retirement/survivor and unemployment/sickness insurance benefit 
programs for railroad workers and their families under the 
Railroad Retirement Act (Public Law 93-445) and Railroad 
Unemployment Insurance Act (Public Law 100-647).

                     DUAL BENEFITS PAYMENTS ACCOUNT

Appropriations, 2024....................................      $8,000,000
Budget estimate, 2025...................................       7,000,000
Committee recommendation................................       7,000,000

    The Committee recommends $7,000,000 for the Dual Benefits 
Payments Account together with any estimated income derived 
from income taxes on vested dual benefits. This appropriation 
provides for vested dual benefit payments to beneficiaries 
covered under both the railroad retirement and Social Security 
systems.

          FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNTS

Appropriations, 2024....................................        $150,000
Budget estimate, 2025...................................         150,000
Committee recommendation................................         150,000

    The Committee recommends $150,000 for Federal Payments to 
the Railroad Retirement Account. These funds reimburse the 
railroad retirement trust funds for interest earned on non-
negotiated checks.

                      LIMITATION ON ADMINISTRATION

Appropriations, 2024....................................    $126,000,000
Budget estimate, 2025...................................     134,000,000
Committee recommendation................................     129,000,000

    The Committee recommends $129,000,000 for RRB's costs 
associated with the administration of railroad retirement/
survivor and unemployment/sickness benefit programs. This 
account limits the amount of funds in the railroad retirement 
and railroad unemployment insurance trust funds that may be 
used by the Board for administrative expenses.
    The Committee continues to request annual updates on the 
project status, including timelines to completion, total 
anticipated cost of development, funding obligations, and 
contracts for RRB's fully funded information technology 
modernization system.
    The Committee maintains bill language giving RRB the 
authority to hire new attorneys in the excepted service.

           LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2024....................................     $14,000,000
Budget estimate, 2025...................................      14,600,000
Committee recommendation................................      14,000,000

    The Committee recommends $14,000,000 for RRB Office of the 
Inspector General. This Office conducts audits and 
investigations to protect the integrity of the RRB trust funds 
and provides comprehensive oversight of all RRB operations and 
programs.

                     Social Security Administration


                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2024....................................     $10,000,000
Budget estimate, 2025...................................      15,000,000
Committee recommendation................................      15,000,000

    The Committee recommends $15,000,000 in mandatory funds for 
payments to Social Security trust funds. This account 
reimburses the Old Age and Survivors Insurance [OASI] and 
Disability Insurance [DI] trust funds for special payments to 
certain uninsured persons, costs incurred administering pension 
reform activities, and the value of the interest for benefit 
checks issued but not negotiated. This appropriation restores 
the trust funds to the same financial position they would have 
been in had they not borne these costs and they were properly 
charged to general revenues.

                  SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2024.................................... $45,365,042,000
Budget estimate, 2025...................................  46,555,635,000
Committee recommendation................................  46,388,833,000

    The Committee recommends $46,388,833,000 in fiscal year 
2025 mandatory funds for the SSI program. This is in addition 
to the $21,700,000,000 provided in the fiscal year 2024 
appropriations act for the first quarter of fiscal year 2025. 
In addition, the Committee recommends $22,100,000,000 in 
advance funding for the first quarter of fiscal year 2026. The 
SSI program guarantees a minimum level of income to individuals 
who are disabled, blind, or older than age 65, and meet certain 
income and resource limitations.

Federal Benefit Payments

    The Committee recommendation includes a fiscal year 2025 
program level of $63,108,000,000 for Federal benefit payments.

Beneficiary Services

    The Committee recommendation includes $144,000,000 in new 
mandatory budget authority for beneficiary services.
    These funds reimburse vocational rehabilitation [VR] 
agencies for successfully rehabilitating disabled SSI 
recipients by helping them achieve and sustain productive, 
self-supporting work activity. Funds also support the Ticket to 
Work program that provides SSI recipients with a ticket to 
offer employment networks [ENs], including VR agencies, in 
exchange for employment and support services. Instead of 
reimbursing ENs for specific services, the Ticket to Work 
program pays ENs based on recipients achieving certain 
milestones and outcomes.

Research and Demonstration

    The Committee recommendation includes $91,000,000 in 
mandatory funds for research and demonstration projects 
conducted under sections 1110, 1115, and 1144 of the Social 
Security Act (Public Law 74-271), as amended. These funds 
support a variety of research and demonstration projects 
designed to improve the disability process, promote self-
sufficiency and assist individuals in returning to work, 
encourage savings and retirement planning through financial 
literacy, and generally provide analytical and data resources 
for use in preparing and reviewing policy proposals.

Administrative Expenses

    The Committee recommendation includes $4,745,833,000 for 
SSI program administrative expenses. This appropriation funds 
the SSI program's share of administrative expenses incurred 
through the Limitation on Administrative Expenses [LAE] 
account.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2024.................................... $14,225,978,000
Budget estimate, 2025...................................  15,400,924,000
Committee recommendation................................  14,734,978,000

    This account provides resources for SSA to administer the 
OASI, DI, and SSI programs, and to support CMS in administering 
the Medicare program. The LAE account is funded by the Social 
Security and Medicare trust funds for their share of 
administrative expenses, the general fund for the SSI program's 
share of administrative expenses, and applicable user fees. 
These funds support core administrative activities including 
processing retirement and disability claims, conducting 
hearings to review disability determination appeals, issuing 
Social Security numbers and cards, processing individuals' 
annual earnings information, and ensuring the integrity of 
Social Security programs through continuing disability reviews 
[CDR] and SSI redeterminations of non-medical eligibility.
    The Committee recommendation includes $1,903,000,000 for 
program integrity activities, including CDRs, SSI 
redeterminations of non-medical eligibility, and Cooperative 
Disability Investigations units. This includes $273,000,000 in 
base funding and $1,630,000,000 in cap adjustment funding, as 
authorized and specified in the Fiscal Responsibility Act of 
2023.
    The Committee recommendation also includes up to 
$171,000,000 for administrative activities funded from user 
fees. This includes up to $170,000,000 in fees collected from 
States that request SSA to administer State SSI supplementary 
payments and up to $1,000,000 from fees collected from non-
attorney claimant representatives.
    The Committee recommendation also includes not less than 
$2,993,000 for the Social Security Advisory Board. This board 
advises the Commissioner of Social Security and makes 
recommendations to Congress and the President on policies 
relating to the OASI, DI, and SSI programs.
    Cooperative Disability Investigations [CDI].--The Committee 
directs SSA to provide an update in its fiscal year 2026 CJ on 
CDI units, including updates on the program's projected savings 
to SSA's disability programs, total recovery amounts, and 
projected savings to other Federal and State programs. Such 
updates shall also include suggestions regarding other ways 
Federal and State agencies may partner on anti-fraud 
initiatives with respect to Social Security programs.
    Disability Claims Backlogs.--The Committee recognizes that 
disability claim and reconsideration processing times have been 
increasing in recent years. To ensure that disability claims 
are processed in a timely and efficient manner, the Committee 
continues to direct SSA to prioritize funding, to the greatest 
extent possible, toward reducing the initial disability claims 
backlog and other disability benefit workloads, including by 
directing resources and workload assistance to areas with the 
greatest need. The Committee continues to direct SSA to provide 
monthly reports to the Committee on key agency performance 
metrics, including but not limited to initial disability 
claims, reconsiderations, and hearings.
    IT Modernization Procurement Policies.--In the Office of 
Management and Budget's [OMB], Managing Information as a 
Strategic Resource, Circular No. A-130, OMB requires that 
agency information technology [IT] investments ``implement an 
Agile development approach, as appropriate.'' According to the 
SSA's OIG report titled ``Agile Software Development at the 
Social Security Administration'', SSA is not using Agile best 
practices consistently across all its software development 
projects. In the analysis, OIG identified instances in which 
SSA did not follow key Agile development best practices related 
to delivery of planned work; appropriate development of system 
requirements, capabilities, and features; size and composition 
of Agile development teams; definition of team policies and 
other basic practices; lessons learned; human-centered design 
practices; testing; and peer reviews. The Committee recommends 
SSA work with General Services Administration on future IT 
Modernization projects.
    Outreach to People with Disabilities and Experiencing 
Homelessness.--The Committee strongly encourages SSA to expand 
outreach to potential beneficiaries, prioritizing underserved 
communities and individuals most likely to need support, 
including those experiencing homelessness. The Committee 
encourages SSA to leverage its existing Federal and State 
relationships to identify individuals who may be eligible for 
the SSI and SSDI programs. The Committee directs SSA to include 
information in its fiscal year 2026 CJ on such efforts.
    Reducing Submission of Physical Documentation.--Pursuant to 
Executive Order 14058, Transforming Federal Customer Experience 
and Service Delivery to Rebuild Trust in Government, SSA is 
directed to identify ``potential opportunities for policy 
reforms that can support modernized customer experiences while 
ensuring original or physical documentation requirements remain 
where there is a statutory or strong policy rationale.'' SSA 
was also directed to ``develop a mobile-accessible, online 
process so that any individual applying for or receiving 
services from the Social Security Administration can upload 
forms, documentation, evidence, or correspondence associated 
with their transaction without the need for service-specific 
tools or traveling to a field office.'' The Committee looks 
forward to receiving the report requested under this heading in 
Senate Report 118-84.
    Staffing Plan.--The Committee notes the importance of 
ensuring SSA has the necessary workforce to operate efficiently 
and provide high-quality service to program beneficiaries. The 
Committee requests SSA continue to provide a quarterly staffing 
report detailing FTEs and new hires by component. These reports 
shall include the total number of new hires, departed 
employees, net change in FTEs, and funds obligated and expended 
on new hires, broken down by programmatic area. These reports 
should also include a written hiring plan detailing SSA's 
strategy to enhance its recruitment and retention, its 
implementation of the strategy, and recommended administrative 
and legislative actions to enhance the agency's recruitment and 
retention.
    Supplemental Security Income Application Simplification.--
The complexity of the SSI program and the application process, 
compounded by long wait times in the field offices and on the 
National 800 number, can make it difficult for individuals to 
apply for benefits. This is an even bigger challenge given the 
individuals relying on SSI, including those experiencing 
homelessness, diagnosed with a terminal illness, and disabled 
veterans. It is also one of SSA's most resource intensive and 
time-consuming workloads that contributes to SSA's overall 
service delivery challenges and funding needs. The Committee 
strongly encourages SSA to prioritize simplifying the SSI 
application and making it available online. As many components 
of the SSI application are required by statute, simplification 
may require legislative changes. The Committee looks forward to 
receiving the report requested under this heading in Senate 
Report 118-84.
    Improving Effectuation of Disability Benefits.--The Social 
Security Advisory Board published a report, ``Effectuation of 
Disability Benefits,'' which examined the agency's effectuation 
process, focusing on SSDI and SSI awards. The report found 
significant variance in processing time based on the type of 
benefit and the stage in which the claim was awarded. The 
Committee directs SSA to submit a report to the Committees, the 
House Committee on Ways and Means, and the Senate Committee on 
Finance within 180 days regarding proposed changes to improve 
the speed and accuracy of effectuation.
    Beneficiary Information on Claims Timing.--The Committee is 
concerned many retiring beneficiaries make their claiming 
decision without a full understanding of the financial 
implications of benefit reductions for early retirement or 
delayed retirement credits. The Committee requests a report in 
the fiscal year 2026 CJ describing SSA's protocols, operating 
procedures, and informational materials (including 
nomenclature) used to inform retiring beneficiaries of how 
changes in their claiming date may affect their monthly benefit 
after claiming. Such report shall also include changes to such 
protocols, procedures, materials, and nomenclature SSA has 
considered using to help beneficiaries make more informed 
decisions regarding the timing of their retirement claim and 
improve the public's understanding of the effect of different 
claiming strategies.
    Ticket to Work Improvements.--The Committee recognizes that 
the Ticket to Work program may be underutilized and can provide 
important resources for individuals looking to return to work. 
The Committee encourages SSA to work to identify ways to 
improve the program's effectiveness through existing and 
relevant statutory authorities.
    Modernization of Production of Notices.--The Committee 
supports SSA's efforts to modernize its systems, which produce 
18-20 million Social Security cards annually and 12 million 
notices per year. As the agency moves forward these efforts, 
the Committee encourages SSA to leverage existing commercial 
off-the-shelf technology and techniques, including color, when 
appropriate to improve the readability of important notices, as 
well as improve accessibility and service, increase security, 
reduce costs, and increase redundancy and efficiency. The 
Committee directs SSA to provide information in the 2026 CJ 
regarding SSA's modernization strategy, and how the agency is 
looking to take advantage of modern technology and design 
techniques to improve readability, accessibility, and service 
to beneficiaries and reduce costs to taxpayers.
    IT Activities.--The Committee directs SSA to provide a 
report to the Committee, within 90 days of enactment of this 
act, detailing the number and amount of contracts, grants, and 
cooperative agreements awarded for the purpose of maintaining, 
expanding, and/or modernizing/enhancing its information 
technology capabilities and infrastructure. Such report shall 
include, at a minimum, the name of the contractor or grantee, 
the amount of funding, the contract duration, the governmental 
purpose, and the programmatic area(s) within SSA's IT portfolio 
(as described on Table 3.26-Appendix A of the fiscal year 2025 
CJ) the contract serves.
    Rural and Frontier Service Delivery.--The Committee is 
concerned that senior citizens and Americans with disabilities 
in rural and frontier areas of the Nation are unable to access 
in-person Social Security services and that access by phone or 
videoconference is limited. The Committee strongly urges SSA to 
evaluate its service delivery options in rural and frontier 
areas and, when feasible, implement expanded access to options 
that have been most effective for residents of these areas to 
ensure that SSA is able to provide timely assistance, whether 
in-person, by phone, or by videoconference.
    Survivor Benefits Processing.--The Committee notes the 
importance of ensuring that timely, quality beneficiary 
services are rendered to current and prospective recipients of 
survivors benefits. The Committee emphasizes that, as with 
other types of Social Security benefits, the timing of claiming 
and associated services can be critical for the livelihood of 
survivors, especially child beneficiaries.
    Vocational Guidelines.--The Committee is aware that 
implementation of the Occupational Information System [OIS] 
project, which aims to bring the vocational list used in 
disability determinations in line with current job 
opportunities, is ongoing. The Committee notes that SSA has 
obligated and expended significant resources and time on this 
project to-date. Therefore, the Committee directs SSA, within 
90 days of enactment of this act, to provide a briefing to the 
Committees on Appropriations and Finance of the Senate and the 
Committees on Appropriations and Ways and Means of the House of 
Representatives regarding SSA's status in making these changes 
to occupational data, completed actions to-date, and planned 
actions for this project over the coming fiscal year.
    Work Incentives Planning and Assistance [WIPA] and 
Protection and Advocacy for Beneficiaries of Social Security 
[PABSS].--The Committee recommendation includes $23,000,000 for 
WIPA and $10,000,000 for PABSS, the same as the comparable 
fiscal year 2024 levels, respectively. These programs provide 
valuable services to help Social Security disability 
beneficiaries return to work. The Committee notes that delayed 
suitability determinations have in some cases significantly 
affected the ability of PABSS grantees to carry out their 
mission to protect the rights and best interests of individuals 
with disabilities.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2024....................................    $114,665,000
Budget estimate, 2025...................................     121,254,000
Committee recommendation................................     114,665,000

    The Committee recommends $114,665,000 for SSA's OIG. This 
includes $82,665,000 funded from the OASI and DI trust funds 
for those programs' share of OIG's expenses and $32,000,000 
funded from general revenues for the SSI program's share of 
expenses.
    Combating Social Security Impersonation Scams.--The 
Committee continues to commend the work that SSA OIG has done 
to combat Social Security impersonation scams. The Committee 
again encourages SSA OIG to prioritize work with SSA to 
increase awareness of this scam and to pursue the criminals 
perpetrating this fraud.

                                TITLE V

                           GENERAL PROVISIONS

    Section 501. The bill continues a provision authorizing 
transfers of unexpended balances.
    Section 502. The bill continues a provision limiting 
funding to 1-year availability unless otherwise specified.
    Section 503. The bill continues a provision limiting 
lobbying and related activities.
    Section 504. The bill modifies a provision limiting 
official representation expenses.
    Section 505. The bill continues a provision clarifying the 
requirement to identify Federal funding made available in this 
act as a component of State and local grant funds in all public 
materials related to such funds.
    Sections 506 and 507. The bill continues provisions 
limiting the use of funds for abortions.
    Section. 508. The bill continues a provision restricting 
human embryo research.
    Section 509. The bill continues a provision limiting the 
use of funds for promotion of legalization of controlled 
substances.
    Section 510. The bill continues a provision prohibiting the 
use of funds to promulgate regulations regarding the individual 
health identifier.
    Section 511. The bill continues a provision limiting the 
use of funds to enter into or review contracts with entities 
subject to the requirement in section 4212(d) of title 38, 
United States Code, if the report required by that section has 
not been submitted.
    Section 512. The bill continues a provision prohibiting the 
transfer of funds made available in this act to any department, 
agency, or instrumentality of the U.S. Government, except as 
otherwise provided by this or any other act.
    Section 513. The bill continues a provision prohibiting 
Federal funding in this act for libraries unless they are in 
compliance with the Children's Internet Protection Act (Public 
Law 106-554).
    Section 514. The bill continues a provision maintaining a 
procedure for reprogramming of funds.
    Section 515. The bill continues a provision prohibiting 
candidates for scientific advisory committees from having to 
disclose their political activities.
    Section 516. The bill continues a provision requiring each 
department and related agency to submit an operating plan.
    Section 517. The bill continues a provision requiring the 
Secretaries of Labor, Health and Human Services, and Education 
to submit a report on the number and amounts of contracts, 
grants, and cooperative agreements awarded by the Departments 
on a noncompetitive basis.
    Section 518. The bill continues a provision prohibiting SSA 
from processing earnings for work performed under a fraudulent 
social security number if based on a conviction for a violation 
under section 208(a)(6) or (7) of the Social Security Act 
(Public Law 74-271).
    Section 519. The bill continues a provision prohibiting SSA 
from establishing a totalization agreement with Mexico.
    Section 520. The bill continues a provision requiring 
computer networks to block pornography.
    Section 521. The bill continues a provision related to 
reporting requirements for conference spending.
    Section 522. The bill continues a provision related to 
advertisement costs.
    Section 523. The bill modifies a provision on Performance 
Partnerships.
    Section 524. The bill continues a provision regarding 
reporting status of balances of appropriations.
    Section 525. The bill continues a provision on grant 
notifications.
    Section 526. The bill continues a provision regarding 
funding for programs that carry out distribution of sterile 
needles or syringes.
    Section 527. The bill continues a provision requiring 
questions for the record be submitted within 45 days of 
receipt.
    Section 528. The bill includes a new provision providing an 
additional $5,000,000 available for obligation through 
September 30, 2029 solely for costs necessary to modernize 
NLRB's outdated case management system and information 
technology [IT] infrastructure that are negatively affecting 
case-handling efficiency and exposing increased cybersecurity 
risks. The NLRB is directed to report annually on the spending 
of these IT modernization funds and progress toward upgrading 
its case management system.
    Section 529. The bill modifies a provision rescinding funds 
from the Children's Health Insurance Program child enrollment 
contingency fund.
    Sections 530. The bill includes a provision rescinding 
funds from the Children's Insurance Program.
    Section 531. The bill includes a provision rescinding funds 
from section 2401 of the American Rescue Plan Act of 2021 
(Public Law 117-2).
    Section 532. The bill continues a provision related to 
research and evaluation funding flexibility.
    Section 533. The bill includes a new provision regarding 
amounts available in this act designated as an emergency 
requirement.

  COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE 
                                 SENATE

    Paragraph 7 of rule XVI requires that Committee reports on 
general appropriations bills identify each Committee amendment 
to the House bill ``which proposes an item of appropriation 
which is not made to carry out the provisions of an existing 
law, a treaty stipulation, or an act or resolution previously 
passed by the Senate during that session.''
    The Committee is filing an original bill, which is not 
covered under this rule, but reports this information in the 
spirit of full disclosure.
    The Committee recommends funding for the following programs 
and activities which currently lack authorization: Workforce 
Innovation and Opportunity Act programs; Trade Adjustment 
Assistance; School-Based Health Centers; Nurse Education Loan 
Repayment; Education and Training Related to Geriatrics; Mental 
and Behavioral Health Training; Children's Hospital Graduate 
Medical Education; Title XVII of the PHS Act; Ryan White CARE 
Act; Ending the HIV Epidemic; Universal Newborn Hearing 
Screening; Organ Transplantation; Family Planning; Rural Health 
programs; Traumatic Brain Injury programs; Autism 
Collaboration, Accountability, Research, Education, and Support 
Act; Public Health Improvement Act; Firefighter Cancer Registry 
Act of 2018; Cybersecurity and National Security programs; 
Healthy Start; Telehealth; Health Professions Education 
Partnership Act; Children's Health Act; Women's Health Research 
and Prevention Amendments of 1998; Birth Defects Prevention, 
Preventive Health Amendments of 1993; Research on Health Costs, 
Quality, and Outcomes; Substance Use and Mental Health Services 
programs; Protection and Advocacy for Individuals with Mental 
Illness; State Opioid Response Grants; Low Income Home Energy 
Assistance Program; Refugee and Entrant Assistance programs; 
Child Care and Development Block Grant; Children and Families 
Services Programs; Head Start; Preschool Development Grants; 
Runaway and Homeless Youth programs; Adoption and Legal 
Guardianship Incentive Payments; CAPTA programs; Family 
Violence programs; National Domestic Violence Hotline; Child 
Welfare Services; Developmental Disabilities programs; Voting 
Access for Individuals with Disabilities; Native American 
Programs; Community Services Block Grant Act programs; National 
Institutes of Health; Assets for Independence; Alzheimer's 
Disease Demonstration Grants; Office of Disease Prevention and 
Health Promotion; Assistive Technology Act; Elementary and 
Secondary Education Act of 1965; Rehabilitation Act of 1973 
programs; Helen Keller National Center Act; Education of the 
Deaf Act; Adult Education and Family Literacy Act programs; 
Education Sciences Reform Act; Parts C and D of the Individuals 
with Disabilities Education Act; Special Olympics Sport and 
Empowerment Act of 2004; Corporation for Public Broadcasting; 
Corporation for National and Community Service; National 
Council on Disability; Older Americans Act; Second Chance Act; 
Work Incentive Planning and Assistance; and Protection and 
Advocacy for Beneficiaries of Social Security.

COMPLIANCE WITH PARAGRAPH 7(c), RULE XXVI OF THE STANDING RULES OF THE 
                                 SENATE

    Pursuant to paragraph 7(c) of rule XXVI, on August 1, 2024, 
the Committee ordered favorably reported an original bill (S. 
4942) making appropriations for the Departments of Labor, 
Health and Human Services, and Education, and related agencies 
for the fiscal year ending September 30, 2025, and for other 
purposes, provided, that the bill be subject to amendment and 
that the bill be consistent with its budget allocation, and 
provided that the Chair of the Committee or her designee be 
authorized to offer the substance of the original bill as a 
Committee amendment in the nature of a substitute to the House 
companion measure, by a recorded vote of 25-3, a quorum being 
present. The vote was as follows:
        Yeas                          Nays
Chair Murray                        Mr. Hagerty
Mr. Durbin                          Mr. Rubio
Mr. Reed                            Mrs. Fischer
Mr. Tester
Mrs. Shaheen
Mr. Merkley
Mr. Coons
Mr. Schatz
Ms. Baldwin
Mr. Murphy
Mr. Manchin
Mr. Van Hollen
Mr. Heinrich
Mr. Peters
Ms. Sinema
Ms. Collins
Mr. McConnell
Ms. Murkowski
Mr. Graham
Mr. Moran
Mr. Boozman
Mrs. Capito
Mr. Kennedy
Mrs. Hyde-Smith
Mrs. Britt

 COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE STANDING RULES OF THE 
                                 SENATE

    Paragraph 12 of rule XXVI requires that the Committee 
report on a bill or joint resolution repealing or amending any 
statute or part of any statute include ``(a) the text of the 
statute or part thereof which is proposed to be repealed; and 
(b) a comparative print of that part of the bill or joint 
resolution making the amendment and of the statute or part 
thereof proposed to be amended, showing by stricken-through 
type and italics, parallel columns, or other appropriate 
typographical devices the omissions and insertions which would 
be made by the bill or joint resolution if enacted in the form 
recommended by the Committee.''
    In compliance with this rule, changes in existing law 
proposed to be made by the bill are shown as follows: existing 
law to be omitted is enclosed in black brackets; new matter is 
printed in italic; and existing law in which no change is 
proposed is shown in roman.

                          TITLE 20--EDUCATION


     Chapter 28--Higher Education Resources and Student Assistance


                    Subchapter I--General Provisions


                 PART B--ADDITIONAL GENERAL PROVISIONS

Sec. 1011c. National Advisory Committee on Institutional Quality and 
                    Integrity

(a) Establishment

           *       *       *       *       *       *       *


(f) Termination

    The Committee shall terminate on September 30, [2021] 2025.

           *       *       *       *       *       *       *


                   Subchapter IV--Student Assistance


          PART D--WILLIAM D. FORD FEDERAL DIRECT LOAN PROGRAM

Sec. 1087h. Funds for administrative expenses

(a) Administrative expenses

  (1) Mandatory funds for fiscal year 2006

           *       *       *       *       *       *       *


  (4) Continuing mandatory funds for account maintenance fees

    For each of the fiscal years 2007 through [2021] 2025, 
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).
                                ------                                


                            TITLE 29--LABOR


                    Chapter 12--Department of Labor


Sec. 551. Establishment of Department; Secretary; seal

    There shall be an executive department in the Government to 
be called the Department of Labor, with a Secretary of Labor, 
who shall be the head thereof, to be appointed by the 
President, by and with the advice and consent of the Senate, 
and whose tenure of office shall be like that of the heads of 
the other executive departments. The provisions of title 4 of 
the Revised Statutes, including all amendments thereto, shall 
be applicable to said department. The purpose of the Department 
of Labor shall be to foster, promote, and develop the welfare 
of the wage earners of the United States, to improve their 
working conditions, and to advance their opportunities for 
profitable employment. The said Secretary shall cause a seal of 
office to be made for the said department of such device as the 
President shall approve and judicial notice shall be taken of 
the said seal.

    (a) In General.--The Secretary of Labor is authorized to 
employ law enforcement officers or special agents to--

            (1) provide protection for the Secretary of Labor 
        during the workday of the Secretary and during any 
        activity that is preliminary or postliminary to the 
        performance of official duties by the Secretary;

            (2) provide protection, incidental to the 
        protection provided to the Secretary, to a member of 
        the immediate family of the Secretary who is 
        participating in an activity or event relating to the 
        official duties of the Secretary;

            (3) provide continuous protection to the Secretary 
        (including during periods not described in paragraph 
        (1)) and to the members of the immediate family of the 
        Secretary if there is a unique and articulable threat 
        of physical harm, in accordance with guidelines 
        established by the Secretary; and

            (4) provide protection to the Deputy Secretary of 
        Labor or another senior officer representing the 
        Secretary of Labor at a public event if there is a 
        unique and articulable threat of physical harm, in 
        accordance with guidelines established by the 
        Secretary.

    (b) Authorities.--The Secretary of Labor may authorize a 
law enforcement officer or special agent employed under 
subsection (a), for the purpose of performing the duties 
authorized under subsection (a), to--

            (1) carry firearms;

            (2) make arrests without a warrant for any offense 
        against the United States committed in the presence of 
        such officer or special agent;

            (3) perform protective intelligence work, including 
        identifying and mitigating potential threats and 
        conducting advance work to review security matters 
        relating to sites and events;

            (4) coordinate with local law enforcement agencies; 
        and

            (5) initiate criminal and other investigations into 
        potential threats to the security of the Secretary, in 
        coordination with the Inspector General of the 
        Department of Labor.

    (c) Compliance With Guidelines.--A law enforcement officer 
or special agent employed under subsection (a) shall exercise 
any authority provided under this section in accordance with 
any--

            (1) guidelines issued by the Attorney General; and

            (2) guidelines prescribed by the Secretary of 
        Labor.
                                ------                                


     NATIONAL AND COMMUNITY SERVICE ACT OF 1990, PUBLIC LAW 101-610


      TITLE I--NATIONAL AND COMMUNITY SERVICE STATE GRANT PROGRAM


 Subtitle D--National Service Trust and Provision of Educational Awards


SEC. 148. DISBURSEMENT OF EDUCATIONAL AWARDS.

    (a) In General.--

           *       *       *       *       *       *       *

    (f) Transfer of Educational Awards.--

            (1) In general.-- * * *

            (2) Conditions for transfer.--An educational award 
        may be transferred under this subsection if--

                    (A)(i) the award is a national service 
                educational award for service in [a national 
                service program that receives a grant under 
                subtitle C] an approved national service 
                position; and
                                ------                                


                CONSOLIDATED APPROPRIATIONS ACT, 2014, 
                           PUBLIC LAW 113-76


   DIVISION H--DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND 
        EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2014


                                TITLE V


                           GENERAL PROVISIONS

    Sec. 526. (a) Definitions.-- * * *

           *       *       *       *       *       *       *

    (b) Use of Discretionary Funds in [Fiscal Year 2014] Fiscal 
Year 2025.-- * * *

           *       *       *       *       *       *       *

    (c) Performance Partnership Agreements.--Federal agencies 
may use Federal discretionary funds, as authorized in 
subsection (b), to participate in a Performance Partnership 
Pilot only in accordance with the terms of a Performance 
Partnership Agreement that--

            (1) is entered into between--

           *       *       *       *       *       *       *

            (2) specifies, at a minimum, the following 
        information: (A) the length of the Agreement (which 
        shall not extend beyond [September 30, 2018] September 
        30, 2029);

           *       *       *       *       *       *       *

    (e) Transfer Authority.--For the purpose of carrying out 
the Pilot in accordance with the Performance Partnership 
Agreement, and subject to the written approval of the Director 
of the Office of Management and Budget, the head of each 
participating Federal agency may transfer Federal discretionary 
funds that are being used in the Pilot to an account of the 
lead Federal administering agency that includes Federal 
discretionary funds that are being used in the Pilot. Subject 
to the waiver authority under subsection (f), such transferred 
funds shall remain available for the same purposes for which 
such funds were originally appropriated: Provided, That such 
transferred funds shall remain available for obligation by the 
Federal Government until the expiration of the period of 
availability for those Federal discretionary funds (which are 
being used in the Pilot) that have the longest period of 
availability, except that any such transferred funds shall not 
remain available beyond [September 30, 2018] September 30, 
2029.
                                ------                                


    FURTHER CONSOLIDATED APPROPRIATIONS ACT, 2024, PUBLIC LAW 118-47


  DIVISION C--DEPARTMENT OF HOMELAND SECURITY APPROPRIATIONS ACT, 2024


                                TITLE V


                           GENERAL PROVISIONS

    Sec. 547. Notwithstanding the amounts made available for 
vocational rehabilitation services pursuant to title I of the 
Rehabilitation Act in ``Department of Education--Rehabilitation 
Services'' in division D of this Act and notwithstanding 
sections 100(b)(1) and 100(c)(2) of the Rehabilitation Act, 
each State shall be entitled to an allotment equal to the 
amount such State received pursuant to section 110(a) of the 
Rehabilitation Act for the fiscal year ending September 30, 
2023, prior to any additions or reductions under section 110(b) 
or section 111(a)(2)(B): Provided, That, of such amounts made 
available under the heading ``Department of Education--
Rehabilitation Services'' in division D of this Act, 
$286,791,761 is hereby rescinded: [Provided further, That, for 
fiscal year 2025, each State shall be entitled to an allotment 
pursuant to section 110(b) of the Rehabilitation Act that shall 
be calculated as if this section were not in effect in fiscal 
year 2024.] Provided further, That, for fiscal year 2025, each 
State shall be entitled to an allotment pursuant to section 
110(a) of the Rehabilitation Act that shall be calculated as if 
the percentage change in the Consumer Price Index determined 
under section 100(c) of such Act was not used to set the amount 
of the appropriation in fiscal year 2024.
                                ------                                


                        BUDGETARY IMPACT OF BILL


  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO  SEC. 308(A), PUBLIC LAW 93-344, AS
                                                     AMENDED
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                  Budget authority               Outlays
                                                             ---------------------------------------------------
                                                               Committee    Amount  in   Committee    Amount  in
                                                               allocation      bill      allocation      bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with the subcommittee
 allocation for 2025: Subcommittee on Labor, HHS, Education,
 and Related Agencies:
    Mandatory...............................................    1,150,142    1,150,142    1,148,619  \1\1,148,61
                                                                                                               9
    Discretionary...........................................      198,655      198,655      250,586   \1\240,215
        Defense.............................................  ...........  ...........           NA           NA
        Non-defense.........................................      198,655      198,655           NA           NA
Projection of outlays associated with the recommendation:
    2025....................................................  ...........  ...........  ...........  \2\1,260,15
                                                                                                               8
    2026....................................................  ...........  ...........  ...........      117,056
    2027....................................................  ...........  ...........  ...........       37,795
    2028....................................................  ...........  ...........  ...........        7,139
    2029 and future years...................................  ...........  ...........  ...........        1,563
Financial assistance to State and local governments for                NA      469,750           NA   \2\639,571
 2025.......................................................
 
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
\2\Excludes outlays from prior-year budget authority.
 
NA: Not applicable.
 
NOTE.--Consistent with the funding recommended in the bill for continuing disability reviews and
  redeterminations, for health care fraud and abuse control, for reemployment services and eligibility
  assessments, and for emergency requirements in accordance with subparagraphs (B), (C), (E), and (A)(i) of the
  Balanced Budget and Emergency Deficit Control Act of 1985, the Committee anticipates that the Budget Committee
  will provide, at the appropriate time, a 302(a) allocation for the Committee on Appropriations reflecting a
  net upward adjustment of $9,531,000,000 in budget authority plus the associated outlays. Pursuant to section
  1001(b)(3)(B) of the 21st Century Cures Act (Public Law 114-255), $127,000,000 in budget authority and the
  resulting outlays do not count for the purposes of estimates under the Congressional Budget and Impoundment
  Control Act of 1974 or the Balanced Budget and Emergency Deficit Control Act of 1985.

         DISCLOSURE OF CONGRESSIONALLY DIRECTED SPENDING ITEMS

    The Constitution vests in the Congress the power of the 
purse. The Committee believes strongly that Congress should 
make the decisions on how to allocate the people's money. As 
defined in Rule XLIV of the Standing Rules of the Senate, the 
term ``congressionally directed spending item'' means a 
provision or report language included primarily at the request 
of a Senator, providing, authorizing, or recommending a 
specific amount of discretionary budget authority, credit 
authority, or other spending authority for a contract, loan, 
loan guarantee, grant, loan authority, or other expenditure 
with or to an entity, or targeted to a specific State, locality 
or congressional district, other than through a statutory or 
administrative, formula-driven, or competitive award process.
    For each item, a Member is required to provide a 
certification that neither the Member nor the Member's 
immediate family has a pecuniary interest in such 
congressionally directed spending item. Such certifications are 
available to the public on the website of the Senate Committee 
on Appropriations (https://www.appropriations.senate.gov/
congressionally-directed-spending-requests). Following is a 
list of congressionally directed spending items included in the 
Senate recommendation discussed in this explanatory statement, 
along with the name of each Senator who submitted a request to 
the Committee of jurisdiction for each item so identified. 
Neither the Committee recommendation nor this report contains 
any limited tax benefits or limited tariff benefits as defined 
in rule XLIV.

                                                         CONGRESSIONALLY DIRECTED SPENDING ITEMS
--------------------------------------------------------------------------------------------------------------------------------------------------------
           Department                        Account                                   Project                          Amount          Requestor(s)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Akron Metropolitan Housing Authority (AMHA), OH,      1,563,000  Brown
                                  Administration.                  for expanding workforce training and providing
                                                                   supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Alaska Joint Electrical Apprenticeship & Training     1,000,000  Murkowski
                                  Administration.                  Trust, AK, for the purchase of equipment and
                                                                   supplies for workforce training programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Alaska Primary Care Association, AK, for a            1,722,000  Murkowski
                                  Administration.                  workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          AltaMed Health Services Corporation, CA, for            995,000  Butler, Padilla
                                  Administration.                  healthcare workforce training, which may include
                                                                   tuition and fees and purchasing equipment and
                                                                   training materials.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Androscoggin Home Health Services Inc DBA               192,000  Collins
                                  Administration.                  Androscoggin Home Healthcare & Hospice, ME, for
                                                                   a nurse practitioner fellowship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Applied Behavioral Rehabilitation Institute,            120,000  Blumenthal, Murphy
                                  Administration.                  Inc., CT, for workforce development programming,
                                                                   including supportive services for veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Arouet Foundation, AZ, for a reentry workforce          600,000  Sinema
                                  Administration.                  program, including for the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          ASI, Inc., IL, for providing employment and             750,000  Durbin
                                  Administration.                  training services, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Baltimore Alliance for Careers in Healthcare, MD,       579,000  Cardin, Van Hollen
                                  Administration.                  for an apprenticeship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Bay Consortium Workforce Development Board, VA,         319,000  Kaine, Warner
                                  Administration.                  for improving education and workforce training,
                                                                   which may include the purchase of technology and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Blackstone Valley Community Action Program, Inc.        110,000  Reed
                                  Administration.                  (BVCAP), RI, for improving job training services
                                                                   at a career development center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          CASA, Inc., MD, for expanding workforce training,     1,000,000  Cardin, Van Hollen
                                  Administration.                  including the purchase of equipment and
                                                                   materials.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          CCARC, Inc., CT, for supporting a manufacturing         189,000  Blumenthal, Murphy
                                  Administration.                  internship program and workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Cecil College, MD, for improving commercial truck       109,000  Cardin, Van Hollen
                                  Administration.                  driver workforce training, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Central Council Tlingit & Haida Indian Tribes of      1,000,000  Murkowski
                                  Administration.                  Alaska, AK, for pre-apprenticeship programs,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Central Minnesota Jobs and Training Services,           445,000  Klobuchar, Smith
                                  Administration.                  Inc., MN, for workforce development programs,
                                                                   which may include purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Central Washington University, WA, for education      1,700,000  Murray
                                  Administration.                  and workforce training opportunities for
                                                                   students, which may include stipends and tuition
                                                                   payments.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          City and County of Denver, CO, for supporting a       1,000,000  Bennet, Hickenlooper
                                  Administration.                  youth work-based learning program, including
                                                                   wages for participants and supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          City of Detroit, MI, for summer workforce             2,000,000  Peters, Stabenow
                                  Administration.                  development for youth, including wages for youth
                                                                   participants.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          City of New Haven, CT, for a career learning          2,500,000  Blumenthal, Murphy
                                  Administration.                  center, which may include the purchase of
                                                                   equipment and lab materials.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Cloud County Community College, KS, for the             800,000  Moran
                                  Administration.                  purchase of equipment and supplies for workforce
                                                                   training programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          College of Southern Maryland, MD, for education         732,000  Cardin, Van Hollen
                                  Administration.                  and training in water and wastewater treatment
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Columbus Urban League, OH, for improving                398,000  Brown
                                  Administration.                  workforce training opportunities, including the
                                                                   purchase of technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Community Forgiveness and Restoration Initiative,       250,000  Casey
                                  Administration.                  PA, for expanding workforce development
                                                                   opportunities and career services, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          CT Puerto Rican Forum dba Center for Latino           1,184,000  Blumenthal, Murphy
                                  Administration.                  Progress, CT, for workforce development
                                                                   programming, including the purchase of equipment
                                                                   and stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          DAY ONE Early Learning Community, Inc., NY, for       1,500,000  Gillibrand, Schumer
                                  Administration.                  establishing a teacher apprenticeship program,
                                                                   including rental costs and purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Delaware County Community College, PA, for              500,000  Casey, Fetterman
                                  Administration.                  workforce training, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Delaware Workforce Development Board, DE, for        10,000,000  Carper
                                  Administration.                  expanding workforce development opportunities,
                                                                   including work-based learning opportunities,
                                                                   internships, and career navigation opportunities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Dover Adult Learning Center, NH, for healthcare         100,000  Shaheen
                                  Administration.                  workforce training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Drink at the Well, Inc., MD, for expanding              190,000  Cardin, Van Hollen
                                  Administration.                  workforce development programming and providing
                                                                   wrap around services, including child care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Early Childhood Center of Excellence at Santa Fe        201,000  Heinrich
                                  Administration.                  Community College, NM, for expanding
                                                                   apprenticeships and pre-apprenticeships,
                                                                   including providing stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Educate Maine, ME, for the purchase of career and     4,000,000  Collins, King
                                  Administration.                  technical education equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Elliot Health System, NH, for expanding workforce       460,000  Shaheen
                                  Administration.                  training, which may include providing
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Forest Workforce Training Institute, AL, for a        1,320,000  Britt
                                  Administration.                  forest workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Forge City Works, CT, for a culinary job training       500,000  Blumenthal, Murphy
                                  Administration.                  program, which may include supportive services,
                                                                   purchasing equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Generation West Virginia, WV, for a youth               891,000  Capito, Manchin
                                  Administration.                  workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Global Refuge, MD, for expanding workforce              300,000  Cardin, Van Hollen
                                  Administration.                  development programming, including supportive
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Goodwill Industries of Kanawha Valley, WV, for          425,000  Capito, Manchin
                                  Administration.                  mobile workforce development services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Goodwill Industries of the Valleys, VA, for           2,100,000  Kaine, Warner
                                  Administration.                  education and workforce training, which may
                                                                   include the purchase of classroom supplies and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Greater Lake City Alliance, SC, for a workforce         983,000  Graham
                                  Administration.                  training program, including the purchase of
                                                                   equipment and curriculum.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Habitat for Humanity of Greater Providence & East       500,000  Reed, Whitehouse
                                  Administration.                  Bay, RI, for a workforce development program in
                                                                   the construction industry, which may include
                                                                   financial aid, stipends, and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Hanley Center for Health Leadership and Education     1,000,000  Collins, King
                                  Administration.                  DBA Maine Medical Education Trust, ME, for a
                                                                   certified nursing assistant training program,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Health Tech Alley, MD, for expanding workforce          300,000  Cardin, Van Hollen
                                  Administration.                  training and apprenticeships, including
                                                                   supportive services and stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Hispanic Federation, Inc., NY, for workforce            620,000  Schumer
                                  Administration.                  development, which may include technology,
                                                                   supplies, and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          International Brotherhood of Electrical Workers,        347,000  Gillibrand, Schumer
                                  Administration.                  Local Union 43, NY, for an apprenticeship
                                                                   program, including the purchase of equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          International Institute of New England, NH, for         250,000  Shaheen
                                  Administration.                  expanding workforce training and services to
                                                                   refugees and immigrants, which may include
                                                                   purchase of equipment and a van.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          JEVS Human Services, PA, for healthcare workforce       331,000  Fetterman
                                  Administration.                  training, including purchasing supplies and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Johnstown Area Regional Industries (JARI), PA,          300,000  Casey
                                  Administration.                  for expanding a workforce training program,
                                                                   which may include providing stipends and
                                                                   purchasing technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Joint Iron Workers Apprenticeship aka Iron              505,000  Brown
                                  Administration.                  Workers Local 17 Training Fund, OH, for
                                                                   expanding apprenticeship and pre-apprenticeship
                                                                   training, including the purchase of equipment,
                                                                   apprentice tool kits, and rental costs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          KNOX, Inc., CT, for a green jobs apprenticeship         231,000  Blumenthal, Murphy
                                  Administration.                  program, which may include stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Lincoln University of Pennsylvania, PA, for           1,000,000  Casey, Fetterman
                                  Administration.                  creating a career training program, including
                                                                   the purchase of equipment and rental fees.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Literacy Council of Northern Virginia, dba            1,150,000  Kaine, Warner
                                  Administration.                  English Empowerment Center, VA, for adult
                                                                   education and training, including for the
                                                                   purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Literacy Pittsburgh, PA, for workforce training         462,000  Fetterman
                                  Administration.                  and career development programs, including for
                                                                   purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Local 412 Outreach and Education Foundation, NM,        870,000  Heinrich
                                  Administration.                  for expanding workforce training, including the
                                                                   purchase of equipment and classroom supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Local Initiatives Support Corporation, OH, for          700,000  Brown
                                  Administration.                  expanding workforce training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Lomakatsi Restoration Project, OR, for an inter-      1,300,000  Merkley, Wyden
                                  Administration.                  tribal forestry workforce training program,
                                                                   which may include the purchase of equipment and
                                                                   tools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Los Angeles Conservation Corps, CA, for a               350,000  Butler, Padilla
                                  Administration.                  workforce training program for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Lucas Metropolitan Housing, OH, for                     500,000  Brown
                                  Administration.                  apprenticeship programming, including the
                                                                   purchase of work tools and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Massachusetts Down Syndrome Congress, Inc., MA,         723,000  Markey, Warren
                                  Administration.                  for workforce training, including equipment and
                                                                   participant stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Maui Arts & Cultural Center, HI, for workforce        1,050,000  Hirono, Schatz
                                  Administration.                  development, including technology and rental
                                                                   expenses.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Mesalands Community College, NM, for improving        4,000,000  Heinrich
                                  Administration.                  energy workforce training, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Mid-Atlantic States Career and Education Center,        137,000  Booker
                                  Administration.                  NJ, for improving workforce training, including
                                                                   the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Ministers Conference Empowerment Center CDC,            600,000  Cardin, Van Hollen
                                  Administration.                  Inc., MD, for expanding education and workforce
                                                                   training, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Mississippi Coding Academies, MS, for a STEM            750,000  Hyde-Smith
                                  Administration.                  program, including equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Mississippi State University, MS, to support          5,500,000  Hyde-Smith, Wicker
                                  Administration.                  manufacturing workforce training, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Mixed Magic Theatre & Cultural Events, RI, for a        100,000  Reed, Whitehouse
                                  Administration.                  workforce training program, including providing
                                                                   stipends and purchasing supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Mobile Area Education Foundation, AL, for a youth     1,250,000  Britt
                                  Administration.                  workforce training program, including tuition.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Moraine Park Technical College, WI, for improving     1,149,000  Baldwin
                                  Administration.                  education and workforce training, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          National Forest Foundation--New Mexico, NM, for         500,000  Lujan
                                  Administration.                  supporting workforce training and a conservation
                                                                   corps, which may include the purchase of
                                                                   equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          New Mexico Department of Workforce Solutions, NM,       200,000  Heinrich, Lujan
                                  Administration.                  for supporting apprenticeships and pre-
                                                                   apprenticeships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          New Mexico Reentry Center, NM, for providing job      1,517,000  Heinrich
                                  Administration.                  training programs, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Newport Community School, RI, for workforce             125,000  Reed
                                  Administration.                  training, including purchasing equipment and
                                                                   supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          North Country Home Health & Hospice Agency, Inc.,       165,000  Shaheen
                                  Administration.                  NH, for workforce training in palliative care,
                                                                   including purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Northwest Regional Workforce Investment Board,          370,000  Blumenthal, Murphy
                                  Administration.                  CT, for a re-entry job training program, which
                                                                   may include providing supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          NPower, OH, for providing workforce training,           500,000  Brown
                                  Administration.                  including purchasing technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Nudlaghi Leadership Institute, AK, for a youth          100,000  Murkowski
                                  Administration.                  workforce development camp, including
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          PIVOT, Inc., MD, for expanding workforce training       350,000  Cardin, Van Hollen
                                  Administration.                  for justice-involved individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Plattsburgh-North Country Chamber of Commerce,          270,000  Gillibrand, Schumer
                                  Administration.                  NY, for workforce training, including the
                                                                   purchase of equipment, technology, and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          PMichael Boone Foundation, PA, for providing            200,000  Casey
                                  Administration.                  workforce training, which may include the
                                                                   purchase of equipment, student financial aid,
                                                                   and other supports.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Polytech Adult Education, DE, for expanding           2,024,000  Carper, Coons
                                  Administration.                  workforce training, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Preservation Maryland, MD, for expanding                970,000  Cardin, Van Hollen
                                  Administration.                  workforce development opportunities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Prince George's Community College, MD, for pre-         619,000  Cardin, Van Hollen
                                  Administration.                  apprenticeships and workforce training,
                                                                   including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Progreso Latino, Inc., RI, for adult education...       150,000  Reed, Whitehouse
                                  Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Renewable Energy Alaska Project, AK, for a              730,000  Murkowski
                                  Administration.                  workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Rhode Island Manufacturing Institute DBA We Make        480,000  Reed
                                  Administration.                  RI, RI, for job training and employment
                                                                   placement services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Riverzedge Arts Project, Inc., RI, for a job            100,000  Reed
                                  Administration.                  training program, including purchasing equipment
                                                                   and wages.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Rural Alaska Community Action Program, Inc., AK,      3,000,000  Murkowski
                                  Administration.                  for a workforce training program, including
                                                                   curriculum development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          San Juan College, NM, for supporting workforce        1,000,000  Lujan
                                  Administration.                  training for commercial drivers, which may
                                                                   include the purchase of vehicles for training
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          San Juan College, NM, for workforce training,            85,000  Heinrich
                                  Administration.                  including the purchase of equipment to improve
                                                                   training opportunities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Sealaska Heritage Institute, AK, for a cultural         500,000  Murkowski
                                  Administration.                  workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          SMART Local Union No. 49 JATC, NM, for expanding      1,200,000  Heinrich
                                  Administration.                  apprenticeship programs, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Somerset County Technology Center, PA, for              250,000  Casey
                                  Administration.                  expanding an aeronautics and welding workforce
                                                                   training program, including stipends, tuition
                                                                   assistance, and the purchase of technician tools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          South Central Workforce Development Board, VA,          750,000  Kaine, Warner
                                  Administration.                  for improving education and workforce training
                                                                   opportunities, which may include providing
                                                                   stipends or financial aid tuition and the
                                                                   purchase of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Southern Virginia Higher Education Center, VA,          750,000  Kaine, Warner
                                  Administration.                  for technology workforce training, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Southwest Washington Workforce Development            1,000,000  Murray
                                  Administration.                  Council, DBA Workforce Southwest Washington
                                                                   (WSW), WA, for education and workforce
                                                                   development programming, which may include
                                                                   supportive services and tuition.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Southwest Wisconsin Workforce Development Board,      1,000,000  Baldwin
                                  Administration.                  WI, for workforce development projects, which
                                                                   may include stipends and the purchase of
                                                                   equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          St. Michaels Community Center, MD, for expanding        104,000  Cardin, Van Hollen
                                  Administration.                  workforce development programming and wraparound
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          State of Arizona Office of Economic Opportunity,      2,000,000  Kelly
                                  Administration.                  AZ, for supporting apprenticeship programs,
                                                                   which may include the purchase of equipment and
                                                                   providing stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Survivor Ventures, VA, for providing workforce          405,000  Kaine, Warner
                                  Administration.                  development, which may include providing
                                                                   supportive services and financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Tech Goes Home Incorporated, MA, for workforce          750,000  Markey, Warren
                                  Administration.                  development in digital skills and digital
                                                                   literacy, which may include the purchase of
                                                                   equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          The Alliance for Working Together (AWT)                 250,000  Brown
                                  Administration.                  Foundation, OH, for expanding workforce training
                                                                   programs, including the hiring of instructors.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          The Arc Alliance, PA, for workforce training            580,000  Fetterman
                                  Administration.                  activities and improving services for
                                                                   individuals with disabilities, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          The Chrysalis Center, CA, for workforce training,       465,000  Butler, Padilla
                                  Administration.                  which may include scholarships and other
                                                                   supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          The Father Laurence (Larry) Tracy Advocacy              220,000  Schumer
                                  Administration.                  Center, Inc., NY, for workforce training, which
                                                                   may include stipends, equipment, and rental
                                                                   costs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          The Patuxent Partnership, MD, for expanding             575,000  Cardin, Van Hollen
                                  Administration.                  apprenticeship programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          The Precision Institute, DE, for expanding            1,100,000  Carper, Coons
                                  Administration.                  workforce training, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          TriCounty Community Network, PA, for expanding a        250,000  Casey
                                  Administration.                  college and career readiness program, including
                                                                   student stipends and supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Trying Together, PA, for expanding workforce            500,000  Casey, Fetterman
                                  Administration.                  training for child care workers, including
                                                                   providing wraparound supports.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Twin Cities R!SE, MN, for workforce development       1,542,000  Klobuchar, Smith
                                  Administration.                  in the transportation sector, which may include
                                                                   purchasing equipment and tools, and providing
                                                                   stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          United Mine Workers of America Career Centers,          500,000  Casey
                                  Administration.                  Inc., PA, for workforce training for workers in
                                                                   coal communities, which may include equipment
                                                                   and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          University of Alaska Southeast, AK, for a               160,000  Murkowski
                                  Administration.                  maritime workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          University of Georgia Research Foundation, GA,          301,000  Ossoff, Warnock
                                  Administration.                  for agricultural education and workforce
                                                                   training, which may include the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Urban League of Greater Atlanta (ULGA), GA, for       1,204,000  Ossoff
                                  Administration.                  workforce development, which may include
                                                                   stipends, rent, and purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Urban League of Greater Southwestern Ohio, OH,          500,000  Brown
                                  Administration.                  for expanding apprenticeships and pre-
                                                                   apprenticeships, including stipends and the
                                                                   purchase of technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Variety the Children's Charity of the Delaware          250,000  Casey
                                  Administration.                  Valley, PA, for workforce training, which may
                                                                   include the purchase of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Vehicles for Change, Inc., MD, for expanding            667,000  Cardin, Van Hollen
                                  Administration.                  workforce training, including the purchase of
                                                                   equipment and trainee stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Veterans Watchmaker Initiative, DE, for workforce       369,000  Coons
                                  Administration.                  training for veterans, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          VIPER Transitions, AK, for a transitional             1,025,000  Murkowski
                                  Administration.                  employment program for veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Wide Angle Youth Media, MD, for a pre-                  649,000  Cardin, Van Hollen
                                  Administration.                  apprenticeship program, including supplies and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Wisconsin Registry of Interpreters for the Deaf,        500,000  Baldwin
                                  Administration.                  WI, for improving education and training for
                                                                   interpreters, which may include providing
                                                                   scholarships and mentoring.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Work Readiness Academy, OH, for workforce               350,000  Brown
                                  Administration.                  training opportunities for individuals from
                                                                   underserved communities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Workforce Development Board of South Central          2,000,000  Baldwin
                                  Administration.                  Wisconsin, WI, for apprenticeship support,
                                                                   including apprenticeship navigators.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Workforce Solutions for North Central PA, PA, for       200,000  Casey
                                  Administration.                  expanding workforce training, including the
                                                                   purchase of equipment and covering tuition.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Young Women's Christian Association of O'ahu, HI,     1,051,000  Schatz
                                  Administration.                  for workforce development, education, and
                                                                   apprenticeships, including purchasing equipment
                                                                   and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          Youngstown State University, OH, for providing          258,000  Brown
                                  Administration.                  workforce training and coursework for in-demand
                                                                   careers, which may include technology and
                                                                   financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor              Employment and Training          YouthBuild Preparatory Academy, RI, for youth           750,000  Reed
                                  Administration.                  workforce development, including purchasing
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Abraham Baldwin Agricultural College, GA, for           424,000  Warnock
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Acadia Hospital Corporation DBA Northern Light          421,000  Collins, King
 Services                         Administration.                  Acadia Hospital, ME, for behavioral health
                                                                   technology and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Adelante Healthcare Inc., AZ, for facilities and      2,500,000  Kelly
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    AdventHealth Shawnee Mission, KS, for facilities        100,000  Moran
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    AIDS Resource Alliance, Inc., PA, for equipment..       375,000  Casey, Fetterman
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Alaska Native Tribal Health Consortium, AK, for       3,000,000  Murkowski
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Alternative Community Resource Program, Inc.          1,000,000  Fetterman
 Services                         Administration.                  (ACRP), PA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Amador Health Center, Inc., NM, for facilities          291,000  Lujan
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Amani Center, OR, for facilities and equipment...     1,023,000  Merkley, Wyden
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Amherst H. Wilder Foundation, MN, for facilities      1,500,000  Klobuchar, Smith
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Ammonoosuc Community Health Services, Inc., NH,         250,000  Shaheen
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Anchorage Community Mental Health Services Inc        1,930,000  Murkowski
 Services                         Administration.                  dba Alaska Behavioral Health, AK, for facilities
                                                                   and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Appalachian Regional Healthcare, Inc., WV, for          500,000  Capito, Manchin
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Arctic Slope Native Association Ltd., AK, for         1,500,000  Murkowski
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Arkansas State University--Newport, AR, for           8,000,000  Boozman
 Services                         Administration.                  facilities and equipment, including rural health
                                                                   workforce training activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Arkansas State University, AR, for facilities and    10,000,000  Boozman
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Athens Neighborhood Health Center, GA, for            1,000,000  Ossoff
 Services                         Administration.                  equipment, including mobile clinics.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Atlantic Health System, NJ, for facilities and          750,000  Booker
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    AtlanticCare Health System, NJ, for equipment....     1,000,000  Booker
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Bailey's Crossroads Health Access Partnership,          500,000  Kaine, Warner
 Services                         Administration.                  Inc. (D/B/A Culmore Clinic), VA, for facilities
                                                                   and equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Bangor Nursing and Rehabilitation Center, ME, for     1,062,000  Collins, King
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Barrow Neurological Institute, AZ, for equipment.       700,000  Sinema
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Barstow Community College, CA, for a rural mental       750,000  Butler, Padilla
 Services                         Administration.                  health program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Beacon Clinic for Health and Hope, PA, for               12,000  Fetterman
 Services                         Administration.                  equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Beebe Healthcare, DE, for facilities and              1,775,000  Carper, Coons
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Behavioral Health and Developmental Services of         110,000  Shaheen
 Services                         Administration.                  Strafford County, Inc., NH, for facilities and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Bennett County Hospital, SD, for facilities and       3,318,000  Rounds
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Bethel Family Clinic, AK, for rural health care         220,000  Murkowski
 Services                         Administration.                  services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Birdie's Haven Health Clinic, PA, for programming        20,000  Fetterman
 Services                         Administration.                  and personnel.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Blackstone Valley Community Health Care, Inc.,          500,000  Reed, Whitehouse
 Services                         Administration.                  RI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Blue Mountain Heart to Heart, WA, for facilities      1,000,000  Cantwell
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Board of Trustees of the University of Illinois,        700,000  Durbin
 Services                         Administration.                  IL, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Bridgton Hospital, ME, for facilities and             5,094,000  Collins
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Brightpoint Community College, VA, for facilities       314,000  Kaine, Warner
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Buckskin Fire District, AZ, for equipment........       394,000  Kelly
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Bucksport Regional Health Center, ME, for             1,491,000  Collins
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Bullhead City Fire Department, AZ, for equipment,       351,000  Kelly, Sinema
 Services                         Administration.                  including an ambulance.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    C.A.R.E. Clinic, MN, for facilities and equipment     1,100,000  Klobuchar, Smith
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    CAMC Greenbrier Valley Medical Center, WV, for        1,500,000  Capito, Manchin
 Services                         Administration.                  equipment, including health information
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Camden County College, NJ, for equipment.........       185,000  Booker
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Cameron County Ambulance Service Inc., PA, for          352,000  Casey, Fetterman
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Cancer Support Community (CSC), OH, for cancer          150,000  Brown
 Services                         Administration.                  support services in rural counties.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Canton Potsdam Hospital, NY, for facilities and         870,000  Gillibrand, Schumer
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Capital Hospice DBA Capital Caring Health, VA,          263,000  Kaine, Warner
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Caring Hands Healthcare Centers, Inc., OK, for          950,000  Mullin
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Carroll County Youth Service Bureau, MD, for          1,000,000  Cardin, Van Hollen
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Catskills Hatzalah Inc., NY, for the purchase of        870,000  Schumer
 Services                         Administration.                  ambulances.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Centerville Clinics, Inc., PA, for equipment.....       250,000  Casey
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Central Arizona Fire and Medical Authority, AZ,         788,000  Kelly, Sinema
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Central Oklahoma Family Medical Center, OK, for       1,500,000  Mullin
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Central Oregon Community College, OR, for             3,000,000  Merkley, Wyden
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Charles County Department of Health, MD, for             36,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Chase Brexton Health Services, Inc., MD, for            944,000  Cardin, Van Hollen
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Cherokee County Local Government, NC, for             3,000,000  Tillis
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    CHI Memorial Hospital Georgia, GA, for equipment.       964,000  Ossoff
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Children's Hospital of Orange County, CA, for         1,204,000  Butler, Padilla
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Children's Mercy Kansas City, KS, for facilities      3,000,000  Moran
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Children's National Medical Center, MD, for             600,000  Cardin, Van Hollen
 Services                         Administration.                  equipment, including a mobile clinic.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    ChristianaCare Health Services, DE, for               4,308,000  Carper, Coons
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Circle the City, AZ, for equipment...............       340,000  Sinema
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Citizens Medical Center, LA, for equipment.......     2,000,000  Kennedy
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Carlin, NV, for equipment................        97,000  Cortez Masto, Rosen
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Chicago, IL, for facilities and equipment     1,000,000  Duckworth
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Clarksburg, WV, for equipment............       266,000  Manchin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of East Point, GA, for equipment............       302,000  Ossoff, Warnock
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Fairbanks, AK, for equipment.............       728,000  Murkowski
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Fairbanks, AK, for facilities and             1,640,000  Murkowski
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Lexington, VA, for facilities and             2,500,000  Kaine, Warner
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Livonia, MI, for facilities and equipment       115,000  Peters, Stabenow
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Nogales, AZ, for equipment...............       550,000  Kelly, Sinema
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Saginaw, MI, for facilities and equipment     2,000,000  Peters, Stabenow
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    City of Wells, NV, for expanding primary health         333,000  Cortez Masto, Rosen
 Services                         Administration.                  care services, including imaging and testing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Clackamas County, OR, for facilities and              2,500,000  Merkley, Wyden
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Clear Path for Veterans New England, Inc., MA,           97,000  Markey, Warren
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Coastal Community Health Services, GA, for              500,000  Warnock
 Services                         Administration.                  equipment, including mobile units.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    CODAC Behavioral Healthcare, RI, for facilities         852,000  Reed, Whitehouse
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Cold Spring Harbor Laboratory, NY, for facilities     2,370,000  Schumer
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Coleman Health Services, OH, for facilities and       1,500,000  Brown
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Colorado State University, CO, for facilities and     1,500,000  Bennet, Hickenlooper
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Community Clinic of Maui, Inc. dba Malama I Ke        2,370,000  Hirono
 Services                         Administration.                  Ola Health Center, HI, for expanding rural
                                                                   health services, including an electronic health
                                                                   records system.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Community Health & Dental Care, Inc., PA, for           228,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Community Health Care Systems, GA, for equipment,       475,000  Ossoff
 Services                         Administration.                  including a mobile clinic.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Community Health Care, Inc., IL, for equipment...       328,000  Durbin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Community Health Connections, Inc., MA, for           1,500,000  Markey, Warren
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Compass Health, WA, for facilities and equipment.     2,400,000  Murray
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Concord University, WV, for facilities and            5,000,000  Capito, Manchin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Confederated Tribes of Coos, Lower Umpqua, and        1,041,000  Merkley, Wyden
 Services                         Administration.                  Siuslaw Indians, OR, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Coosa County Emergency Management Agency, AL, for       300,000  Britt
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Cornerstone Care, Inc., PA, for facilities and          500,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    County of Cheshire Administration, NH, for              936,000  Shaheen
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    County of Delaware, PA, for facilities and            1,000,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    County of Union, NJ, for facilities and equipment     2,000,000  Booker
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Creighton University Health Sciences-- Phoenix        1,000,000  Sinema
 Services                         Administration.                  Campus, AZ, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Crenshaw Community Hospital, AL, for equipment...        18,000  Britt
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Cullman Regional Medical Center, AL, for              1,000,000  Tuberville
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Daily Planet Health Services, VA, for facilities        500,000  Kaine, Warner
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Dar a Luz Birth and Health Center, NM, for            2,063,000  Heinrich
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Dartmouth Health, NH, for a doula training              205,000  Shaheen
 Services                         Administration.                  program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Dartmouth Health, NH, for facilities and                900,000  Shaheen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Day Kimball Hospital, CT, for facilities and            838,000  Blumenthal, Murphy
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Day One, RI, for facilities and equipment........       990,000  Whitehouse
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Delta Health System, MS, for equipment...........     1,250,000  Wicker
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Denver Health & Hospital Authority, CO, for           3,000,000  Bennet, Hickenlooper
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Desert Hills Fire District, AZ, for equipment....       224,000  Kelly, Sinema
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Dodge County Hospital Authority, GA, for                583,000  Warnock
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Dona Ana County, NM, for equipment to expand             35,000  Lujan
 Services                         Administration.                  telehealth services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Dr. Terry Sinclair Health Clinic, VA, for                55,000  Kaine, Warner
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Duncan Valley Rural Fire District, AZ, for              181,000  Kelly
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Eagle View Community Health System, IL, for a           550,000  Duckworth
 Services                         Administration.                  mobile clinic.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    East Adams Rural Healthcare, WA, for facilities       2,500,000  Murray
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    East Central University, OK, for equipment.......     3,033,000  Mullin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Eastern Maine Community College, ME, for              5,308,000  Collins
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Eastern Maine Health Care Systems DBA Northern        1,555,000  Collins
 Services                         Administration.                  Light Health, ME, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Emory University, GA, for equipment..............       476,000  Ossoff, Warnock
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Erie County Health Department, OH, for facilities     2,000,000  Brown
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Erie County Medical Center Corporation, NY, for         870,000  Gillibrand, Schumer
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Escambia County Health Care Authority d/b/a             700,000  Britt
 Services                         Administration.                  McMillan Hospital, AL, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Evergreen Treatment Services, WA, for facilities      3,000,000  Cantwell
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    EvergreenHealth Monroe, WA, for facilities and        1,500,000  Murray
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Exceptional Care for Children, DE, for facilities     1,000,000  Coons
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Fairfield Medical Center (FMC), OH, for equipment     1,500,000  Brown
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Family & Children's Aid, Inc., CT, for facilities       350,000  Blumenthal, Murphy
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Family and Children's Center of Wisconsin, WI,        1,200,000  Baldwin
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Family Tree, Inc. (DBA Family Tree Clinic), MN,         334,000  Klobuchar, Smith
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    First 5 FUNdamentals, WA, for equipment,                320,000  Murray
 Services                         Administration.                  including information technology and virtual
                                                                   interpretation services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Fisher-Titus Medical Center, OH, for equipment...       495,000  Brown
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Florence Crittenton Services of Arizona, AZ, for        500,000  Sinema
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Florence-Darlington Technical College, SC, for        1,000,000  Graham
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Floyd Healthcare Management inc. d/b/a/ Atrium        1,500,000  Ossoff, Warnock
 Services                         Administration.                  Health Floyd, GA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    For All Seasons, Inc., MD, for facilities and         1,000,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Franklin Community Health Network (MaineHealth),     10,988,000  Collins
 Services                         Administration.                  ME, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Frontier Behavioral Health, WA, for facilities        2,000,000  Cantwell
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Gallup Community Health, NM, to expand behavioral       750,000  Heinrich, Lujan
 Services                         Administration.                  and specialty care services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Gloucester Mathews Care Clinic, VA, for                 136,000  Kaine, Warner
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Grande Ronde Hospital, OR, for facilities and         1,356,000  Merkley, Wyden
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Grant County Commission, WV, for equipment.......       250,000  Capito, Manchin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Great Lakes Inter-Tribal Council, Inc., WI, for       4,700,000  Baldwin
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Great Lakes Recovery Centers, MI, for facilities      3,000,000  Stabenow
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Greater Fairbanks Community Hospital Foundation,      3,000,000  Murkowski
 Services                         Administration.                  AK, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Greater Health Now, WA, for a rural maternal          2,100,000  Murray
 Services                         Administration.                  health initiative, including transportation.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Greenwood Genetic Center, SC, for facilities and      1,106,000  Graham
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Gunderson La Crosse Medical Center Campus, WI,        1,000,000  Baldwin
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hale Makua Health Services, HI, for facilities        1,260,000  Hirono, Schatz
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Harney District Hospital, OR, for facilities and      1,250,000  Merkley, Wyden
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Harry E. Davis Partnership for Children's Oral          526,000  Collins, King
 Services                         Administration.                  Health, ME, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Health Brigade, VA, for facilities and equipment.       750,000  Kaine, Warner
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Health Emergency Lifeline Programs DBA Corktown       3,000,000  Stabenow
 Services                         Administration.                  Health, MI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Healthcare Authority of the City of Eufaula, AL         500,000  Britt
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    HealthReach Community Health Centers, ME, for           500,000  Collins, King
 Services                         Administration.                  facilities and equipment, including software
                                                                   licenses.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hennepin Technical College Foundation, MN, for        1,771,000  Klobuchar, Smith
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Heritage Health and Housing, Inc., NY, for            2,000,000  Gillibrand, Schumer
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hocking Valley Community Hospital (HVCH), OH, for     1,500,000  Brown
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Holzer Health System, OH, for facilities and            500,000  Brown
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hope Unlimited, Inc., KS, for facilities and          2,700,000  Moran
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hospital Authority of Ben Hill, GA, for               1,500,000  Warnock
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hospital Authority of Irwin County, GA, for           1,450,000  Ossoff, Warnock
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hospital Development Co. dba Roane General            2,225,000  Capito, Manchin
 Services                         Administration.                  Hospital, WV, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Hoy Recovery Program, Inc., NM, for facilities          280,000  Lujan
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Illinois Eye Institute, IL, for facilities and          500,000  Duckworth
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Inclusion Connections, KS, for facilities and         3,000,000  Moran
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Inspira Health Network, NJ, for equipment........     2,000,000  Booker
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Interior Aids Association, AK, for facilities and     1,200,000  Murkowski
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Jackson County Health Department, IL, for               176,000  Duckworth
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Jackson Hospital and Clinic, AL, for facilities       6,000,000  Britt
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Jackson Laboratory, ME, for facilities and            3,031,000  Collins, King
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Jackson Parish Hospital, LA, for facilities and       4,000,000  Cassidy, Kennedy
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Jackson-Hillsdale Community Mental Health Board       2,308,000  Stabenow
 Services                         Administration.                  DBA LifeWays, MI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Jefferson County Commission, WV, for facilities         500,000  Capito
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Jewels School Inc., MD, for facilities and              350,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Julia Hospice and Palliative Care, PA, for              750,000  Casey
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Kent County Memorial Hospital, RI, for facilities       320,000  Reed, Whitehouse
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Ketchikan Gateway Borough, AK, for equipment.....       694,000  Murkowski
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Keystone Rural Health Consortia, Inc., PA, for          100,000  Casey, Fetterman
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    La Clinica Del Pueblo, CO, for facilities and           100,000  Bennet, Hickenlooper
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Lamoille Health Partners, Inc., VT, for a rural       1,000,000  Sanders
 Services                         Administration.                  community paramedicine program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Lamprey Health Care, Inc., NH, for facilities and       250,000  Shaheen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    LaSalle General Hospital (LaSalle Parish Hospital     3,420,000  Kennedy
 Services                         Administration.                  Service District No. 2), LA, for facilities and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Lawrence General Hospital, MA, for facilities and     2,863,000  Markey, Warren
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Lebanon Valley Volunteers in Medicine, PA, for          115,000  Fetterman
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Leo A Hoffmann Center, MN, for facilities and           750,000  Klobuchar, Smith
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Liberation Programs, Inc., CT, for facilities and     3,000,000  Blumenthal, Murphy
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Limen House, Inc., DE, for facilities and             1,000,000  Carper, Coons
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Lonesome Pine Community Hospital (Norton                683,000  Kaine, Warner
 Services                         Administration.                  Community Hospital), VA, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Los Angeles County Department of Mental Health,       1,500,000  Butler, Padilla
 Services                         Administration.                  CA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Lowell Community Health Center, MA, for               1,000,000  Markey, Warren
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Lummi Nation, WA, for facilities and equipment...    10,400,000  Cantwell, Murray
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Maine Behavioral Healthcare (MaineHealth), ME,        3,927,000  Collins, King
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Maine Veterans' Homes, ME, for facilities and         2,946,000  Collins, King
 Services                         Administration.                  equipment, including information technology for
                                                                   health records.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    MaineGeneral Health, ME, for facilities and          11,750,000  Collins, King
 Services                         Administration.                  equipment, including information technology for
                                                                   health records.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Maniilaq Association, AK, for facilities and          1,000,000  Murkowski
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Maricopa County Special Health Care District dba        755,000  Sinema
 Services                         Administration.                  Valleywise Health, AZ, for facilities and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Marion County Health Department, WV, for                320,000  Manchin
 Services                         Administration.                  equipment, including a mobile clinic.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mariposa Community Health Center, Inc., AZ, for       1,500,000  Sinema
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Marshall University Research Corporation, WV, for    15,000,000  Capito, Manchin
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Martinsville Henry County Coalition for Health          772,000  Kaine, Warner
 Services                         Administration.                  and Wellness, VA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Maryhaven, Inc., OH, for facilities and equipment     1,000,000  Brown
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mary's Shelter DBA Mary's Path, CA, for                 376,000  Butler
 Services                         Administration.                  facilities and equipment, including information
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mat-Su Health Services, AK, for facilities and          350,000  Murkowski
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Maui Memorial Medical Center, HI, for equipment..       645,000  Hirono, Schatz
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    McCall Foundation, Inc. dba McCall Behavioral           263,000  Blumenthal, Murphy
 Services                         Administration.                  Health Network, CT, for equipment, including a
                                                                   mobile clinic.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    McLeod Health, SC, for facilities and equipment..     2,580,000  Graham
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Medical College of Wisconsin, WI, for equipment..     2,300,000  Baldwin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Meeker Memorial Hospital and Clinics, MN, for            12,000  Klobuchar, Smith
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Memorial Health System, MS, for facilities and        5,600,000  Hyde-Smith, Wicker
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Memorial Health System, OH, for equipment........     2,000,000  Brown
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Memorial Hospital Belleville, IL, for equipment..     1,250,000  Durbin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Meritus Healthcare Foundation, MD, for health           215,000  Cardin, Van Hollen
 Services                         Administration.                  services and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Misericordia University, PA, for facilities and         250,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mississippi Methodist Hospital & Rehabilitation       2,000,000  Hyde-Smith
 Services                         Administration.                  Center, Inc., MS, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mississippi Organ Recovery Agency, MS, for            1,000,000  Hyde-Smith
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mississippi Public Health Institute, MS, for          3,500,000  Hyde-Smith, Wicker
 Services                         Administration.                  equipment and information technology to improve
                                                                   rural maternal health outcomes.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mon Health Medical Center, WV, for facilities and     3,000,000  Capito, Manchin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mon Health Medical Center, WV, for facilities and     4,250,000  Capito, Manchin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mon Health Medical Center, WV, for facilities and     5,000,000  Capito, Manchin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Monroe County Health Care Authority, d/b/a Monroe       500,000  Britt, Tuberville
 Services                         Administration.                  County Hospital, AL, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Montefiore Nyack Foundation, NY, for facilities       2,387,000  Gillibrand
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Montefiore St. Luke's Cornwall, NY, for                 870,000  Schumer
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Morrow County Health District, OR, for equipment.       567,000  Merkley, Wyden
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Mount Desert Island Biological Laboratory, ME,        1,975,000  Collins, King
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Murray State College, OK, for facilities and          5,000,000  Mullin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Muslim Association of Puget Sound, WA, for            2,500,000  Murray
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    National Jewish Health, CO, for facilities and        2,450,000  Bennet
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    National Veterans Wellness and Healing Center in      3,028,000  Lujan
 Services                         Administration.                  Angel Fire, Inc., NM, for facilities and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Nazareth University, NY, for facilities and             870,000  Gillibrand, Schumer
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Neighborhood Health, VA, for facilities and           1,664,000  Kaine, Warner
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Neosho Memorial Regional Medical Center, KS, for      1,220,000  Moran
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Nevada Department of Health and Human Services,       5,500,000  Cortez Masto, Rosen
 Services                         Administration.                  NV, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    New England College, NH, for facilities and             775,000  Shaheen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    New Mexico Department of Health, NM, for disease        750,000  Heinrich, Lujan
 Services                         Administration.                  intervention specialists.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    New Mexico Poison Control Center (Fiscal Agent:       1,484,000  Heinrich, Lujan
 Services                         Administration.                  University of New Mexico), NM, for expanding
                                                                   substance use disorder outreach and services,
                                                                   including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    New Mexico State University, NM, for a rural            750,000  Heinrich
 Services                         Administration.                  residency training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    New York Stem Cell Foundation, Inc., NY, for          5,000,000  Gillibrand, Schumer
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    North Penn Comprehensive Health Services, PA, for     1,000,000  Fetterman
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Northeast Oregon Area Health Education Center,          163,000  Merkley, Wyden
 Services                         Administration.                  Inc., OR, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Northeastern Oklahoma Community Health Centers,       1,500,000  Mullin
 Services                         Administration.                  Inc., OK, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Northeastern Vermont Regional Hospital, VT, for       1,410,000  Welch
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Northwest Colorado Health, CO, for facilities and       500,000  Bennet, Hickenlooper
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Northwest Mississippi Regional Medical Center,          850,000  Hyde-Smith
 Services                         Administration.                  MS, for facilities and equipment, including
                                                                   information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Norwalk Community Health Center, Inc., CT, for          907,000  Blumenthal, Murphy
 Services                         Administration.                  equipment, including a mobile unit and
                                                                   information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    NYC Health + Hospitals/Queens, NY, for facilities       870,000  Gillibrand, Schumer
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    NYU Langone Hospitals, NY, for equipment.........       870,000  Schumer
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Ochsner LSU Health--Monroe Medical Center, LA,        1,186,000  Kennedy
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Odyssey House Louisiana, Inc., LA, for facilities     2,000,000  Cassidy
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    OhioHealth, OH, for equipment....................       600,000  Brown
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Oklahoma Primary Care Association, OK, for            2,500,000  Mullin
 Services                         Administration.                  equipment, including telehealth and information
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Olivet Medical Ministries dba Lackey Clinic, VA,        507,000  Kaine, Warner
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Olympic Medical Center, WA, for facilities and        1,500,000  Cantwell, Murray
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    One Community Health, WA, for facilities and          1,000,000  Cantwell, Murray
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Oregon Institute of Technology, OR, for               1,700,000  Merkley, Wyden
 Services                         Administration.                  equipment, including mobile dental clinics.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    OSF HealthCare System, IL, for facilities and         2,000,000  Durbin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Oshun Family Center, PA, for facilities and             750,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    OU Medicine, Inc. d.b.a. OU Health, OK, for           4,585,000  Mullin
 Services                         Administration.                  equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Parkland College District 505, IL, for facilities     3,500,000  Durbin
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Penn State College of Medicine, PA, for community       500,000  Casey
 Services                         Administration.                  outreach and training, including vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Penn State Health Holy Spirit Medical Center, PA,       500,000  Casey
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Pennsylvania Association for the Blind, PA, for         665,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Pennsylvania Organization for Women in Early            515,000  Casey
 Services                         Administration.                  Recovery, PA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Petersburg Medical Center, AK, for facilities and     3,000,000  Murkowski
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Philadelphia College of Osteopathic Medicine, GA,       910,000  Ossoff, Warnock
 Services                         Administration.                  for equipment, including a mobile training unit.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Philander Smith University, AR, for facilities        7,150,000  Boozman
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Phoenix Children's, AZ, for facilities and            1,500,000  Sinema
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Pines Health Services, ME, for facilities and         8,900,000  Collins
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Pocahontas County Commission, WV, for equipment..       150,000  Capito, Manchin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Portland Recovery Community Center, ME, for           2,647,000  Collins, King
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Princeton Health Care Center, WV, for facilities     10,000,000  Capito, Manchin
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Prisma Health--Upstate, SC, for facilities and        8,000,000  Graham
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Pueblo Community Health Center, CO, for                 475,000  Bennet, Hickenlooper
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Pueblo of Pojoaque, NM, for facilities and            2,304,000  Heinrich
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Pyramid Lake Paiute Tribe, NV, for facilities and     4,000,000  Cortez Masto, Rosen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Racine County, WI, for facilities and equipment..     5,000,000  Baldwin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Range Mental Health Center, MN, for facilities        1,136,000  Klobuchar, Smith
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Recovery Wellness Initiative, ME, for facilities        229,000  Collins, King
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Rhode Island Free Clinic, RI, for telehealth            145,000  Reed
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    RI Department of Behavioral Health, Developmental     4,200,000  Reed, Whitehouse
 Services                         Administration.                  Disabilities and Hospitals, RI, for the purchase
                                                                   of hospital beds.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Richland Parish Hospital, LA, for facilities and      2,000,000  Cassidy
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Ridgecrest Regional Hospital, CA, for a rural         1,000,000  Butler, Padilla
 Services                         Administration.                  mental health program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Rivier University, NH, for equipment.............       317,000  Shaheen
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Roper St. Francis Hospital, SC, for facilities        5,000,000  Graham
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Rumford Hospital, ME, for facilities and              6,425,000  Collins
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Rural Alaska Emergency Services Inc., AK, for         2,000,000  Murkowski
 Services                         Administration.                  rural health emergency services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Saint Francis hospital, DE, for facilities and        1,323,000  Carper, Coons
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    San Luis Fire Department, AZ, for equipment,            587,000  Kelly
 Services                         Administration.                  including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Sauk Valley Voices of Recovery, IL, for                 156,000  Duckworth
 Services                         Administration.                  equipment, including a mobile clinic.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Sea Mar Community Health Centers, WA, for             1,650,000  Murray
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Seasons Housing, WA, for facilities and equipment       833,000  Cantwell
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Seattle Children's Hospital, WA, for facilities       3,000,000  Murray
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    SECU Family House at UNC Hospitals, NC, for             316,000  Tillis
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Self Regional Healthcare, SC, for facilities and      5,300,000  Graham
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Self-Help Movement, Inc., PA, for facilities and      1,000,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Seven Hills New Hampshire, Inc., NH, for              3,000,000  Shaheen
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Sharkey Issaquena Community Hospital, MS, for         9,000,000  Wicker
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Shawnee Health Service and Development                1,150,000  Durbin
 Services                         Administration.                  Corporation, IL, for equipment, including
                                                                   information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Sinai Hospital of Baltimore, Inc., MD, for              212,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Slippery Rock University of Pennsylvania, PA, for       500,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Smithsburg Emergency Medical Services, Inc., MD,        250,000  Cardin, Van Hollen
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    South Georgia Medical Center, GA, for equipment..     1,500,000  Ossoff, Warnock
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    South Shore Hospital, MA, for facilities and          2,000,000  Markey, Warren
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Southcentral Foundation, AK, for facilities and       5,000,000  Murkowski
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    SouthEast Alaska Regional Health Consortium, AK,      2,500,000  Murkowski
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Southeast Technical College, SD, for facilities       5,500,000  Rounds
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Southern Highlands Community Mental Health              708,000  Capito, Manchin
 Services                         Administration.                  Center, WV, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Southern Regional Medical Center, GA, for             1,000,000  Ossoff
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Southern Research Institute, AL, for facilities       3,000,000  Britt
 Services                         Administration.                  and equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Southwest Health System, Inc., CO, for facilities       410,000  Bennet, Hickenlooper
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Southwest Minnesota State University (SMSU)           1,136,000  Klobuchar, Smith
 Services                         Administration.                  Foundation, Inc., MN, for facilities and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Spartanburg Regional Healthcare System, SC, for       8,000,000  Graham
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Spokane County, WA, for facilities and equipment.     3,000,000  Cantwell, Murray
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Spurwink Services, Inc., ME, for facilities and       5,666,000  Collins, King
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    St. Joseph Hospital of Nashua, N.H., NH, for          2,750,000  Shaheen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    St. Joseph Hospital, ME, for facilities and             700,000  Collins, King
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    St. Mary's Regional Medical Center, ME, for           2,542,000  Collins, King
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    St. Tammany Health System, LA, for facilities and     1,050,000  Kennedy
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    State of Hawaii Department of Corrections and           867,000  Hirono, Schatz
 Services                         Administration.                  Rehabilitation, HI, for equipment for telehealth
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    State University of New York Upstate Medical            870,000  Gillibrand, Schumer
 Services                         Administration.                  University, NY, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Statewide Office on Homelessness and Housing          1,000,000  Hirono
 Services                         Administration.                  Solutions, HI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    StayWell Health Care Inc., CT, for facilities and       400,000  Blumenthal, Murphy
 Services                         Administration.                  equipment, including information technology and
                                                                   an electronic health records system.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Stroger Hospital, IL, for equipment..............       500,000  Duckworth
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Sunrise Community Health, CO, for facilities and      3,000,000  Bennet, Hickenlooper
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Temple University Hospital, PA, for equipment....       880,000  Fetterman
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    TGen, AZ, for facilities and equipment...........     1,500,000  Sinema
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Board of Trustees of Southern Illinois            1,100,000  Durbin
 Services                         Administration.                  University (School of Dental Medicine), IL, for
                                                                   facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Center for Discovery, Inc., NY, for equipment       275,000  Schumer
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Children's Advocacy Center of Delaware, DE,         312,000  Coons
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Children's Inn at NIH, MD, for facilities and     1,155,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The City of Friend, NE, for facilities and            2,500,000  Fischer
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The HealthCare Connection, OH, for equipment.....       750,000  Brown
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Kline Galland Center, WA, for facilities and      2,500,000  Murray
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Mary Imogene Bassett Hospital dba Bassett           820,000  Gillibrand, Schumer
 Services                         Administration.                  Medical Center, NY, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Medical University of South Carolina (MUSC),      8,000,000  Graham
 Services                         Administration.                  SC, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Mental Health Association of Oregon, OR, for        750,000  Merkley, Wyden
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Mental Health Center of Greater Manchester,         770,000  Shaheen
 Services                         Administration.                  NH, for facilities and equipment, including
                                                                   information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The MetroHealth System, OH, for facilities and        2,000,000  Brown
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The Queen's Health System, HI, for facilities and     2,000,000  Schatz
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    The State University of New York at Albany, NY,       1,370,000  Gillibrand, Schumer
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Thomas Jefferson University and Jefferson Health,       350,000  Fetterman
 Services                         Administration.                  PA, for equipment, including vehicles and
                                                                   information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Three Lower Counties Community Services, Inc. D/b/       90,000  Cardin, Van Hollen
 Services                         Administration.                  a Chesapeake Health Care, MD, for facilities and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Tidelands Health, SC, for facilities and              8,000,000  Graham
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Tidewater Community College Educational                 842,000  Kaine, Warner
 Services                         Administration.                  Foundation, VA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Town of Gouldsboro, ME, for equipment............       421,000  Collins, King
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Town of South Kingstown, RI, for equipment.......       425,000  Reed
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Town of Waldoboro, ME, for equipment.............       306,000  Collins, King
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Trident Technical College, SC, for facilities and     1,700,000  Graham
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Troy Community Hospital, PA, for facilities and         484,000  Casey
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Tucson Medical Center, AZ, for facilities and         1,500,000  Sinema
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Tuerk House, Inc., MD, for facilities and               500,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Tufts University School of Dental Medicine, MA,         760,000  Markey, Warren
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Uncompahgre Combined Clinics, CO, for patient           100,000  Bennet, Hickenlooper
 Services                         Administration.                  transportation services, including a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University Health Partners of Hawaii, HI, for a       1,997,000  Schatz
 Services                         Administration.                  rural maternal health initiative, including
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University Hospitals, OH, for equipment..........       400,000  Brown
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Alaska, AK, for equipment..........       500,000  Murkowski
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Alaska, AK, for facilities and            725,000  Murkowski
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Arkansas--Fort Smith, AR, for          15,000,000  Boozman
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Arkansas for Medical Sciences, AR,      2,000,000  Boozman
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Arkansas for Medical Sciences, AR,      3,000,000  Boozman
 Services                         Administration.                  for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Arkansas for Medical Sciences, AR,      2,000,000  Boozman
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Arkansas for Medical Sciences, AR,      5,000,000  Boozman
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Arkansas for Medical Sciences, AR,     12,000,000  Boozman
 Services                         Administration.                  for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Arkansas Hope--Texarkana, AR, for       7,000,000  Boozman
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Detroit Mercy, VT, for facilities       4,600,000  Sanders, Welch
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Kansas Hospital, KS, for facilities    10,000,000  Moran
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Kansas Hospital, KS, for facilities    10,000,000  Moran
 Services                         Administration.                  and imaging equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Kentucky, KY, for facilities and       15,000,000  McConnell
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Louisiana at Monroe College of            906,000  Kennedy
 Services                         Administration.                  Health Sciences, LA, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Louisiana Lafayette, LA, for           10,000,000  Kennedy
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Louisville, KY, for equipment to        9,385,000  McConnell
 Services                         Administration.                  support precision medicine research.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Louisville, KY, for facilities and     12,500,000  McConnell
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Louisville, KY, for facilities and      8,000,000  McConnell
 Services                         Administration.                  equipment, including information technology to
                                                                   support precision medicine.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Maine System, ME, for facilities        1,900,000  Collins
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Mississippi Medical Center, MS, for     5,275,000  Hyde-Smith
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Mississippi, MS, for facilities and     8,000,000  Hyde-Smith, Wicker
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Nebraska Board of Regents, NE, for     12,000,000  Fischer
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Nebraska Board of Regents, NE, for        500,000  Fischer
 Services                         Administration.                  rural telehealth services, including equipment
                                                                   and information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Nevada, Reno, NV, for facilities        3,049,000  Cortez Masto, Rosen
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of New Mexico, NM, for rural               1,540,000  Lujan
 Services                         Administration.                  telehealth, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of North Georgia, GA, for facilities         600,000  Ossoff, Warnock
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of South Carolina Aiken, SC, for           2,500,000  Graham
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Southern Mississippi, MS, for             343,000  Hyde-Smith, Wicker
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Vermont and State Agricultural            850,000  Welch
 Services                         Administration.                  College, VT, for a community health worker
                                                                   program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Vermont Health Network, VT, for         1,040,000  Welch
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of West Alabama, AL, for facilities        2,200,000  Britt
 Services                         Administration.                  and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    University of Wisconsin-Milwaukee School of             300,000  Baldwin
 Services                         Administration.                  Nursing, WI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Upland Hills Health, WI, for facilities and           5,000,000  Baldwin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Valley Family Health Care, Inc., OR, for              1,500,000  Merkley, Wyden
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Valley Healthcare System Inc., GA, for equipment.       105,000  Warnock
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Valley Hope Association Foundation, KS, for           4,000,000  Moran
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Valley-Wide Health Systems, Inc., CO, for               500,000  Bennet, Hickenlooper
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Verde Valley Fire District, AZ, for equipment,          361,000  Kelly, Sinema
 Services                         Administration.                  including an ambulance.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Versiti, WI, for facilities and equipment........     3,000,000  Baldwin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Veterans Recovery Resources, AL, for equipment...     2,000,000  Britt
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Virginia Community Healthcare Association, VA,          342,000  Kaine, Warner
 Services                         Administration.                  for a nutrition program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    VNA Home Health & Hospice DBA Northern Light Home        82,000  Collins, King
 Services                         Administration.                  Care & Hospice, ME, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Voices of Hope, Inc., MD, for facilities and            107,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Wabash General Hospital District, IL, for             1,300,000  Durbin
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Walworth County, WI, for facilities and equipment     1,500,000  Baldwin
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Warren General Hospital, PA, for equipment.......       500,000  Casey
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Wasco County, OR, for facilities and equipment...     1,658,000  Merkley, Wyden
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Washington Poison Center, WA, for equipment,            250,000  Murray
 Services                         Administration.                  including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Washington State Hospital Association, WA, for a      1,000,000  Cantwell, Murray
 Services                         Administration.                  rural maternal health initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Wayne General Hospital, MS, for equipment........       737,000  Hyde-Smith
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Weirton Medical Center, WV, for facilities and        2,450,000  Capito, Manchin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    West Hawaii Community Health Center dba Hawaii        1,500,000  Hirono, Schatz
 Services                         Administration.                  Island Community Health Center, HI, for
                                                                   facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    West Virginia University, WV, for facilities and     15,000,000  Capito, Manchin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Western Maine Health (MaineHealth), ME, for          10,810,000  Collins
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Whitfield Regional Hospital, AL, for equipment...     1,000,000  Tuberville
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Wichita State University, KS, for equipment......    10,000,000  Moran
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Wilkes University, PA, for facilities and               500,000  Casey, Fetterman
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    WomenCare dba FamilyCare Health Centers, WV, for      1,748,000  Capito, Manchin
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Woodlawn Fire Department, PA, for equipment,            200,000  Fetterman
 Services                         Administration.                  including vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Worcester County Health Department, MD, for              52,000  Cardin, Van Hollen
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    WVU Medicine Rockefeller Neuroscience Institute,     11,934,000  Capito, Manchin
 Services                         Administration.                  WV, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Xavier University, LA, for facilities and             4,000,000  Cassidy
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Yavapai Regional Medical Centers, AZ, for               228,000  Kelly, Sinema
 Services                         Administration.                  equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    York County Community Action Corporation, ME, for       715,000  Collins
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    York Hospital, ME, for facilities and equipment,      6,337,000  Collins, King
 Services                         Administration.                  including information technology for health
                                                                   records.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Youngstown City Health District, OH, for                100,000  Brown
 Services                         Administration.                  facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Health Resources and Services    Yuma Regional Medical Center, AZ, for equipment..       880,000  Sinema
 Services                         Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       4th Dimension Sobriety, WI, for behavioral health       400,000  Baldwin
 Services                         Health Services Administration.  services including peer support services
                                                                   training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Alaska Eating Disorders Alliance, AK, for               250,000  Murkowski
 Services                         Health Services Administration.  behavioral health services to address eating
                                                                   disorders.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Alcohol, Drug Addiction, and Mental Health              500,000  Brown
 Services                         Health Services Administration.  Services Board of Hancock County, OH, to develop
                                                                   youth mental health programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Amos House, RI, for mental and behavioral health        540,000  Reed, Whitehouse
 Services                         Health Services Administration.  services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Ann & Robert H. Lurie Children's Hospital of          1,000,000  Durbin
 Services                         Health Services Administration.  Chicago, IL, for mental health and trauma
                                                                   services for pediatric patients.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Axiom Community of Recovery, AZ, for substance          400,000  Sinema
 Services                         Health Services Administration.  use disorder treatment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Bhutanese Community in Harrisburg, PA, for mental       160,000  Casey
 Services                         Health Services Administration.  health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       BirdieLight, OH, for a substance use prevention         120,000  Brown
 Services                         Health Services Administration.  program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Boys & Girls Club Fox Valley, Inc., WI, for           1,000,000  Baldwin
 Services                         Health Services Administration.  mental health programming for children and youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Brazilian Worker Center, Inc., MA, for mental           250,000  Markey, Warren
 Services                         Health Services Administration.  health and wellness programming, including
                                                                   trauma services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Centro Latino de New Hampshire, NH, for mental          299,000  Shaheen
 Services                         Health Services Administration.  health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Child Health and Development Institute of               371,000  Blumenthal, Murphy
 Services                         Health Services Administration.  Connecticut, Inc., CT, for a substance use
                                                                   prevention and education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Children's Friend and Service, RI, for mental           430,000  Whitehouse
 Services                         Health Services Administration.  health services for low income families in early
                                                                   childhood settings.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Chinese-American Planning Council, Inc., NY, for        300,000  Gillibrand, Schumer
 Services                         Health Services Administration.  mental health and supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       City of Chicago, IL, for an overdose prevention       1,387,000  Duckworth
 Services                         Health Services Administration.  program and substance use services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       City of Grand Rapids, MI, for a crisis                  130,000  Peters, Stabenow
 Services                         Health Services Administration.  intervention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       City of Long Beach, CA, for a community crisis          989,000  Butler, Padilla
 Services                         Health Services Administration.  response program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       City of Lynn, MA, for mental and behavioral             500,000  Markey, Warren
 Services                         Health Services Administration.  health care services through an alternative
                                                                   response team.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       City of Portland, OR, for a mobile medication         1,500,000  Merkley, Wyden
 Services                         Health Services Administration.  program to prevent drug overdoses.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       City of Seattle, WA, to support overdose-response     1,600,000  Cantwell, Murray
 Services                         Health Services Administration.  teams.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Clark County, NV, for behavioral health services      3,514,000  Cortez Masto, Rosen
 Services                         Health Services Administration.  for children and youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Coalicion De Lideres Latinos, GA, for mental            150,000  Ossoff
 Services                         Health Services Administration.  health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Community Health Partnership, CO, to address            839,000  Bennet, Hickenlooper
 Services                         Health Services Administration.  mental and behavioral health disparities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Copiah-Lincoln Community College, MS, for mental        303,000  Hyde-Smith
 Services                         Health Services Administration.  and behavioral health services, including
                                                                   telehealth services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Cornell Scott-Hill Health Corporation, CT, for          822,000  Blumenthal, Murphy
 Services                         Health Services Administration.  substance use disorder treatment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       County of Kent, MI, for behavioral health crisis        750,000  Peters, Stabenow
 Services                         Health Services Administration.  services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Covenant House International, NY, for behavioral        320,000  Gillibrand, Schumer
 Services                         Health Services Administration.  health services for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Department of New Jersey Veterans of Foreign            280,000  Booker
 Services                         Health Services Administration.  Wars, Inc., NJ, for mental health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Eluna, MA, for a grief support and counseling           111,000  Markey, Warren
 Services                         Health Services Administration.  program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Fair Haven Community Health Clinic, Inc., CT, for       381,000  Blumenthal, Murphy
 Services                         Health Services Administration.  behavioral health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Family Resource Center of the Roaring Fork              250,000  Bennet, Hickenlooper
 Services                         Health Services Administration.  Schools, CO, for mental health services for
                                                                   students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Finishing Trades Institute of the Upper Midwest       1,176,000  Klobuchar, Smith
 Services                         Health Services Administration.  Trust Fund, MN, for mental health and supportive
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       For All Ages, Inc., CT, to support the mental           222,000  Blumenthal, Murphy
 Services                         Health Services Administration.  health and wellness of college students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       GameChanger, WV, for substance use prevention and       100,000  Manchin
 Services                         Health Services Administration.  education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Global Partnership to End Human Trafficking             105,000  Blumenthal, Murphy
 Services                         Health Services Administration.  Corporation, CT, for behavioral health services
                                                                   for survivors.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Hawaii Department of Human Services, Office of          850,000  Schatz
 Services                         Health Services Administration.  Youth Services, HI, for a youth suicide
                                                                   prevention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Herren Project, RI, for a substance use disorder        100,000  Reed
 Services                         Health Services Administration.  recovery program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Honor Wellness Center, Inc., CT, for mental              50,000  Blumenthal, Murphy
 Services                         Health Services Administration.  health support and training including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Hope Coalition, NC, for youth substance use           1,014,000  Tillis
 Services                         Health Services Administration.  prevention, treatment, and mental health
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       HopeHealth Hospice & Palliative Care, RI, for           350,000  Reed, Whitehouse
 Services                         Health Services Administration.  mental health services and grief counseling.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       International Association of Fire Fighters Local        500,000  Lujan
 Services                         Health Services Administration.  244/New Mexico Professional Fire Fighters
                                                                   Association, NM, for behavioral health care and
                                                                   substance use disorder treatment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       International Rescue Committee, WA, for mental          330,000  Murray
 Services                         Health Services Administration.  health services for immigrants and refugees.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Jacob's Ladder Assistance Fund, Inc., WV, for           200,000  Capito, Manchin
 Services                         Health Services Administration.  substance use disorder and mental health
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       James Biever Police-Community Alliance, PA, for a        39,000  Casey
 Services                         Health Services Administration.  mental and behavioral health crisis training
                                                                   program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Johnson Health Center, VT, for substance use          2,385,000  Sanders
 Services                         Health Services Administration.  disorder and mental health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Journey to Recovery Community Center, VT, for a       1,065,000  Welch
 Services                         Health Services Administration.  substance use treatment program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Juanita Strong Forever Project, AK, for youth           100,000  Murkowski
 Services                         Health Services Administration.  substance use prevention and behavioral health
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Lesbian and Gay Community Services Center, Inc.,        220,000  Gillibrand, Schumer
 Services                         Health Services Administration.  NY, for mental health care services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       LGBT Center of Greater Reading, PA, for mental          565,000  Casey, Fetterman
 Services                         Health Services Administration.  health care for at-risk and underserved
                                                                   populations.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Lifeline Horse Rescue and Rehabilitation, Inc.,          88,000  Cardin, Van Hollen
 Services                         Health Services Administration.  Lifeline Equine Therapy Services (LETS), MD, for
                                                                   mental health and suicide prevention programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Lily's Place, WV, for mental health services for        589,000  Capito
 Services                         Health Services Administration.  first responders.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Lines for Life, OR, for youth mental health           1,611,000  Merkley, Wyden
 Services                         Health Services Administration.  support through a peer-to-peer crisis line.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Maui Family Support Services, Inc., HI, for a            29,000  Schatz
 Services                         Health Services Administration.  substance use prevention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Monarch School Project, CA, for mental health           708,000  Butler, Padilla
 Services                         Health Services Administration.  services for at-risk youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       NAMI Michigan, MI, for youth mental health            2,415,000  Stabenow
 Services                         Health Services Administration.  programming, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       NAMI New Hampshire, NH, for an overdose                 444,000  Shaheen
 Services                         Health Services Administration.  prevention program, including training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       NAMI St. Tammany, LA, for mental and behavioral         500,000  Cassidy
 Services                         Health Services Administration.  health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       National Alliance Mental Illness Albuquerque, NM,       300,000  Heinrich
 Services                         Health Services Administration.  for mental health and substance use disorder
                                                                   treatment services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Nevada Department of Education, NV, for mental          511,000  Cortez Masto, Rosen
 Services                         Health Services Administration.  health programming for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       New Mexico Alliance of Boys & Girls Clubs, NM,          636,000  Heinrich
 Services                         Health Services Administration.  for mental health programming for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       New Mexico Chronic Disease Prevention Council,          130,000  Lujan
 Services                         Health Services Administration.  NM, for a peer support network to improve
                                                                   behavioral health care outcomes.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       NH Black Women Health Project, NH, for a mental         400,000  Shaheen
 Services                         Health Services Administration.  health and resiliency program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Not My Child, Inc., MD, for substance use               200,000  Cardin, Van Hollen
 Services                         Health Services Administration.  disorder recovery services and education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Once Upon A Preemie, Inc., PA, for mental health        275,000  Fetterman
 Services                         Health Services Administration.  education programming for providers to support
                                                                   families of premature infants.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Penn State University, PA, for a coordinated            500,000  Casey
 Services                         Health Services Administration.  response to substance use disorders in order to
                                                                   improve outcomes.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Pennsylvania School-Based Health Alliance, PA, to       350,000  Casey
 Services                         Health Services Administration.  support mental health screenings and services
                                                                   for youth, including data collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Rady Children's Hospital, CA, to improve access       1,800,000  Butler, Padilla
 Services                         Health Services Administration.  to mental health services for pediatric patients.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       ReadyKids, Inc., VA, for mental health and              200,000  Kaine, Warner
 Services                         Health Services Administration.  counseling services for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Resilience Resource Center, PA, for mental health       350,000  Fetterman
 Services                         Health Services Administration.  services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Rosecrance, Inc., IL, for behavioral health care        800,000  Duckworth
 Services                         Health Services Administration.  services for veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       San Juan County Partnership, NM, for a substance        307,000  Lujan
 Services                         Health Services Administration.  use prevention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Sinai Health System, IL, for a trauma recovery        1,500,000  Durbin
 Services                         Health Services Administration.  program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Southwest Washington Accountable Community of           750,000  Cantwell, Murray
 Services                         Health Services Administration.  Health, WA, for a mobile substance use disorder
                                                                   medical clinic, including a vehicle and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Starfish Family Services, MI, for substance use       1,400,000  Stabenow
 Services                         Health Services Administration.  disorder treatment and mental health care
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       STRYV365, WI, for mental health programming for         100,000  Baldwin
 Services                         Health Services Administration.  youth, including professional development for
                                                                   youth-serving organizations.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Taos Pueblo Health and Community Services, NM,          331,000  Heinrich
 Services                         Health Services Administration.  for peer-led recovery programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       The Carnegie Hall Corporation, NY, for a program        870,000  Gillibrand, Schumer
 Services                         Health Services Administration.  to promote mental wellbeing for children and
                                                                   families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       The Martinsburg Initiative, Inc., WV, for youth         520,000  Capito, Manchin
 Services                         Health Services Administration.  substance use prevention and mental health
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       The Salvation Army, CO, for mental and behavioral       600,000  Bennet, Hickenlooper
 Services                         Health Services Administration.  health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       The Trevor Project, CA, for a crisis intervention     1,050,000  Butler
 Services                         Health Services Administration.  training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Tides Family Services, RI, for a mental and             527,000  Whitehouse
 Services                         Health Services Administration.  behavioral health program for at-risk youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Turning Point Center, VT, for a community-based         167,000  Welch
 Services                         Health Services Administration.  program to reduce substance use and address
                                                                   mental health needs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Unified School District #233--Olathe Public           1,100,000  Moran
 Services                         Health Services Administration.  Schools, KS, for school-based mental health
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       University of Alaska, AK, for mental and                250,000  Murkowski
 Services                         Health Services Administration.  behavioral health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       University of Oregon, OR, to support pediatric        2,980,000  Merkley, Wyden
 Services                         Health Services Administration.  mental and behavioral health care, including
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       University of Rhode Island, RI, for mental health     1,500,000  Reed, Whitehouse
 Services                         Health Services Administration.  programming for youth, including trainings.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Valley Family Health Care, Inc., OR, for a              816,000  Merkley, Wyden
 Services                         Health Services Administration.  substance use disorder treatment program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Vinfen, Corporation, MA, for a mental health            554,000  Markey, Warren
 Services                         Health Services Administration.  crisis and substance use disorder treatment
                                                                   program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Virginia Telemental Health Initiative, VA, for          299,000  Kaine, Warner
 Services                         Health Services Administration.  mental health counseling through telemedicine.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Voices of September 11, Inc., CT, for resources         350,000  Blumenthal, Murphy
 Services                         Health Services Administration.  and information for individuals impacted by
                                                                   tragedy.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Volunteers of America of Alaska, AK, for mental       1,000,000  Murkowski
 Services                         Health Services Administration.  and behavioral health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Wellspring, Inc., ME, for mental health and             125,000  King
 Services                         Health Services Administration.  recovery services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       West Care Wisconsin, WI, for a mobile mental            575,000  Baldwin
 Services                         Health Services Administration.  health clinic.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Wichita Children's Home, KS, for mental and             350,000  Moran
 Services                         Health Services Administration.  behavioral health services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Windham Region Chamber of Commerce Foundation,          380,000  Blumenthal, Murphy
 Services                         Health Services Administration.  CT, for mental health and supportive services
                                                                   for veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Wyoming County Human Services, PA, for an in-           147,000  Casey
 Services                         Health Services Administration.  home, behavioral health therapy program for
                                                                   mothers.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       YMCA of Silicon Valley, CA, for mental health           736,000  Butler, Padilla
 Services                         Health Services Administration.  programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Substance Abuse and Mental       Youth Advocate Programs, Inc., CT, for prevention     2,000,000  Blumenthal, Murphy
 Services                         Health Services Administration.  programming and behavioral health services for
                                                                   youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Adult Friends for Youth, HI, to support at-risk         367,000  Schatz
 Services                         Families.                        youth through counseling and supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Aloha United Way, HI, to support referral and           800,000  Hirono, Schatz
 Services                         Families.                        helpline services for basic needs, crisis, and
                                                                   disaster response.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  American Chinese Christian Education and Social          50,000  Markey, Warren
 Services                         Families.                        Services (ACCESS), MA, to support afterschool
                                                                   programming for low income children.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Anne Arundel County Food Bank, MD, to support low       173,000  Cardin, Van Hollen
 Services                         Families.                        income families through food distribution,
                                                                   including the purchase of a refrigerated vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Asian Girls Ignite, CO, to support a mentorship         238,000  Bennet, Hickenlooper
 Services                         Families.                        program for girls.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Baltimore Urban Leadership Foundation, Inc., MD,         50,000  Cardin, Van Hollen
 Services                         Families.                        for services for at-risk youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Bangladeshi American Society Inc., NY, for              184,000  Schumer
 Services                         Families.                        services for low income individuals and
                                                                   families, including food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Battered Women's Legal Advocacy Project D/B/A         1,000,000  Klobuchar, Smith
 Services                         Families.                        Standpoint, MN, to support survivors of child
                                                                   abuse and domestic violence.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Beautiful Day, RI, to support self-sufficiency        1,210,000  Reed
 Services                         Families.                        through a food entrepreneurship program,
                                                                   including child care and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Big Brothers Big Sisters of Alaska, AK, for a           100,000  Murkowski
 Services                         Families.                        mentoring program for vulnerable youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Boulder Food Rescue, CO, for a food purchasing          132,000  Bennet, Hickenlooper
 Services                         Families.                        and education program for low income
                                                                   individuals, including the purchase of food and
                                                                   supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Center for Housing and Health, IL, for supportive     1,300,000  Durbin
 Services                         Families.                        services for at-risk individuals, including
                                                                   housing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Churches United For Fair Housing, Inc., NY, for a       420,000  Schumer
 Services                         Families.                        program to support low income families to find
                                                                   and maintain affordable housing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  City of Whitewater, WI, to reduce poverty through        85,000  Baldwin
 Services                         Families.                        an immigrant liaison.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Commonwealth of Massachusetts United Ways, MA, to     1,500,000  Markey, Warren
 Services                         Families.                        reduce poverty for low income individuals and
                                                                   families, including for the purchase of food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Cradles to Crayons, PA, to support low income           548,000  Fetterman
 Services                         Families.                        children and families, including through the
                                                                   purchase of supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Davinci Center for Community Progress, RI, for          250,000  Reed
 Services                         Families.                        community services for at-risk individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Divine Konnections Inc., MN, for child abuse            136,000  Klobuchar, Smith
 Services                         Families.                        prevention and supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Dorcas International Institute of Rhode Island,         680,000  Reed
 Services                         Families.                        RI, for a refugee assistance program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Easter Seals North Georgia, Inc., GA, for               767,000  Ossoff, Warnock
 Services                         Families.                        programming to support children and families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Elena's Light, CT, for programming for refugee          325,000  Blumenthal, Murphy
 Services                         Families.                        families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  EP International Ministries, Inc., MD, to                97,000  Cardin, Van Hollen
 Services                         Families.                        decrease food insecurity through a mobile meal
                                                                   program, including the purchase of vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Essex County Legal Aid Association, Inc., NJ, for       500,000  Booker
 Services                         Families.                        legal services for children.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Federal Hill House Association, RI, for community       410,000  Reed
 Services                         Families.                        services and programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Feeding Westchester, NY, for a food delivery            220,000  Gillibrand, Schumer
 Services                         Families.                        program for at-risk individuals, including food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Foundation for Black Women's Wellness, WI, for        1,167,000  Baldwin
 Services                         Families.                        programming to enhance economic security and
                                                                   family stability for at-risk women and families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Friendly House, Inc., MA, to support individuals         50,000  Markey, Warren
 Services                         Families.                        and families facing housing insecurity.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Haa Yaitx'u Saiani, AK, for supportive services         100,000  Murkowski
 Services                         Families.                        for kinship households.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Hawaii Children's Action Network, HI, to help           150,000  Schatz
 Services                         Families.                        reduce economic disparities through community
                                                                   engagement training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Homes for Families, OH, for support and training        100,000  Brown
 Services                         Families.                        for low income individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Hosea Feed the Hungry and Homeless Inc., GA, to         244,000  Ossoff, Warnock
 Services                         Families.                        support low income communities at risk of food
                                                                   insecurity, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Jackson Leadership Foundation, MS, for a youth          160,000  Hyde-Smith
 Services                         Families.                        mentoring program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Jasmin Child Care and Preschool, MN, for child          500,000  Klobuchar, Smith
 Services                         Families.                        care services and professional development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Joshua Homes Community Development Corporation,         513,000  Cardin, Van Hollen
 Services                         Families.                        MD, to reduce poverty, including through housing
                                                                   counseling and financial coaching.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Justice For Housing, Inc., MA, to support at-risk       250,000  Markey, Warren
 Services                         Families.                        families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Lakeside Education Network d.b.a Lakeside Youth         475,000  Casey
 Services                         Families.                        Network, PA, for a parenting education program
                                                                   for Head Start parents and staff.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Las Cumbres Community Services, NM, for a               333,000  Heinrich, Lujan
 Services                         Families.                        kindship care program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Legal Aid of West Virginia, WV, for a program to        470,000  Capito, Manchin
 Services                         Families.                        provide legal services to prevent homelessness
                                                                   and child abuse.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Marjaree Mason Center, CA, for crisis services        1,500,000  Butler
 Services                         Families.                        and support for domestic violence survivors.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Metropolitan New York Coordinating Council on           670,000  Gillibrand, Schumer
 Services                         Families.                        Jewish Poverty, NY, for supportive services for
                                                                   low income individuals, including food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Mitzvah Circle Foundation, PA, to support low           650,000  Fetterman
 Services                         Families.                        income populations, including through the
                                                                   purchase of supplies and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Mothers in Arms (dba Motherful), OH, for services       500,000  Brown
 Services                         Families.                        for low income mothers.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  New Hampshire Children's Trust, Inc., NH, to            500,000  Shaheen
 Services                         Families.                        prevent child abuse and neglect.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  New Jersey Coalition to End Domestic Violence           500,000  Booker
 Services                         Families.                        (NJCEDV), NJ, for services for survivors of
                                                                   domestic violence, including housing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  New Orleans Health Department, LA, for newborn          500,000  Cassidy
 Services                         Families.                        supply kits.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  NH Hunger Solutions, NH, to support low income          430,000  Shaheen
 Services                         Families.                        individuals and families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Ohio County Family Resource Network, Inc., WV, to       100,000  Capito, Manchin
 Services                         Families.                        provide assistance to low income individuals,
                                                                   including food and hygiene products.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Partners in Development Foundation, HI, to            2,000,000  Hirono, Schatz
 Services                         Families.                        support low income families and children through
                                                                   a financial literacy program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Pennsylvania Coalition Against Domestic Violence,       500,000  Casey
 Services                         Families.                        PA, for services for survivors of domestic
                                                                   violence, including housing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Polar Cubs Childcare Center, MN, for child care          50,000  Klobuchar, Smith
 Services                         Families.                        services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  PorchLight, A Family Justice Center, CO, for            620,000  Bennet, Hickenlooper
 Services                         Families.                        services for survivors of domestic violence or
                                                                   abuse.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Rhode Island Community Food Bank Association, RI,       210,000  Reed
 Services                         Families.                        to reduce poverty, including through the
                                                                   purchase of food and a truck.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Share Our Spare, IL, to support family relief           387,000  Duckworth
 Services                         Families.                        initiatives for low income families, including
                                                                   supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  St. Christopher's Hospital for Children, PA, to         497,000  Fetterman
 Services                         Families.                        support low income children and families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Team for West Virginia Children, WV, for a child        118,000  Capito
 Services                         Families.                        abuse prevention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  The Children's Law Center, Inc., CT, to support         100,000  Blumenthal, Murphy
 Services                         Families.                        legal representation for children in family
                                                                   court.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  The Community Investment Alliance, CO, for              800,000  Bennet, Hickenlooper
 Services                         Families.                        supportive services, including housing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  The ELISHA Project, RI, for supportive services         350,000  Whitehouse
 Services                         Families.                        for veterans, including food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  The Family Tree, MD, for a home visiting program        300,000  Cardin, Van Hollen
 Services                         Families.                        to support new parents and infants.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  The Housing Collective, CT, for a data platform         500,000  Blumenthal, Murphy
 Services                         Families.                        to connect low income individuals with
                                                                   affordable housing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  The Northern Lighthouse, Inc., ME, to support a          80,000  Collins
 Services                         Families.                        youth emergency shelter and transitional living
                                                                   program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  The Northern Lighthouse, ME, for mental health          339,000  King
 Services                         Families.                        services for homeless youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Tidewater Electrical Joint Apprenticeship and           442,000  Kaine, Warner
 Services                         Families.                        Training Committee (Tidewater JATC) 501(c)(6),
                                                                   VA, for child care assistance.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  TRWIB, Inc. (DBA Partner4Work), PA, to support          450,000  Casey
 Services                         Families.                        low income families through child care services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  United Way of Aroostook, ME, to improve childcare       182,000  Collins, King
 Services                         Families.                        services, including professional development,
                                                                   curriculum, and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  United Way of the Blue Mountains, WA, to expand       1,000,000  Murray
 Services                         Families.                        access to childcare, including through community
                                                                   workforce development and teacher training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  University of Arkansas for Medical Sciences, AR,      8,000,000  Boozman
 Services                         Families.                        for an infant and maternal mortality prevention
                                                                   program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Valley Youth House Committee, Inc., PA, for an in-      511,000  Casey
 Services                         Families.                        home family therapy training program to support
                                                                   stable families and reduce foster care
                                                                   placements.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Volunteers of America South Central Louisiana,        1,500,000  Cassidy
 Services                         Families.                        Inc., LA, for supportive services for at-risk
                                                                   youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Wakeman Memorial Association, CT, for after             300,000  Blumenthal, Murphy
 Services                         Families.                        school programming for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  West Virginia CASA Association, Inc., WV, for a       1,010,000  Manchin
 Services                         Families.                        program to prevent and address child abuse and
                                                                   neglect.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Western Pennsylvania Diaper Bank, PA, for a             200,000  Casey, Fetterman
 Services                         Families.                        mobile diaper distribution program, including
                                                                   for the purchase of a vehicle and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Children and  Wisconsin Child Abuse and Neglect Prevention          1,000,000  Baldwin
 Services                         Families.                        Board, WI, for child abuse prevention.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     All Out Adventures, Inc., MA, for vehicles and          101,000  Markey, Warren
 Services                         Living.                          equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Amputee Center, WV, for supportive services for         175,000  Capito, Manchin
 Services                         Living.                          individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Anchorage Coalition to End Homelessness, AK, for      1,439,000  Murkowski
 Services                         Living.                          expanding services and supports for older
                                                                   individuals and individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Appalachian Agency for Senior Citizens, VA, for          75,000  Kaine, Warner
 Services                         Living.                          supportive services for older adults, including
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Berks Encore, Inc., PA, for supportive services         500,000  Casey
 Services                         Living.                          for older adults, including food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Borough of East Rutherford, NJ, for the purchase         29,000  Booker, Menendez
 Services                         Living.                          of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Cabell County Community Services Organization,           73,000  Manchin
 Services                         Living.                          WV, for delivery vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Chinese Mutual Aid Association, IL, for                 135,000  Duckworth
 Services                         Living.                          facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Citizens for Independence & Access d.b.a. Center        125,000  Casey, Fetterman
 Services                         Living.                          for Independent Living Opportunities, PA, for
                                                                   training, staffing, and supplies to expand
                                                                   supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     City of Hyattsville, MD, for supportive services        106,000  Cardin, Van Hollen
 Services                         Living.                          for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Coalition for Food and Health Equity, NJ, for a         200,000  Booker
 Services                         Living.                          meal delivery program, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Denver Regional Council of Governments, CO, for         853,000  Bennet, Hickenlooper
 Services                         Living.                          supportive services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     End Hunger in Calvert County, MD, for supportive        275,000  Cardin, Van Hollen
 Services                         Living.                          services for individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Family Service-Upper Ohio Valley, WV, for               200,000  Manchin
 Services                         Living.                          supportive services for older adults, including
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Friendship Community, PA, for vehicles and              450,000  Casey
 Services                         Living.                          equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Goodwill Industries of Northern New England, ME,        649,000  Collins, King
 Services                         Living.                          for enhancing community accessibility for
                                                                   individuals with disabilities, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Great Bay Services, Inc., ME, for enhancing             204,000  Collins
 Services                         Living.                          community accessibility for individuals with
                                                                   disabilities, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Green Acres Regional Center, DBA LeSage Water           150,000  Manchin
 Services                         Living.                          Division, WV, for vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Hands On Hartford, CT, for supportive services          585,000  Blumenthal, Murphy
 Services                         Living.                          for seniors and individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Hawaii Good Food Alliance, HI, for a meal program       500,000  Schatz
 Services                         Living.                          for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Helping Harvest Fresh Food Bank, PA, for a meal         750,000  Casey
 Services                         Living.                          distribution program for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     J-HAP Inc., MN, for supportive services for              50,000  Klobuchar, Smith
 Services                         Living.                          individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Jin Huo Community, Inc., OH, for supportive             400,000  Brown
 Services                         Living.                          services for older adults, including evaluation
                                                                   and translation services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Madison House Autism Foundation, MD, for                650,000  Cardin, Van Hollen
 Services                         Living.                          supportive services for individuals with
                                                                   disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Marshall University Research Corporation, WV, for     1,697,000  Capito, Manchin
 Services                         Living.                          helping expand access to services and supports
                                                                   for older individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Meristem, Inc., CA, for programming and                 800,000  Padilla
 Services                         Living.                          supportive services for individuals with
                                                                   disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Middlesex United Way, CT, for supportive services        75,000  Blumenthal, Murphy
 Services                         Living.                          for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Minnesota Assistance Council for Veterans, MN,          975,000  Klobuchar, Smith
 Services                         Living.                          for supportive services for older veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     National Asian Pacific Center on Aging, WA, for       1,000,000  Murray
 Services                         Living.                          outreach and helpline services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     New York City Ballet, Inc., NY, for programming         223,000  Gillibrand, Schumer
 Services                         Living.                          for individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     NextStep Fitness Raleigh, Inc., NC, for expanding       677,000  Tillis
 Services                         Living.                          services and supports for individuals with
                                                                   disabilities, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     NextStep Kansas City, Inc., KS, for expanding           500,000  Moran
 Services                         Living.                          services and supports for individuals with
                                                                   disabilities, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Open Up, PA, for programming for individuals with       200,000  Casey
 Services                         Living.                          disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     OPTIONS, Inc., LA, for expanding access to              660,000  Cassidy
 Services                         Living.                          services and supports for individuals with
                                                                   disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Ossipee Concerned Citizens, NH, for supportive          100,000  Shaheen
 Services                         Living.                          services for older adults, including meals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Ranch Hope, Inc., NJ, for supportive services and       500,000  Booker
 Services                         Living.                          equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     SilverSource, Inc., CT, for supportive services         200,000  Blumenthal, Murphy
 Services                         Living.                          for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Special Olympics New Jersey, NJ, for health and         500,000  Booker
 Services                         Living.                          wellness programming for individuals with
                                                                   disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Team Gleason Foundation, LA, for addressing the       3,000,000  Cassidy, Kennedy
 Services                         Living.                          needs of individuals with ALS, including the
                                                                   purchase of equipment and assistive technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Telespond Senior Services, Inc., PA, for                500,000  Casey
 Services                         Living.                          supportive services and vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     The Arc of Blackstone Valley, RI, for vehicles          120,000  Reed
 Services                         Living.                          and charging stations.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     The Arc of Pennsylvania, PA, for the development        500,000  Casey
 Services                         Living.                          and dissemination of resources to support
                                                                   individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     The Arc of Southern MD, MD, for supportive              239,000  Cardin, Van Hollen
 Services                         Living.                          services for individuals with disabilities,
                                                                   including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     The Autism Project, RI, for programming for             160,000  Reed
 Services                         Living.                          individuals with autism.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Vermont Association of Area Agencies on Aging,          243,000  Sanders
 Services                         Living.                          VT, for supportive services for older adults,
                                                                   including meal deliveries.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human     Administration for Community     Vermont Association of Senior Centers and Meal          500,000  Sanders
 Services                         Living.                          Providers, VT, for supportive services for older
                                                                   adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  ``I Have a Dream'' Foundation of Boulder County,        600,000  Bennet, Hickenlooper
                                                                   CO, for a two-generation education initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  50CAN, INC. dba HawaiiKidsCAN, HI, for tutoring,         80,000  Hirono, Schatz
                                                                   including postsecondary financial aid for
                                                                   participants.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  ACCESS, MI, for out-of-school time programming...     1,200,000  Stabenow
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Accokeek Foundation, Inc., MD, for environmental        425,000  Cardin, Van Hollen
                                                                   education programs and implementation of social
                                                                   studies and environmental literacy framework,
                                                                   including the purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Achieve Twin Cities, MN, for college and career       1,500,000  Klobuchar, Smith
                                                                   readiness programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Aha Punana Leo, HI, for an early childhood            1,160,000  Hirono, Schatz
                                                                   education Hawaiian language immersion program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Alaska Council of School Administrators, AK, for        200,000  Murkowski
                                                                   teacher professional development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Alaska Native Heritage Center, AK, for an               300,000  Murkowski
                                                                   afterschool program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Alaska Resource Education, AK, for a STEM and           150,000  Murkowski
                                                                   natural resources education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Albany State University Foundation, GA, to              784,000  Warnock
                                                                   improve literacy through summer reading camps,
                                                                   including the purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Alpena Community College, MI, for dual enrollment       750,000  Peters, Stabenow
                                                                   and early college programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Altera, WA, for early childhood education and           500,000  Murray
                                                                   literacy programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Annapolis and Anne Arundel County Scholarship           200,000  Cardin, Van Hollen
                                                                   Trust, MD, for educational programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Arts Council of Greater New Haven, CT, for youth         98,000  Blumenthal, Murphy
                                                                   arts journalism initiative, including student
                                                                   stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Asian Americans for Equality, Inc., NY, for             150,000  Gillibrand, Schumer
                                                                   college readiness and access programming and
                                                                   youth development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Association of Alaska School Boards, AK, for a          500,000  Murkowski
                                                                   youth mentoring program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Aviation Career Enrichment Inc., GA, for STEM           785,000  Warnock
                                                                   education, including aviation workforce
                                                                   development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Ballet After Dark, Inc., MD, for a comprehensive      1,071,000  Cardin, Van Hollen
                                                                   program for girls and young women focused on
                                                                   wellness, health education, mentorship, and
                                                                   leadership training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Baltimore SquashWise, Inc., MD, for youth               200,000  Cardin, Van Hollen
                                                                   development programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Best Buddies International, Inc., LA, for the           274,000  Kennedy
                                                                   Best Buddies in Louisiana inclusion project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Best Buddies International, Inc., MA, to                400,000  Markey, Warren
                                                                   establish and deliver community-based inclusion
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Best Buddies International, Inc., NC, for the           250,000  Tillis
                                                                   Best Buddies in North Carolina inclusion project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Big Brothers Big Sisters of Puget Sound, WA, for      1,000,000  Murray
                                                                   career pathways and training programs for
                                                                   secondary students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Big Brothers Big Sisters of Rhode Island, RI, for       100,000  Reed, Whitehouse
                                                                   a youth mentoring program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Big Picture Philadelphia, PA, for school-based          350,000  Fetterman
                                                                   health and wellness services and nutrition
                                                                   education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Big Sister Association of Greater Boston, MA, for       251,000  Markey, Warren
                                                                   school-based mentoring programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys & Girls Club of Allentown, PA, for equipment       165,000  Casey
                                                                   for an out-of-school time education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys & Girls Club of East Providence, RI, for           650,000  Reed
                                                                   youth programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys & Girls Club of the Big Island, HI, for            683,000  Hirono
                                                                   afterschool, academic support, substance abuse
                                                                   prevention, and nutrition programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys & Girls Clubs of Central Virginia, VA, to           61,000  Kaine, Warner
                                                                   increase out-of-school time program
                                                                   participation through the expansion of
                                                                   transportation services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys & Girls Clubs of Contra Costa, CA, for             900,000  Butler, Padilla
                                                                   afterschool and summer youth development
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys & Girls Clubs of Warwick, RI, for youth            485,000  Reed
                                                                   programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys and Girls Club of Delaware, DE, for out-of-        455,000  Carper, Coons
                                                                   school time youth support services, including
                                                                   mentoring, social emotional learning, and mental
                                                                   health.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys and Girls Club of Maui, Inc., HI, for youth        700,000  Hirono, Schatz
                                                                   wellness and mental health programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Boys and Girls Clubs of Southcentral Alaska, AK,        800,000  Murkowski
                                                                   for an out-of-school time program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Brockton Public Schools, MA, to replace laptop        2,128,000  Markey, Warren
                                                                   computers.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Cal Ripken, Sr. Foundation, MD, for a STEM            1,000,000  Cardin, Van Hollen
                                                                   education initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Career Girls, CA, for college and career                100,000  Butler, Padilla
                                                                   readiness programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Ceeds of Peace, HI, to expand the community             835,000  Hirono
                                                                   school model at Hawaii public schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Chariho Regional School District, RI, for               120,000  Whitehouse
                                                                   tutoring and out of school time programming,
                                                                   including the purchase of vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Chesapeake Bay Outward Bound School, MD, for            250,000  Cardin, Van Hollen
                                                                   experiential outdoor learning, including vehicle
                                                                   expenses.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Children's Foundation of Mississippi, MS, for a         698,000  Hyde-Smith
                                                                   project to improve education outcomes.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Children's Theatre of Charleston, Inc., WV, for         100,000  Capito, Manchin
                                                                   arts education, including for the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Citizens Campaign Fund for the Environment, NY,         100,000  Schumer
                                                                   for an environmental education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  City of Charleston, WV, for youth nutrition and         500,000  Capito, Manchin
                                                                   nutrition education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  City of North Las Vegas, NV, for literacy and         2,569,000  Cortez Masto, Rosen
                                                                   educational access expansion, including the
                                                                   acquisition of four vehicles for mobile library
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Cloverleaf Music Associates, OH, for equipment            9,000  Brown
                                                                   for school music programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  College Visions, RI, for college preparedness and       723,000  Reed, Whitehouse
                                                                   access programming, including student stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Collinsville Area Vocational Center, IL, for          3,000,000  Duckworth
                                                                   equipment for education program expansion.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Communities in Schools of Washington State, WA,         900,000  Murray
                                                                   for student mental health programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Community Health Center, Inc. of Connecticut, CT,       550,000  Blumenthal, Murphy
                                                                   for environmental and health education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Concilio de Organizaciones Hispanas, PA, for            716,000  Fetterman
                                                                   pathways to high school graduation, training,
                                                                   mentorships, apprenticeships, internships, and
                                                                   career readiness programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Connecticut Historical Society dba Connecticut        1,000,000  Blumenthal, Murphy
                                                                   Museum of Culture and History, CT, for civic
                                                                   education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Connecticut Junior Republic Association, Inc.,        1,650,000  Blumenthal, Murphy
                                                                   dba CJR, CT, for school-based behavioral and
                                                                   mental health services, including student
                                                                   incentives.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Connecticut Public Broadcasting, Inc., CT, for          709,000  Blumenthal, Murphy
                                                                   educational programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Consortium for Hawaii Ecological Engineering            444,000  Hirono, Schatz
                                                                   Education dba Malama Aina Foundation, HI, for
                                                                   education programs of the Kahikina Learning
                                                                   Center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Contemporary American Theater Festival, Inc.            150,000  Capito, Manchin
                                                                   (CATF), WV, for educational programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Corning Museum of Glass, NY, for education              820,000  Gillibrand, Schumer
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Crenshaw County School District, AL, for the            114,000  Britt
                                                                   purchase of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  CUNY School of Labor and Urban Studies                  520,000  Gillibrand, Schumer
                                                                   Foundation, Inc., NY, for the Public Service
                                                                   Training Corps, including scholarships and
                                                                   stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  DC Regional Community Care Coalition, MD, for           100,000  Cardin, Van Hollen
                                                                   early childhood education services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Deming Public Schools, NM, to develop career and        125,000  Heinrich
                                                                   technical education programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  DePaul University, IL, for the Center for Middle        720,000  Durbin
                                                                   School Civic Leadership, including stipends and
                                                                   tuition support.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Doc Wayne Youth Services, Inc., MA, for youth           400,000  Markey, Warren
                                                                   development and mental health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Domestic Violence Crisis Center, CT, for youth          108,000  Blumenthal, Murphy
                                                                   violence prevention education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Dual Language Education of New Mexico, NM, to           321,000  Heinrich
                                                                   improve student outcomes through culturally and
                                                                   linguistically responsive professional
                                                                   development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Educating for Leadership, Inc., AK, to improve        1,623,000  Murkowski
                                                                   student safety.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Employ Milwaukee, WI, for career exploration and      1,200,000  Baldwin
                                                                   youth development, including youth stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Empower Yourself ltd, MA, for STEM education and        150,000  Markey, Warren
                                                                   financial literacy programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Fairmont State University, WV, for a dual             3,869,000  Capito, Manchin
                                                                   enrollment program for foster youth, including
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Families and Schools Together (FAST), WI, for         1,140,000  Baldwin
                                                                   family engagement programs in Wisconsin.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Farm Fresh Rhode Island, RI, for farm to school         250,000  Whitehouse
                                                                   programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Flagman, Inc., CT, for road safety education in       1,473,000  Blumenthal, Murphy
                                                                   Connecticut schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Forrest County Agricultural High School District,       600,000  Hyde-Smith
                                                                   MS, for the purchase of equipment, technology,
                                                                   and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Friendly House, Inc., AZ, for education,              1,000,000  Sinema
                                                                   training, and support services for immigrants,
                                                                   refugees and underserved populations.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Future Focused Education, NM, for youth mental          500,000  Heinrich
                                                                   health services and career pathways, including
                                                                   stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Gadsden Independent School District, NM, for            250,000  Heinrich
                                                                   workforce and career readiness, including paid
                                                                   youth internships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Genesee Valley Outdoor Learning Center, MD, for          40,000  Cardin, Van Hollen
                                                                   social-emotional learning through outdoor
                                                                   experiences.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Girls on the Run International, MN, to increase         500,000  Klobuchar, Smith
                                                                   access to programming in underserved communities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Goldbelt Heritage Foundation, AK, for culturally        750,000  Murkowski
                                                                   responsive curriculum and career pathways for
                                                                   Indigenous youth, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Hall County School District Meat Science Center,        700,000  Warnock
                                                                   GA, for a career pathway program in meat
                                                                   processing.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Hawaii Department of Education, HI, for Hawaiian      1,000,000  Schatz
                                                                   language and culture-based educator workforce
                                                                   development initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Heights Philadelphia, PA, for college and career        200,000  Casey
                                                                   readiness programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Hispano Roundtable of New Mexico, NM, for STEAM         500,000  Heinrich, Lujan
                                                                   education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Homewood Children's Village, PA, to expand              250,000  Casey
                                                                   services in community schools in Pittsburgh.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Howard County Conservancy, MD, for an                    50,000  Cardin, Van Hollen
                                                                   environmental education program including career
                                                                   awareness.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  i3 Academy Charter School Network, AL, for the          345,000  Britt
                                                                   purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Inupiat Community of the Arctic Slope, AK, for a        500,000  Murkowski
                                                                   teacher apprenticeship and mentoring program,
                                                                   including instructor stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Jacob's Pillow Dance Festival, Inc., MA, for an         375,000  Markey, Warren
                                                                   arts education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  James City County, VA, for a STEAM bookmobile for       300,000  Kaine, Warner
                                                                   early childhood and education for children,
                                                                   including the purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Jumpstart for Young Children, Inc., MA, for the         250,000  Markey, Warren
                                                                   Accelerated Workforce program for early
                                                                   childhood education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  KAMP Hawaii, HI, for mentoring and education            350,000  Schatz
                                                                   programming, including the purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Kansas Children's Discovery Center, KS, for an        1,400,000  Moran
                                                                   afterschool STEM program, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Keene Housing Kids Collaborative, NH, to expand         247,000  Shaheen
                                                                   out-of-school time programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Kent Intermediate School District, MI, to expand        750,000  Peters
                                                                   career and technical education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Keyz 2 The Future, CA, for an educational               100,000  Butler
                                                                   initiative, including leadership development and
                                                                   trauma-informed care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Lanai High and Elementary School (LHES)                 120,000  Hirono
                                                                   Foundation, HI, to develop the community school
                                                                   model at Lanai High and Elementary School.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Las Vegas Library District, NV, for the Teachers      1,400,000  Cortez Masto, Rosen
                                                                   in Libraries tutoring program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Leaders of Tomorrow Youth Center, MD, for after-         50,000  Cardin, Van Hollen
                                                                   school therapeutic mentoring and art therapy
                                                                   services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Learning Point Alaska, AK, for a tutoring program       300,000  Murkowski
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Learning Undefeated, Inc., MD, for mobile STEM          500,000  Cardin, Van Hollen
                                                                   lab and STEM pathway program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Liberty Science Center, NJ, for environmental           559,000  Booker, Menendez
                                                                   education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Life Through Music, MD, for music education,             50,000  Cardin, Van Hollen
                                                                   including stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Lincoln Center for the Performing Arts, Inc., NY,       870,000  Gillibrand, Schumer
                                                                   for arts education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Living Classrooms Foundation, MD, for music             575,000  Cardin, Van Hollen
                                                                   education, including the purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Long Island Children's Museum, NY, for an               420,000  Gillibrand, Schumer
                                                                   education initiative, including improved student
                                                                   access from underserved communities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Manufacturing Serving Our Schools Alliance, WI,       3,000,000  Baldwin
                                                                   to acquire equipment for manufacturing education
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Maryland Institute College of Art, MD, for an art       400,000  Cardin, Van Hollen
                                                                   and design college pathway program, including
                                                                   student stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Maryland State Department of Education (MSDE),          500,000  Cardin, Van Hollen
                                                                   MD, to improve access to and quality of early
                                                                   childhood education through a statewide,
                                                                   centralized enrollment system.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Melwood Horticultural Training Center, Inc., MD,        250,000  Cardin, Van Hollen
                                                                   for an afterschool program, including career
                                                                   awareness activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Mid-Shore Community Foundation--Bellevue Passage         90,000  Cardin, Van Hollen
                                                                   Museum, MD, for STEAM education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Milwaukee Jewish Federation, WI, for education on       312,000  Baldwin
                                                                   and prevention of antisemitism.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Mllinocket School Department, ME, for equipment,      1,560,000  King
                                                                   textbooks and educational materials for
                                                                   education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Montclair Film Festival Inc., NJ, for film               80,000  Booker
                                                                   education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Mount Hope Community Center, RI, for a youth            220,000  Reed
                                                                   reading program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Music Hall Center for the Performing Arts, MI,        2,500,000  Stabenow
                                                                   for equipment for arts education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  National Aviation Hall of Fame (NAHF), OH, for           51,000  Brown
                                                                   support for an aviation education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  New Hampshire School Principals Foundation, NH,         342,000  Shaheen
                                                                   for a workforce development program for school
                                                                   leaders.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  New Jersey Performing Arts Center, NJ, for              552,000  Booker, Menendez
                                                                   equipment and technology for arts education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  New Mexico State University, NM, for a statewide        250,000  Heinrich
                                                                   bilingual education initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  New Neighbor Connections, NH, for a newcomer            300,000  Shaheen
                                                                   student family engagement program for immigrant
                                                                   and refugee students and their families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  New Urban Arts, RI, for an out-of-school time           350,000  Whitehouse
                                                                   program in environmental and outdoor education,
                                                                   including youth stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  New Urban Arts, RI, for arts education and              150,000  Reed
                                                                   curriculum development, including student
                                                                   stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  New York Edge, Inc., NY, to improve afterschool         420,000  Gillibrand, Schumer
                                                                   programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  North Slope Borough School District, AK, for            500,000  Murkowski
                                                                   culturally relevant curriculum and instruction.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Northeastern Pennsylvania Educational Television        500,000  Casey
                                                                   Association, PA, for STEM education, media
                                                                   literacy, and education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Northfield Public Schools, MN, for expansion of         100,000  Klobuchar, Smith
                                                                   Full-Service Community schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Ocean Exploration Trust, CT, for an education           407,000  Blumenthal, Murphy
                                                                   initiative, including traveling exhibit
                                                                   development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Onward We Learn, RI, for college access and             600,000  Reed, Whitehouse
                                                                   support services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Operation Shoestring, MS, for an out of school          515,000  Hyde-Smith
                                                                   time program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Overlake Service League dba Bellevue Lifespring,        250,000  Murray
                                                                   WA, for educational services for children
                                                                   experiencing homelessness.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Ozark City Schools Career Center, AL, for a             350,000  Britt
                                                                   mobile welding lab, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Partnership for Children and Youth, CA, to              700,000  Butler
                                                                   improve access to expanded learning programs
                                                                   through a workforce development initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  PATCH--People Attentive to Children, HI, to             250,000  Hirono
                                                                   improve school readiness through expansion of a
                                                                   credentialing program for early childhood
                                                                   practitioners, including stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Philharmonic-Symphony Society of New York, Inc.,      1,370,000  Gillibrand, Schumer
                                                                   NY, for music education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Pierce County, WA, to improve early childhood           500,000  Cantwell, Murray
                                                                   education readiness and outcomes.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Progreso Latino, Inc., RI, for early childhood          150,000  Reed, Whitehouse
                                                                   education and out of school time programs,
                                                                   including the purchase of vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Project SYNCERE, IL, for equipment for STEM             200,000  Duckworth
                                                                   education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Reach for the Top Therapy Services, NH, to expand       181,000  Shaheen
                                                                   speech language and communication services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Reach Out and Read Rhode Island, RI, for a child         60,000  Reed
                                                                   literacy program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Read Aloud West Virginia, WV, for a literacy             54,000  Capito, Manchin
                                                                   program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Reading Assist, DE, to expand tutoring programs..     1,000,000  Coons
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Reading Partners, MD, for literacy tutoring for         800,000  Cardin, Van Hollen
                                                                   students in Baltimore City and Baltimore County.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Reading Science Center, PA, to expand education         220,000  Casey
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Regional School Unit #3, ME, for a day treatment        250,000  King
                                                                   program for public school-aged children
                                                                   experiencing mental health and behavior
                                                                   challenges.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Rhode Island Black Storytellers, RI, for youth          180,000  Reed
                                                                   educational programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Rhode Island Environmental Education Association,       100,000  Reed
                                                                   Inc., RI, for environmental education, including
                                                                   participant stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Rhode Island Philharmonic Orchestra & Music             450,000  Reed
                                                                   School, RI, for youth music education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  RI Department of State, RI, for youth civic             120,000  Reed, Whitehouse
                                                                   education programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Richland School District, PA, for early childhood       250,000  Casey
                                                                   literacy and STEAM education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Roundabout Theatre Company, Inc., NY, for arts          870,000  Gillibrand, Schumer
                                                                   education and trauma-informed training,
                                                                   including incentives.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  SciTech2U Inc., MD, for seismic quake lab               159,000  Cardin, Van Hollen
                                                                   education initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Shiawassee Regional Education Service District,         267,000  Peters
                                                                   MI, for equipment for career and technical
                                                                   education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Society of Hispanic Professional Engineers, CA,         236,000  Butler, Padilla
                                                                   for STEM education programming at two middle
                                                                   schools in San Diego and Los Angeles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  South Carolina Department of Education, SC, for         500,000  Graham
                                                                   Liberty STEAM Charter School to support the
                                                                   expansion of an additional grade.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Space Foundation, CO, for STEM education in rural       261,000  Bennet, Hickenlooper
                                                                   and underserved communities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Squash and Education Alliance, NY, for youth            420,000  Gillibrand, Schumer
                                                                   development and education programs, which may
                                                                   include lease of a vehicle, stipends, and
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  St. Ann's Warehouse, Inc., NY, for arts education       100,000  Schumer
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  St. George Municipal School Unit, ME, for the           272,000  Collins
                                                                   purchase of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Sunrise of Philadelphia, PA, for an out-of-school       250,000  Casey
                                                                   time education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  SWAN Scaling Walls A Note At A Time, PA, for an         250,000  Casey
                                                                   out-of-school time education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Tacoma School District No. 10 DBA Tacoma Public         500,000  Murray
                                                                   Schools, WA, to develop a maritime skills
                                                                   program for secondary students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Teach For America Bay Area, CA, for the Ignite          240,000  Butler, Padilla
                                                                   tutoring program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Teach For America Greater Baton Rouge, LA, for a        620,000  Cassidy
                                                                   high-dosage tutoring program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Team Long Run, ME, for a literacy program........       250,000  Collins
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Thai Community USA NYC, NY, for out of school           100,000  Schumer
                                                                   time programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Brooklyn Academy of Music, Inc., NY, to             870,000  Gillibrand, Schumer
                                                                   expand and improve educational programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Citizen Science Lab, PA, to expand STEM             500,000  Casey
                                                                   education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Da Vinci Discovery Center of Science and            385,000  Casey
                                                                   Technology, Inc., PA, for an out-of-school time
                                                                   STEAM education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Filipino Veterans Recognition and Education       1,000,000  Hirono, Schatz
                                                                   Project, HI, to expand the Duty to Country
                                                                   Education project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Learning Community, RI, for outdoor learning,       250,000  Reed, Whitehouse
                                                                   including the purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Midtown Management Group Inc. dba Inside            170,000  Gillibrand, Schumer
                                                                   Broadway, NY, for a career awareness program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Narragansett Indian Tribe, RI, for out-of-          500,000  Reed, Whitehouse
                                                                   school time programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The National Aquarium, MD, for environmental            215,000  Cardin, Van Hollen
                                                                   education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  The Possible Zone, MA, for dual enrollment,             800,000  Markey, Warren
                                                                   career pathways, out-of-school time, and social
                                                                   emotional learning programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Theatre Development Fund, Inc., NY, for a mobile        570,000  Gillibrand, Schumer
                                                                   arts education program, which may include
                                                                   purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Thomasville City Schools, GA, for literacy              675,000  Ossoff
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Three Rivers Education Foundation, NM, for an           250,000  Heinrich
                                                                   early childhood literacy initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Tibetan Community of New York & New Jersey, NY,         420,000  Schumer
                                                                   for out of school time programming, including
                                                                   language instruction, education, and college
                                                                   access programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Town of Fontana Dam, NC, for an out-of-school           750,000  Tillis
                                                                   time program, including stipends and the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Town of Westerly, RI, for out of school time          1,000,000  Reed, Whitehouse
                                                                   educational programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Tree of Life, Inc., PA, for educational               1,200,000  Casey, Fetterman
                                                                   initiatives on antisemitism and identity-based
                                                                   hate for elementary and secondary education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Tucson Children's Museum, Inc., AZ, for equipment     1,000,000  Sinema
                                                                   and exhibit development for STEAM education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  United Way of Berks County, PA, for afterschool         500,000  Casey
                                                                   literacy tutoring, including tutor stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  United Way of Kenosha County, WI, for literacy          200,000  Baldwin
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  University of New Mexico, NM, for indigenous            798,000  Lujan
                                                                   language preservation and child language
                                                                   development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  University of New Mexico, NM, to improve reading        450,000  Heinrich, Lujan
                                                                   outcomes for students at-risk for dyslexia from
                                                                   culturally and linguistically diverse
                                                                   backgrounds.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Urban League of Greater Cleveland, OH, for              500,000  Brown
                                                                   education, youth development, and college and
                                                                   career readiness programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Ute Mountain Ute Tribe, CO, for Ute language and      1,400,000  Bennet, Hickenlooper
                                                                   history preservation and year-round student
                                                                   programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Virginia Commemorations, Inc., VA, for curriculum       900,000  Kaine, Warner
                                                                   development, educational materials and
                                                                   resources, and educator training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Vision to Learn, OR, for vision care services for     1,369,000  Merkley, Wyden
                                                                   students in under-resourced schools, including
                                                                   the purchase of mobile vision clinic and two
                                                                   vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Wagner Free Institute of Science, PA, to expand         200,000  Casey, Fetterman
                                                                   STEAM education programs to four North
                                                                   Philadelphia schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Washington County Public Schools, VA, for               750,000  Kaine, Warner
                                                                   equipment and installation of accessible
                                                                   playgrounds at Greendale Elementary and Abingdon
                                                                   Elementary Schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  West Virginia State University, WV, for                 500,000  Manchin
                                                                   agricultural education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  West Virginia Symphony Orchestra, WV, for arts          600,000  Capito, Manchin
                                                                   education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  White Mountain Science Inc., NH, to expand STEM         118,000  Shaheen
                                                                   education programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  White Salmon Valley School District, WA, to             100,000  Murray
                                                                   expand after-school programming for under-
                                                                   resourced and low-income students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Windham Regional Career Center, VT, for career        4,500,000  Sanders
                                                                   and technical education, including subgrants for
                                                                   the acquisition of equipment and vehicles and
                                                                   educator compensation.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Winona State University, MN, for a high school to       430,000  Klobuchar, Smith
                                                                   health care career initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  Youth Guidance, IL, for mentoring programs,             500,000  Durbin
                                                                   including student incentives.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Innovation and Improvement.....  YWCA Tri-County Area, PA, for trauma-informed           250,000  Casey
                                                                   care in early childhood education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  2nd LT RICHARD W COLLINS III FOUNDATION, MD, for         50,000  Cardin, Van Hollen
                                                                   educational programming, including coursework
                                                                   and internships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Alabama Community College System, AL, for the         5,746,000  Britt
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Alaska Christian College, AK, for career and            300,000  Murkowski
                                                                   technical education, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Albertus Magnus College, CT, for improving a            718,000  Blumenthal, Murphy
                                                                   nursing program, including scholarships and the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Anoka Technical College, MN, for improving              400,000  Klobuchar, Smith
                                                                   education and training, which may include the
                                                                   purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Baker University, KS, for the purchase of             2,000,000  Moran
                                                                   equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Barton Community College, KS, for the purchase of       425,000  Moran
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Bay Path University, MA, for preparing and              975,000  Markey, Warren
                                                                   training educators, which may include providing
                                                                   financial aid and purchasing technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Bethany College, WV, for modernizing STEM               500,000  Manchin
                                                                   laboratories, which may include the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  California State University, Stanislaus, CA, for        748,000  Butler, Padilla
                                                                   nursing education, including financial aid and
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Canisius University, NY, for supporting a student       220,000  Gillibrand, Schumer
                                                                   success center, including equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Cape Cod Community College, MA, to improve health     1,732,000  Markey, Warren
                                                                   sciences education, including purchasing
                                                                   equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Cape Fear Community College, NC, to support             650,000  Tillis
                                                                   technical education, including the purchase of
                                                                   equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Central Maine Community College, ME, for the            861,000  Collins, King
                                                                   purchase of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Central New Mexico Community College, NM, for         1,135,000  Heinrich, Lujan
                                                                   expanding education and training in clean
                                                                   energy, including the purchase of equipment and
                                                                   providing scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Century College, MN, for expanding access to open       405,000  Klobuchar, Smith
                                                                   educational resources for students, which may
                                                                   include purchasing texts and equipment, and
                                                                   providing stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Chamber of Commerce of the Borough of Queens, NY,     1,500,000  Gillibrand, Schumer
                                                                   for a cybersecurity education and training
                                                                   program, including the purchase of technology
                                                                   and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Charleston Southern University, SC, to support        1,500,000  Graham
                                                                   aeronautics education, including for the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Cincinnati State Technical and Community College,     1,000,000  Brown
                                                                   OH, for expanding a postsecondary student
                                                                   support program, including academic supports and
                                                                   financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  City College of San Francisco, CA, for a              1,000,000  Padilla
                                                                   transportation program to help postsecondary
                                                                   students access education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Clayton State University, GA, for a crime scene         421,000  Ossoff, Warnock
                                                                   investigation laboratory, which may include the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Clemson University, SC, for veterinary education,     7,000,000  Graham
                                                                   including the purchase of equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  College of Charleston, SC, for applied sciences         695,000  Graham
                                                                   education, including scholarships and the
                                                                   purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  College of Dupage, IL, for improving electric           350,000  Duckworth
                                                                   vehicle education and training, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  College of Southern Nevada, NV, for improving         1,368,000  Cortez Masto, Rosen
                                                                   education and training, including purchasing
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  College Unbound, RI, for supporting parenting           800,000  Reed
                                                                   students and their children, including providing
                                                                   scholarships and childcare.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  CollegeTracks, MD, for expanding programming for        300,000  Cardin, Van Hollen
                                                                   first generation and low-income students,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Collegiate Directions, Inc., MD, for expanding           65,000  Cardin, Van Hollen
                                                                   supports for low-income students in the college
                                                                   admissions and financial aid application
                                                                   processes.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Community College of Rhode Island, RI, for health       180,000  Reed, Whitehouse
                                                                   education, including purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Community College of Vermont, VT, for increasing      1,350,000  Sanders
                                                                   health education in rural areas, which may
                                                                   include stipends and child care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Cuyahoga Community College, OH, for improving           500,000  Brown
                                                                   educational opportunities and supporting
                                                                   workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Dalton State College, GA, for an educator               545,000  Ossoff, Warnock
                                                                   pathways program, including educator stipends
                                                                   and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Delaware State University, DE, for improving a          210,000  Coons
                                                                   neuroscience education program, which may
                                                                   include the purchase of technology and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Delaware State University, DE, for supporting an      1,491,000  Carper, Coons
                                                                   occupational therapy education program,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Delta State University, MS, for aviation              2,000,000  Hyde-Smith
                                                                   education, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  East Carolina University, NC, for                     6,500,000  Tillis
                                                                   biomanufacturing education, including the
                                                                   purchase of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Eastern Mennonite University, VA, for improving       1,253,000  Kaine, Warner
                                                                   STEM education programs, which may include the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Elizabeth City State University, NC, for the          3,900,000  Tillis
                                                                   purchase of aviation equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Fairmont State University, WV, for the purchase       1,650,000  Capito, Manchin
                                                                   of aviation equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Fairmont State University, WV, for the purchase         712,000  Capito, Manchin
                                                                   of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Ferris State University, MI, for college access         500,000  Peters, Stabenow
                                                                   and success programming, including providing
                                                                   financial aid and scholarships to students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Flint Hills Technical College, KS, for the              320,000  Moran
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Future 5, CT, for a college access and success          559,000  Blumenthal, Murphy
                                                                   program, which may include financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Garden City Community College, KS, for the              465,000  Moran
                                                                   purchase of equipment, technology, and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Goucher College, MD, for expanding programming          200,000  Cardin, Van Hollen
                                                                   for first generation and low-income students,
                                                                   including laptops, books, and mental health
                                                                   supports.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Grand Valley State University, MI, for improving      1,000,000  Peters, Stabenow
                                                                   education for veterans and underserved students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Great Basin College, NV, for improving education,     3,641,000  Cortez Masto, Rosen
                                                                   including purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Great Bay Community College, NH, for improving          895,000  Shaheen
                                                                   education and workforce training, including
                                                                   purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Green River College, WA, for increasing                 750,000  Murray
                                                                   educational opportunities for military families,
                                                                   which may include providing financial aid and
                                                                   purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Hampton Roads Educational Telecommunications            678,000  Kaine, Warner
                                                                   Association dba WHRO Public Media, VA, for a
                                                                   student internship program, which may include
                                                                   purchasing equipment and technology and
                                                                   providing salaries, including intern salaries.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Harford Community College, MD, for expanding            329,000  Cardin, Van Hollen
                                                                   education and workforce training opportunities,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Hesston College, KS, for the purchase of                800,000  Moran
                                                                   equipment, technology, and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Highland Community College, KS, for the purchase         45,000  Moran
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Hinds Community College, MS, for aviation             1,500,000  Hyde-Smith
                                                                   education, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Hinds Community College, MS, for the purchase of        236,000  Hyde-Smith
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Hocking College, OH, for healthcare education and     2,750,000  Brown
                                                                   training, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Hostos Community College, City University of New        870,000  Gillibrand, Schumer
                                                                   York, NY, for education and workforce training,
                                                                   including the purchase of equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Husson University, ME, to support marketing           1,100,000  Collins, King
                                                                   education, including for the purchase of
                                                                   equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Illinois Wesleyan University, IL, for improving       1,000,000  Durbin
                                                                   nursing and health sciences education, including
                                                                   the purchase of equipment and classroom
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Independence Community College, KS, for the             300,000  Moran
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Institute of American Indian Arts, NM, for              250,000  Heinrich
                                                                   improving computer science education, which may
                                                                   include purchasing equipment and technology and
                                                                   providing financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Jackson College, MI, for AI education and               600,000  Peters, Stabenow
                                                                   research, including purchasing equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Jeremiah Program, MD, for supporting students in        139,000  Cardin, Van Hollen
                                                                   postsecondary or graduate education, including
                                                                   financial aid, scholarships, and child care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Kansas State University, KS, for the purchase of      4,900,000  Moran
                                                                   equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Kent State University College of Nursing, OH, for       279,000  Brown
                                                                   nursing education, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Lake Superior State University, MI, for improving       600,000  Peters, Stabenow
                                                                   a sustainability education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Lane Community College, OR, for improving             1,600,000  Merkley, Wyden
                                                                   education and apprenticeship opportunities,
                                                                   including the purchase of equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Lehigh Carbon Community College, PA, for                560,000  Casey
                                                                   expanding health care education and workforce
                                                                   training, including the purchase of a vehicle to
                                                                   serve as a mobile teaching unit.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Los Rios Community College District, CA, for          1,200,000  Butler, Padilla
                                                                   expanding an adult learner program, which may
                                                                   include purchasing technology and providing
                                                                   financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Louisiana Christian University, LA, for the           1,200,000  Cassidy, Kennedy
                                                                   purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Loyola College of Nursing and Health, LA, for         2,850,000  Cassidy
                                                                   nursing education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Macomb Community College, MI, for academic              230,000  Peters, Stabenow
                                                                   support services, including the purchase of
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Maine Maritime Academy, ME, for maritime              2,400,000  Collins, King
                                                                   education, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Maine Maritime Academy, ME, for the purchase of       2,800,000  Collins
                                                                   equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Marquette University School of Dentistry (MUSOD),     2,000,000  Baldwin
                                                                   WI, for dental education, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Marshall University Research Corporation, WV, for     1,000,000  Capito, Manchin
                                                                   improving classrooms, which may include the
                                                                   purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mid-America Christian University, OK, for the           776,000  Mullin
                                                                   purchase of equipment, technology, and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Millersville University of Pennsylvania, PA, for        400,000  Casey
                                                                   expanding education and training opportunities,
                                                                   including the purchase of technology and
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Milwaukee Area Technical College, WI, for             1,100,000  Baldwin
                                                                   supporting parenting students, including
                                                                   providing financial aid and scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Minnesota State University Moorhead, MN, for            901,000  Klobuchar, Smith
                                                                   improving education and training for counselors,
                                                                   including financial aid and stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mississippi College, MS, to support physician         1,000,000  Hyde-Smith, Wicker
                                                                   assistant education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mississippi Community College Board, MS, to           3,465,000  Hyde-Smith
                                                                   expand nursing degree programs, including for
                                                                   faculty stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mississippi State University, MS, for the             5,221,000  Hyde-Smith, Wicker
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mississippi State University, MS, to support          1,000,000  Hyde-Smith, Wicker
                                                                   physician assistant education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mohave Community College, AZ, for supporting          2,500,000  Kelly, Sinema
                                                                   advanced manufacturing workforce training
                                                                   programs, which may include the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mohawk Valley Community College, NY, for                870,000  Schumer
                                                                   education and workforce training, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Morehouse College, GA, for improving research           500,000  Warnock
                                                                   opportunities for postsecondary students, which
                                                                   may include providing student financial aid,
                                                                   stipends and purchasing technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Mott Community College, MI, for increasing              660,000  Peters
                                                                   student completion and persistence, including
                                                                   providing child care to parenting students and
                                                                   other supportive services and purchasing
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Nashua Community College, NH, for air traffic           337,000  Shaheen
                                                                   control workforce training, including purchasing
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  New Jersey Institute of Technology, NJ, for           1,000,000  Booker
                                                                   cybersecurity education, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  New Mexico State University, NM, for developing         480,000  Heinrich
                                                                   educational materials and programming, including
                                                                   providing stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Northampton County Area Community College, PA,          500,000  Casey
                                                                   for expanding education and workforce training,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Northcentral Technical College, WI, for               3,126,000  Baldwin
                                                                   firefighter education and workforce development,
                                                                   which may include providing financial aid,
                                                                   purchasing equipment and supplies, and
                                                                   apprenticeship wages.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Northern Arizona University, AZ, for supporting         150,000  Kelly, Sinema
                                                                   nurse education and training, which may include
                                                                   the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Northern Maine Community College, ME, to support        500,000  Collins, King
                                                                   nursing and allied health education, including
                                                                   the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Northern Michigan University, MI, for improving         606,000  Peters
                                                                   cybersecurity education, including purchasing
                                                                   equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Northern New Mexico College, NM, for improving           40,000  Heinrich, Lujan
                                                                   healthcare career pathways, including curriculum
                                                                   development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Northwest Technical College, MN, for improving        1,900,000  Klobuchar, Smith
                                                                   manufacturing education and training programs,
                                                                   which may include the purchase of equipment and
                                                                   providing stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Nunez Community College, LA, for a wind energy          500,000  Cassidy
                                                                   technology program, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Old Dominion University, VA, for supporting           1,000,000  Kaine, Warner
                                                                   students in postsecondary education, which may
                                                                   include purchasing equipment and addressing
                                                                   student basic needs such as food insecurity.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Owens State Community College, OH, for medical        1,000,000  Brown
                                                                   and healthcare education, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Parkland College, IL, for expanding aviation          1,050,000  Duckworth
                                                                   education and training, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Piedmont Technical College, SC, for a mobile          1,250,000  Graham
                                                                   welding lab, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Pierpont Community and Technical College, WV, to        424,000  Capito, Manchin
                                                                   increase student access, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Pivotal Connections, CA, for a college coaching       1,400,000  Butler
                                                                   program, including financial aid and
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Portland Community College, OR, for increasing          854,000  Merkley, Wyden
                                                                   access to education and training opportunities,
                                                                   which may include providing scholarships, child
                                                                   care stipends, and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Pratt Community College, KS, for the purchase of      1,400,000  Moran
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Providence College, RI, for improving                   800,000  Reed, Whitehouse
                                                                   neuroscience education, which may include
                                                                   providing financial aid and purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Quincy University, IL, for expanding doctorate        1,320,000  Durbin
                                                                   degree programs, including the purchase of
                                                                   equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Randolph College, VA, for improving STEM              1,500,000  Kaine, Warner
                                                                   education programs, which may include the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Red Lake Nation College, MN, for improving              666,000  Klobuchar, Smith
                                                                   postsecondary and career pathways programs,
                                                                   including purchase of technology and internship
                                                                   stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Rensselaer Polytechnic Institute, NY, for               870,000  Gillibrand, Schumer
                                                                   education and workforce training, including the
                                                                   purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Rhode Island College, RI, for college access and      1,300,000  Reed, Whitehouse
                                                                   success programming, including providing
                                                                   financial aid and scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Rhode Island College, RI, for improving               1,509,000  Reed, Whitehouse
                                                                   cybersecurity and technology education programs,
                                                                   including the purchase of equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Roger Williams University, RI, for an education         360,000  Whitehouse
                                                                   fellowship program, which may include financial
                                                                   aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Roxbury Community College, MA, for improving          1,500,000  Markey, Warren
                                                                   education and workforce training, which may
                                                                   include purchasing equipment, providing
                                                                   financial aid and scholarships, and purchasing
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Saginaw Valley State University, MI, for              1,500,000  Peters, Stabenow
                                                                   improving environmental research opportunities
                                                                   for students, including purchasing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Salisbury University, MD, for improving                  65,000  Cardin, Van Hollen
                                                                   educational opportunities for transfer students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Salus University in Partnership with Drexel             250,000  Casey
                                                                   University, PA, for improving optometry
                                                                   education, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Schoolcraft Community College District, MI, for       2,000,000  Peters
                                                                   an apprenticeship program, including purchasing
                                                                   equipment and providing financial aid and
                                                                   student stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Siena College, NY, for STEM education, including        670,000  Schumer
                                                                   the purchase of equipment and stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  South Dakota State University College of Nursing,     4,700,000  Rounds
                                                                   SD, for the purchase of equipment, technology,
                                                                   and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Southern Arkansas University Tech, AR, for the        5,000,000  Boozman
                                                                   purchase of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Southern University and A&M College, LA, for          1,030,000  Cassidy
                                                                   student support services, including stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Southside Virginia Community College, VA, for           940,000  Kaine, Warner
                                                                   improving criminal justice education programs,
                                                                   which may include purchasing equipment and
                                                                   providing financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  St. Cloud Technical & Community College, MN, for      1,136,000  Klobuchar, Smith
                                                                   improving an aircraft maintenance training
                                                                   program, which may include purchasing equipment
                                                                   and student supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  St. Mary's College of Maryland, MD, for expanding       114,000  Cardin, Van Hollen
                                                                   educational opportunities, including the
                                                                   purchase of equipment and rental costs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Stark State College, OH, for first responder            352,000  Brown
                                                                   education and training, including the purchase
                                                                   of equipment and tests.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Teachers College, Columbia University, NY, for          420,000  Gillibrand, Schumer
                                                                   supporting a teacher residency program and
                                                                   improving teacher preparation.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  The Research Foundation for the State University        640,000  Gillibrand, Schumer
                                                                   of New York (SUNY Oswego), NY, for education and
                                                                   research, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Thomas College, ME, for STEM education, including     1,750,000  Collins, King
                                                                   curriculum and the purchase of equipment,
                                                                   technology, and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Tiffin University, OH, for improving education        1,000,000  Brown
                                                                   and workforce development opportunities,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Truckee Meadows Community College, NV, for            2,000,000  Cortez Masto, Rosen
                                                                   advanced manufacturing education and training,
                                                                   which may include purchasing equipment and
                                                                   technology upgrades.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Tuskegee University, AL, for an aviation and          5,290,000  Britt
                                                                   aerotechnology program, including scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University at Buffalo, NY, for education and          1,370,000  Schumer
                                                                   workforce development, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Alaska Anchorage, AK, to expand an      1,000,000  Murkowski
                                                                   aviation maintenance technology program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Charleston, WV, for improvements to     6,000,000  Manchin
                                                                   a university library, which may include
                                                                   purchasing equipment and upgrading technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Maine System, ME, for the purchase      3,000,000  Collins
                                                                   of equipment and supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Maryland, MD, for expanding college       225,000  Cardin, Van Hollen
                                                                   access programming and early career counseling,
                                                                   including facility rentals and scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Nevada Las Vegas, NV, for improving     1,000,000  Cortez Masto, Rosen
                                                                   research opportunities for students, including
                                                                   the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Nevada, Las Vegas, NV, for nursing      2,397,000  Cortez Masto, Rosen
                                                                   education, including purchasing equipment and
                                                                   supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Nevada, Reno, NV, for improving           550,000  Cortez Masto, Rosen
                                                                   nursing education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of New Hampshire, NH, for improving        1,900,000  Shaheen
                                                                   health education and workforce training, which
                                                                   may include financial aid and stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of New Mexico, NM, for implementing a        512,000  Heinrich, Lujan
                                                                   teacher residency program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Northern Colorado, CO, for                860,000  Bennet, Hickenlooper
                                                                   improving education research opportunities for
                                                                   postsecondary students, including the purchase
                                                                   of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  University of Vermont and State Agricultural          2,713,000  Welch
                                                                   College, VT, for improving a laboratory
                                                                   technician program, including purchase of
                                                                   equipment and for providing financial aid.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Urban League of Greater Hartford, CT, for college       150,000  Blumenthal, Murphy
                                                                   success programming including financial aid and
                                                                   stipends, school supplies and the purchase of
                                                                   technology equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Vermont State Colleges System, VT, for education      2,500,000  Welch
                                                                   and training, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Virginia Commonwealth University, VA, for               430,000  Kaine, Warner
                                                                   supporting internship opportunities that provide
                                                                   work-based learning experiences for first-
                                                                   generation, low-income, and underrepresented
                                                                   students, which may include stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Washburn Institute of Technology, KS, for the         1,600,000  Moran
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Washington & Jefferson College, PA, for expanding       150,000  Casey
                                                                   nursing education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Waubonsee Community College, IL, for improving          250,000  Duckworth
                                                                   education opportunities for parenting students,
                                                                   including purchasing technology upgrades and
                                                                   accessible furniture.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Wesleyan University, CT, for improving education        700,000  Blumenthal, Murphy
                                                                   programs, including providing financial aid and
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  West Virginia State University Research and             500,000  Capito, Manchin
                                                                   Development Corporation, WV, for a cybersecurity
                                                                   degree program, including equipment and
                                                                   scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  West Virginia University, WV, for a data science      2,640,000  Capito, Manchin
                                                                   program, including curriculum development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  West Virginia University, WV, for a digital           2,400,000  Capito, Manchin
                                                                   network system, including the purchase of
                                                                   equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  West Virginia Wesleyan College, WV, for improving       500,000  Capito, Manchin
                                                                   heating and cooling systems, which may include
                                                                   the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Western Colorado University, CO, for nursing            394,000  Bennet, Hickenlooper
                                                                   education, including the purchase of equipment
                                                                   and technology, financial aid for students, and
                                                                   supportive services for students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Western Michigan University, MI, for education          909,000  Peters
                                                                   and training in aviation, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Western Nevada College, NV, for improving STEM        2,093,000  Cortez Masto, Rosen
                                                                   education, including purchasing equipment and
                                                                   technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  William Carey University, MS, for a nursing             500,000  Hyde-Smith
                                                                   program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Wilson College, PA, for establishing an                 400,000  Casey
                                                                   occupational therapy doctorate program,
                                                                   including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education          Higher Education...............  Wor-Wic Community College, MD, for education and        214,000  Cardin, Van Hollen
                                                                   training in the culinary arts, including the
                                                                   purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------


  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2024 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
                                                                        YEAR 2025
                                                                [In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Senate Committee recommendation
                                                                                                                            compared with (+ or -)
                             Item                                     2024         Budget estimate      Committee    -----------------------------------
                                                                  appropriation                      recommendation         2024
                                                                                                                        appropriation    Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
 
                 TITLE I--DEPARTMENT OF LABOR
 
            EMPLOYMENT AND TRAINING ADMINISTRATION
 
               Training and Employment Services
 
Grants to States:
    Adult Training, current year appropriations...............          173,649           173,649           173,649   ................  ................
        Available from prior year appropriations..............          712,000           712,000           712,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, available this fiscal year..............          885,649           885,649           885,649   ................  ................
 
        Advance appropriation FY 2026.........................          712,000           712,000           712,000   ................  ................
        less prior year appropriations........................         -712,000          -712,000          -712,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, appropriated in this bill...............          885,649           885,649           885,649   ................  ................
 
    Youth Training............................................          948,130           948,130           948,130   ................  ................
    Dislocated Worker Assistance, current year appropriations.          235,553           235,553           235,553   ................  ................
        Available from prior year appropriations..............          860,000           860,000           860,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, available this fiscal year..............        1,095,553         1,095,553         1,095,553   ................  ................
 
        Advance appropriation FY 2026.........................          860,000           860,000           860,000   ................  ................
        less prior year appropriations........................         -860,000          -860,000          -860,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, appropriated in this bill...............        1,095,553         1,095,553         1,095,553   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Grants to States............................        2,929,332         2,929,332         2,929,332   ................  ................
 
            Current year appropriations.......................       (1,357,332)       (1,357,332)       (1,357,332)  ................  ................
            Advance appropriations............................       (1,572,000)       (1,572,000)       (1,572,000)  ................  ................
 
National Programs:
    Dislocated Worker Assistance National Reserve:
        Current year appropriations...........................          100,859            77,859           102,859            +2,000           +25,000
        Available from prior year appropriations..............          200,000           200,000           200,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, available this fiscal year..............          300,859           277,859           302,859            +2,000           +25,000
 
        Advance appropriations FY 2026........................          200,000           200,000           200,000   ................  ................
        less prior year appropriations........................         -200,000          -200,000          -200,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, appropriated in this bill...............          300,859           277,859           302,859            +2,000           +25,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Dislocated Worker Assistance................        1,396,412         1,373,412         1,398,412            +2,000           +25,000
 
    Native American programs..................................           60,000            60,000            60,000   ................  ................
    Migrant and Seasonal Farmworker programs..................           97,396            97,396            97,396   ................  ................
    YouthBuild activities.....................................          105,000           105,000           110,000            +5,000            +5,000
    Reintegration of Ex-Offenders.............................          115,000           120,000           115,000   ................           -5,000
    Workforce Data Quality Initiative.........................            6,000             6,000             6,000   ................  ................
    Apprenticeship programs...................................          285,000           335,000           290,000            +5,000           -45,000
    Community Project Funding / Congressionally Directed                107,834   ................          109,082            +1,248          +109,082
     Spending.................................................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, National Programs...........................        1,077,089         1,001,255         1,090,337           +13,248           +89,082
 
            Current year appropriations.......................          877,089           801,255           890,337           +13,248           +89,082
        Advance appropriations................................          200,000           200,000           200,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Total, Training and Employment Services...............        4,006,421         3,930,587         4,019,669           +13,248           +89,082
                                                               =========================================================================================
            Current year appropriations.......................       (2,234,421)       (2,158,587)       (2,247,669)         (+13,248)         (+89,082)
            Advance appropriations............................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
 
                           Job Corps
 
Operations....................................................        1,603,325         1,605,741         1,603,325   ................           -2,416
Construction, Rehabilitation and Acquisition..................          123,000           123,000           123,000   ................  ................
Administration................................................           33,830            35,635            33,830   ................           -1,805
                                                               -----------------------------------------------------------------------------------------
    Total, Job Corps..........................................        1,760,155         1,764,376         1,760,155   ................           -4,221
                                                               =========================================================================================
Community Service Employment For Older Americans..............          405,000           405,000           405,000   ................  ................
Federal Unemployment Benefits and Allowances (indefinite).....           30,700            33,900            33,900            +3,200   ................
 
State Unemployment Insurance and Employment Service Operations
 
Unemployment Insurance [UI] Compensation (trust fund).........  ................  ................  ................  ................  ................
    State Administration......................................        2,750,635         3,025,274         2,775,635           +25,000          -249,639
    Reemployment Services and Eligibility Assessments (RESEA)--         117,000           117,000           117,000   ................  ................
     UI integrity.............................................
    RESEA cap adjustment......................................          265,000           271,000           271,000            +6,000   ................
    UI Integrity Center of Excellence.........................            9,000             9,000             9,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Unemployment Compensation...................        3,141,635         3,422,274         3,172,635           +31,000          -249,639
 
    Unemployment Insurance National Activities (trust fund)...           18,000            48,000            18,000   ................          -30,000
 
Employment Service [ES]:
    Grants to States:
        Federal Funds.........................................           21,413            21,413            21,413   ................  ................
        Trust Funds...........................................          653,639           658,639           653,639   ................           -5,000
                                                               -----------------------------------------------------------------------------------------
            Subtotal, Grants to States........................          675,052           680,052           675,052   ................           -5,000
 
    ES National Activities (trust fund).......................           25,000            25,000            25,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Employment Service..........................          700,052           705,052           700,052   ................           -5,000
 
            Federal Funds.....................................          (21,413)          (21,413)          (21,413)  ................  ................
            Trust Funds.......................................         (678,639)         (683,639)         (678,639)  ................          (-5,000)
 
Foreign Labor Certifications:
    Federal Administration....................................           60,528            64,168            61,528            +1,000            -2,640
    Grants to States..........................................           23,282            23,282            23,282   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Foreign Labor Certification.................           83,810            87,450            84,810            +1,000            -2,640
 
One-Stop Career Centers/Labor Market Information..............           62,653            62,653            62,653   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, State Unemployment Insurance and Employment Service        4,006,150         4,325,429         4,038,150           +32,000          -287,279
     Operations...............................................
                                                               =========================================================================================
        Federal Funds.........................................          (84,066)          (84,066)          (84,066)  ................  ................
        Trust Funds...........................................       (3,922,084)       (4,241,363)       (3,954,084)         (+32,000)        (-287,279)
 
                    Program Administration
 
Training and Employment.......................................           68,919            71,504            68,919   ................           -2,585
    Trust Funds...............................................            9,253             9,531             9,253   ................             -278
Employment Security...........................................            3,621             4,155             3,621   ................             -534
    Trust Funds...............................................           42,574            49,149            42,574   ................           -6,575
Apprenticeship Services.......................................           38,913            40,340            38,913   ................           -1,427
Executive Direction...........................................            7,447             7,735             7,447   ................             -288
    Trust Funds...............................................            2,188             2,254             2,188   ................              -66
                                                               -----------------------------------------------------------------------------------------
        Total, Program Administration.........................          172,915           184,668           172,915   ................          -11,753
                                                               =========================================================================================
            Federal Funds.....................................         (118,900)         (123,734)         (118,900)  ................          (-4,834)
            Trust Funds.......................................          (54,015)          (60,934)          (54,015)  ................          (-6,919)
                                                               -----------------------------------------------------------------------------------------
        Total, Employment and Training Administration.........       10,381,341        10,643,960        10,429,789           +48,448          -214,171
                                                               =========================================================================================
            Federal Funds.....................................        6,405,242         6,341,663         6,421,690           +16,448           +80,027
                Current year appropriations...................       (4,633,242)       (4,569,663)       (4,649,690)         (+16,448)         (+80,027)
                Advance appropriations........................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
            Trust Funds.......................................        3,976,099         4,302,297         4,008,099           +32,000          -294,198
 
           VETERANS EMPLOYMENT AND TRAINING SERVICE
 
           Veterans' Employment and Training Service
 
State Administration, Grants..................................          185,000           185,000           185,000   ................  ................
Transition Assistance Program.................................           34,379            34,379            34,379   ................  ................
Federal Administration........................................           47,048            49,008            47,048   ................           -1,960
National Veterans' Employment and Training Services Institute.            3,414             3,414             3,414   ................  ................
Homeless Veterans' Programs...................................           65,500            65,500            65,500   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Veterans' Employment and Training..................          335,341           337,301           335,341   ................           -1,960
                                                               =========================================================================================
        Federal Funds.........................................           65,500            65,500            65,500   ................  ................
        Trust Funds...........................................         (269,841)         (271,801)         (269,841)  ................          (-1,960)
 
           EMPLOYEE BENEFITS SECURITY ADMINISTRATION
 
                     Salaries and Expenses
 
Enforcement and Participant Assistance........................  ................          169,535   ................  ................         -169,535
Policy and Compliance Assistance..............................  ................           24,607   ................  ................          -24,607
Executive Leadership, Program Oversight and Administration....  ................           11,521   ................  ................          -11,521
Employee benefits security programs...........................          191,100   ................          206,100           +15,000          +206,100
                                                               -----------------------------------------------------------------------------------------
    Total, Employee Benefits Security Administration..........          191,100           205,663           206,100           +15,000              +437
                                                               =========================================================================================
 
             PENSION BENEFIT GUARANTY CORPORATION
 
Pension Benefit Guaranty Corporation Fund.....................         (512,900)         (514,063)         (514,063)          (+1,163)  ................
 
           OFFICE OF WORKERS' COMPENSATION PROGRAMS
 
Salaries and Expenses.........................................          120,500           128,271           120,500   ................           -7,771
    Trust Funds...............................................            2,205             2,274             2,205   ................              -69
                                                               -----------------------------------------------------------------------------------------
        Total, Salaries and Expenses..........................          122,705           130,545           122,705   ................           -7,840
                                                               =========================================================================================
 
                       Special Benefits
 
Federal Employees' Compensation Benefits......................          698,000           724,670           724,670           +26,670   ................
Longshore and Harbor Workers' Benefits........................            2,000             2,000             2,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Special Benefits...................................          700,000           726,670           726,670           +26,670   ................
                                                               =========================================================================================
 
    Energy Employees Occupational Illness Compensation Fund
 
Administrative Expenses.......................................           66,532            66,966            66,966              +434   ................
 
           Special Benefits for Disabled Coal Miners
 
Benefit Payments..............................................           28,000            26,200            26,200            -1,800   ................
Administration................................................            5,140             5,167             5,167               +27   ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, available this fiscal year......................           33,140            31,367            31,367            -1,773   ................
 
Advance appropriations, FY 2026, 1st quarter..................            7,000             6,000             6,000            -1,000   ................
Less prior year advance appropriations........................          -10,250            -7,000            -7,000            +3,250   ................
                                                               -----------------------------------------------------------------------------------------
    Total, appropriated in this bill..........................           29,890            30,367            30,367              +477   ................
                                                               =========================================================================================
 
               Black Lung Disability Trust Fund
 
Benefit Payments and Interest on Advances.....................          366,906           391,827           391,827           +24,921   ................
Workers' Compensation Programs, Salaries and Expenses.........           44,059            51,580            51,580            +7,521   ................
Departmental Management, Salaries and Expenses................           41,178            41,570            41,570              +392   ................
Departmental Management, Inspector General....................              368               373               373                +5   ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Black Lung Disability Trust Fund................          452,511           485,350           485,350           +32,839   ................
 
Treasury Department Administrative Costs......................              356               356               356   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Black Lung Disability Trust Fund...................          452,867           485,706           485,706           +32,839   ................
                                                               =========================================================================================
    Total, Office of Workers' Compensation Programs...........        1,371,994         1,440,254         1,432,414           +60,420            -7,840
                                                               =========================================================================================
        Federal Funds.........................................        1,369,789         1,437,980         1,430,209           +60,420            -7,771
            Current year appropriations.......................       (1,362,789)       (1,431,980)       (1,424,209)         (+61,420)          (-7,771)
            Advance appropriations............................           (7,000)           (6,000)           (6,000)          (-1,000)  ................
        Trust Funds...........................................            2,205             2,274             2,205   ................              -69
 
                    WAGE AND HOUR DIVISION
 
Salaries and Expenses.........................................          260,000           294,901           267,500            +7,500           -27,401
 
        OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS
 
Salaries and Expenses.........................................          110,976           116,132           110,976   ................           -5,156
 
             OFFICE OF LABOR-MANAGEMENT STANDARDS
 
Salaries and Expenses.........................................           48,515            50,845            48,515   ................           -2,330
 
         OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
 
                     Salaries and Expenses
 
Safety and Health Standards...................................           21,000            21,476            21,000   ................             -476
Federal Enforcement...........................................          243,000           261,635           246,000            +3,000           -15,635
Whistleblower enforcement.....................................           22,500            23,121            22,500   ................             -621
State Programs................................................          120,000           120,000           121,000            +1,000            +1,000
Technical Support.............................................           26,000            26,483            26,000   ................             -483
 
Compliance Assistance:
    Federal Assistance........................................           78,262            80,561            79,262            +1,000            -1,299
    State Consultation Grants.................................           63,160            63,160            63,160   ................  ................
    Training Grants...........................................           12,787            12,787            12,787   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Compliance Assistance.......................          154,209           156,508           155,209            +1,000            -1,299
 
Safety and Health Statistics..................................           35,500            35,915            35,500   ................             -415
Executive Direction and Administration........................           10,100            10,325            10,100   ................             -225
                                                               -----------------------------------------------------------------------------------------
    Total, Occupational Safety and Health Administration......          632,309           655,463           637,309            +5,000           -18,154
                                                               =========================================================================================
 
             MINE SAFETY AND HEALTH ADMINISTRATION
 
                     Salaries and Expenses
 
Mine Safety and Health Enforcement............................          265,774           279,923           268,774            +3,000           -11,149
Standards Development.........................................            5,000             5,235             5,000   ................             -235
Assessments...................................................            7,191             7,549             7,191   ................             -358
Educational Policy and Development............................           39,820            41,051            41,020            +1,200               -31
Technical Support.............................................           36,041            37,730            36,841              +800              -889
Program Evaluation and Information Resources [PEIR]...........           17,990            18,273            17,990   ................             -283
Program Administration........................................           16,000            16,777            16,000   ................             -777
                                                               -----------------------------------------------------------------------------------------
    Total, Mine Safety and Health Administration..............          387,816           406,538           392,816            +5,000           -13,722
                                                               =========================================================================================
    Total, Labor Enforcement Agencies.........................        1,753,421         1,860,087         1,785,921           +32,500           -74,166
                                                               =========================================================================================
        Federal Funds.........................................       (1,751,216)       (1,857,813)       (1,783,716)         (+32,500)         (-74,097)
        Trust Funds...........................................           (2,205)           (2,274)           (2,205)  ................             (-69)
 
                  BUREAU OF LABOR STATISTICS
 
                     Salaries and Expenses
 
Employment and Unemployment Statistics........................          243,952           253,058           248,952            +5,000            -4,106
Labor Market Information (trust fund).........................           68,000            68,000            68,000   ................  ................
Prices and Cost of Living.....................................          246,000           247,521           246,000   ................           -1,521
Compensation and Working Conditions...........................           91,000            92,554            91,000   ................           -1,554
Productivity and Technology...................................           12,000            13,244            12,000   ................           -1,244
Executive Direction and Staff Services........................           37,000            38,409            37,000   ................           -1,409
                                                               -----------------------------------------------------------------------------------------
    Total, Bureau of Labor Statistics.........................          697,952           712,786           702,952            +5,000            -9,834
                                                               =========================================================================================
        Federal Funds.........................................          629,952           644,786           634,952            +5,000            -9,834
        Trust Funds...........................................           68,000            68,000            68,000   ................  ................
 
                    DEPARTMENTAL MANAGEMENT
 
                     Salaries and Expenses
 
Executive Direction...........................................           32,658            35,876            32,658   ................           -3,218
Departmental Program Evaluation...............................            4,281             8,613             4,281   ................           -4,332
Legal Services................................................          130,754           145,245           134,754            +4,000           -10,491
    Trust Funds...............................................              308               308               308   ................  ................
International Labor Affairs...................................          116,125           162,395           118,125            +2,000           -44,270
Administration and Management.................................           30,804            31,991            30,804   ................           -1,187
Adjudication..................................................           37,000            38,405            37,000   ................           -1,405
Women's Bureau................................................           23,000            26,282            24,000            +1,000            -2,282
Civil Rights Activities.......................................            7,586             9,252             7,586   ................           -1,666
Chief Financial Officer.......................................            5,681             5,883             5,681   ................             -202
GSA Technology Transformation.................................  ................            1,351   ................  ................           -1,351
                                                               -----------------------------------------------------------------------------------------
    Total, Salaries and Expenses..............................          388,197           465,601           395,197            +7,000           -70,404
                                                               =========================================================================================
        Federal Funds.........................................         (387,889)         (465,293)         (394,889)          (+7,000)         (-70,404)
        Trust Funds...........................................             (308)             (308)             (308)  ................  ................
 
                        IT Modernization
 
Departmental support systems..................................            6,889             6,889             6,889   ................  ................
Infrastructure technology modernization.......................           22,380            28,397            22,380   ................           -6,017
                                                               -----------------------------------------------------------------------------------------
    Total, IT Modernization...................................           29,269            35,286            29,269   ................           -6,017
                                                               =========================================================================================
 
                  Office of Inspector General
 
Program Activities............................................           91,187           100,396            91,187   ................           -9,209
    Trust Funds...............................................            5,841             5,841             5,841   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Total, Office of Inspector General....................           97,028           106,237            97,028   ................           -9,209
                                                               =========================================================================================
        Total, Departmental Management........................          514,494           607,124           521,494            +7,000           -85,630
                                                               =========================================================================================
            Federal Funds.....................................         (508,345)         (600,975)         (515,345)          (+7,000)         (-85,630)
            Trust Funds.......................................           (6,149)           (6,149)           (6,149)  ................  ................
 
            OFFICE OF DISABILITY EMPLOYMENT POLICY
 
Salaries and Expenses.........................................           43,000            44,876            43,000   ................           -1,876
                                                               -----------------------------------------------------------------------------------------
    Total, Workforce Innovation and Opportunity Act Programs..        5,766,576         5,694,963         5,779,824           +13,248           +84,861
                                                               =========================================================================================
        Current year appropriations...........................       (3,994,576)       (3,922,963)       (4,007,824)         (+13,248)         (+84,861)
        Advance appropriations................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
 
            GENERAL PROVISIONS--DEPARTMENT OF LABOR
 
Treasure Island Job Corps Facility (Sec 111)..................  ................            1,000             1,000            +1,000   ................
Proceeds from Job Corps facilities (Sec 114)..................            1,000             1,000   ................           -1,000            -1,000
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Title I General Provisions......................            1,000             2,000             1,000   ................           -1,000
                                                               -----------------------------------------------------------------------------------------
    Total, title I, Department of Labor.......................       14,975,838        15,517,843        15,129,206          +153,368          -388,637
                                                               =========================================================================================
        Federal Funds.........................................      (10,653,544)      (10,867,322)      (10,774,912)        (+121,368)         (-92,410)
            Current year appropriations.......................       (8,874,544)       (9,089,322)       (8,996,912)        (+122,368)         (-92,410)
            Advance appropriations............................       (1,779,000)       (1,778,000)       (1,778,000)          (-1,000)  ................
        Trust Funds...........................................       (4,322,294)       (4,650,521)       (4,354,294)         (+32,000)        (-296,227)
                                                               -----------------------------------------------------------------------------------------
    Total, Title I Department of Labor discretionary..........       13,695,849        14,174,234        13,785,597           +89,748          -388,637
                                                               =========================================================================================
            Advance appropriations............................         (-10,250)          (-7,000)          (-7,000)          (+3,250)  ................
 
       TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
                     PUBLIC HEALTH SERVICE
 
      HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA)
 
                      Primary Health Care
 
Health Centers................................................        1,857,772         1,857,772         1,857,772   ................  ................
Free Clinics Medical Malpractice..............................            1,000             1,000             1,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Primary Health Care................................        1,858,772         1,858,772         1,858,772   ................  ................
                                                               =========================================================================================
 
                       Health Workforce
 
National Health Service Corps (NHSC)..........................          128,600           125,600           128,600   ................           +3,000
Health Professions Training...................................  ................  ................  ................  ................  ................
    Centers of Excellence.....................................           28,422            28,422            28,422   ................  ................
    Health Careers Opportunity Program........................           16,000            16,000            16,000   ................  ................
    Faculty Loan Repayment....................................            2,310             2,310             2,310   ................  ................
    Scholarships for Disadvantaged Students...................           55,014            55,014            55,014   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Training for Diversity......................          101,746           101,746           101,746   ................  ................
 
Primary Care Training and Enhancement.........................           49,924            49,924            49,924   ................  ................
Oral Health Training..........................................           42,673            42,673            42,673   ................  ................
 
Interdisciplinary Community-Based Linkages:
    Area Health Education Centers.............................           47,000            47,000            47,000   ................  ................
    Geriatric Workforce Enhancement Program...................           48,245            47,245            49,245            +1,000            +2,000
    Mental and Behavioral Health..............................           44,053   ................           44,053   ................          +44,053
    Behavioral Health Workforce Education and Training........          113,000           253,553           113,000   ................         -140,553
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Interdisciplinary Community-Based Linkages..          252,298           347,798           253,298            +1,000           -94,500
                                                               =========================================================================================
Substance Use Disorder Treatment and Recovery Loan Repayment             40,000   ................           65,000           +25,000           +65,000
 Program......................................................
Workforce Information and Analysis............................            5,663             5,663             5,663   ................  ................
Public Health and Preventive Medicine programs................           18,000            18,000            18,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Health Professions Education and Training (Title          510,304           565,804           536,304           +26,000           -29,500
     VII).....................................................
 
Nursing Workforce Development Programs:
    Advanced Nursing Education................................           89,581            99,581            89,581   ................          -10,000
    Nurse Education, Practice, Quality, and Retention.........           64,413            69,413            69,413            +5,000   ................
    Nurse Practitioner Optional Fellowship Program............            6,000             6,000             6,000   ................  ................
    Nursing Workforce Diversity...............................           24,343            24,343            24,343   ................  ................
    Nurse Corps Loan Repayment and Scholarship................           92,635            92,635            92,635   ................  ................
    Nursing Faculty Loan Program..............................           28,500            28,500            28,500   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Nursing Workforce Development Programs                305,472           320,472           310,472            +5,000           -10,000
         (Title VIII).........................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Health Professions (Titles VII and VIII)........          815,776           886,276           846,776           +31,000           -39,500
 
Children's Hospitals Graduate Medical Education...............          390,000           385,000           390,000   ................           +5,000
Medical Student Education.....................................           60,000            50,500            36,000           -24,000           -14,500
Pediatric Specialty Loan Repayment (Sec 775)..................           10,000            10,000            10,000   ................  ................
Health Care Workforce Innovation Program......................  ................           10,000   ................  ................          -10,000
National Practitioner Data Bank...............................           18,814            18,814            18,814   ................  ................
    User Fees.................................................          -18,814           -18,814           -18,814   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Health Workforce............................        1,404,376         1,467,376         1,411,376            +7,000           -56,000
 
                   Maternal and Child Health
 
Maternal and Child Health Services Block Grant:
    Maternal and Child Health Services Block Grant............          603,584           603,584           603,584   ................  ................
    Special Projects of National Significance.................          210,116           228,130           213,116            +3,000           -15,014
                                                               -----------------------------------------------------------------------------------------
        Subtotal, MCH Block Grant.............................          813,700           831,714           816,700            +3,000           -15,014
 
Sickle Cell Disease...........................................            8,205             8,205             8,205   ................  ................
Autism and Other Developmental Disabilities...................           56,344            56,344            56,344   ................  ................
Heritable Disorders...........................................           20,883            20,883            20,883   ................  ................
Healthy Start.................................................          145,000           172,000           145,250              +250           -26,750
Early Hearing Detection and Intervention......................           18,818            18,818            18,818   ................  ................
Emergency Medical Services for Children.......................           24,334            24,334            24,334   ................  ................
Screening and Treatment for Maternal Mental Health and                   11,000            15,500            12,000            +1,000            -3,500
 Substance Use Disorders......................................
Pediatric Mental Health Care Access...........................           13,000            13,000            14,000            +1,000            +1,000
Innovation for Maternal Health................................           15,300            30,300            17,800            +2,500           -12,500
Maternal Mental Health Hotline................................            7,000             7,000             8,000            +1,000            +1,000
Poison Control Centers........................................           26,846            26,846            28,846            +2,000            +2,000
Integrated Services for Pregnant and Postpartum Women.........           10,000            10,000            10,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Maternal and Child Health.......................        1,170,430         1,234,944         1,181,180           +10,750           -53,764
 
                  Ryan White HIV/AIDS Program
 
Emergency Assistance (Part A).................................          680,752           680,752           680,752   ................  ................
Comprehensive Care Programs (Part B)..........................        1,364,878         1,364,878         1,364,878   ................  ................
    AIDS Drug Assistance Program [ADAP] (NA)..................         (900,313)         (900,313)         (900,313)  ................  ................
Early Intervention Program (Part C)...........................          208,970           208,970           208,970   ................  ................
Children, Youth, Women, and Families (Part D).................           77,935            77,935            77,935   ................  ................
AIDS Dental Services (Part F).................................           13,620            13,620            13,620   ................  ................
Education and Training Centers (Part F).......................           34,886            34,886            34,886   ................  ................
Special Projects of Regional and National Significance........           25,000            25,000            25,000   ................  ................
Ending the HIV/AIDS Epidemic Initiative.......................          165,000           175,000           165,000   ................          -10,000
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Ryan White HIV/AIDS program.....................        2,571,041         2,581,041         2,571,041   ................          -10,000
                                                               =========================================================================================
 
                        Health Systems
 
Organ Transplantation.........................................           54,049            67,049            67,049           +13,000   ................
National Cord Blood Inventory.................................           19,266            19,266            19,266   ................  ................
C W Bill Young Cell Transplantation Program...................           33,009            33,009            33,009   ................  ................
Hansen's Disease Services.....................................           13,706            13,706            13,706   ................  ................
Hansen's Disease Program--Buildings and Facilities............              122               122               122   ................  ................
Payment to Hawaii, Treatment of Hansen's......................            1,857             1,857             1,857   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Health Systems..................................          122,009           135,009           135,009           +13,000   ................
 
                         Rural Health
 
Rural Outreach Grants.........................................          100,975            92,975           105,975            +5,000           +13,000
Rural Health Policy Development...............................           11,076            11,076            12,076            +1,000            +1,000
Rural Hospital Flexibility Grants.............................           64,277            64,277            64,277   ................  ................
State Offices of Rural Health.................................           12,500            12,500            14,500            +2,000            +2,000
Black Lung Clinics............................................           12,190            12,190            12,190   ................  ................
Radiation Exposure Screening and Education Program............            1,889             1,889             1,889   ................  ................
Rural Communities Opioid Response.............................          145,000           145,000           155,000           +10,000           +10,000
Rural Residency...............................................           12,700            12,500            14,000            +1,300            +1,500
Rural Hospital Stabilization..................................            4,000   ................            6,000            +2,000            +6,000
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Rural Health....................................          364,607           352,407           385,907           +21,300           +33,500
 
Family Planning (Title X).....................................          286,479           390,000           286,479   ................         -103,521
 
           HRSA-Wide Activities and Program Support
 
Program Management............................................          165,300           163,800           165,300   ................           +1,500
Community Project Funding / Congressionally Directed Spending.          890,788   ................          871,077           -19,711          +871,077
Office of Pharmacy Affairs (340B Program).....................           12,238            12,238            12,238   ................  ................
Office for the Advancement of Telehealth......................           42,050            38,050            44,050            +2,000            +6,000
                                                               -----------------------------------------------------------------------------------------
    Subtotal, HRSA-Wide Activities and Program Support........        1,110,376           214,088         1,092,665           -17,711          +878,577
                                                               =========================================================================================
    Total, Health Resources and Services......................        8,888,090         8,233,637         8,922,429           +34,339          +688,792
                                                               =========================================================================================
 
        Vaccine Injury Compensation Program Trust Fund
 
Post-FY 1988 Claims...........................................          261,497           266,727           266,727            +5,230   ................
HRSA Administrative expenses..................................           15,200            20,200            15,200   ................           -5,000
                                                               -----------------------------------------------------------------------------------------
    Total, Vaccine Injury Compensation Trust Fund.............          276,697           286,927           281,927            +5,230            -5,000
                                                               =========================================================================================
Covered Countermeasures Process Fund..........................            7,000            10,000             7,000   ................           -3,000
                                                               -----------------------------------------------------------------------------------------
    Total, Health Resources and Services Administration.......        9,171,787         8,530,564         9,211,356           +39,569          +680,792
                                                               =========================================================================================
        Discretionary.........................................       (8,910,290)       (8,263,837)       (8,944,629)         (+34,339)        (+680,792)
        Mandatory.............................................         (261,497)         (266,727)         (266,727)          (+5,230)  ................
 
       CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)
 
Immunization and Respiratory Diseases.........................          237,358           499,941           464,941          +227,583           -35,000
    Prevention and Public Health Fund.........................         (681,933)         (469,350)         (469,350)        (-212,583)  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal..............................................          919,291           969,291           934,291           +15,000           -35,000
 
HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and         1,391,056         1,391,056         1,394,056            +3,000            +3,000
 Tuberculosis Prevention......................................
Emerging and Zoonotic Infectious Diseases.....................          708,272           728,772           753,272           +45,000           +24,500
    Prevention and Public Health Fund.........................          (52,000)          (52,000)          (52,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, EZID program level..........................          760,272           780,772           805,272           +45,000           +24,500
 
Chronic Disease Prevention and Health Promotion...............        1,192,647         1,304,464         1,192,964              +317          -111,500
    Prevention and Public Health Fund.........................         (241,267)         (254,950)         (270,950)         (+29,683)         (+16,000)
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Chronic Disease Prevention and Health               1,433,914         1,559,414         1,463,914           +30,000           -95,500
         Promotion, program level.............................
 
Birth Defects, Developmental Disabilities, Disabilities and             206,060           205,560           210,060            +4,000            +4,500
 Health.......................................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal: Birth Defects and Developmental Disabilities,             206,060           205,560           210,060            +4,000            +4,500
     program level............................................
                                                               =========================================================================================
Public Health Scientific Services.............................          711,553           621,197           481,564          -229,989          -139,633
    Evaluation Funding (PHS Act Sec 241)......................          (42,944)  ................         (110,033)         (+67,089)        (+110,033)
    Prevention and Public Health Fund.........................  ................         (182,900)         (182,900)        (+182,900)  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Public Health Scientific Services, program            754,497           804,097           774,497           +20,000           -29,600
         level................................................
 
Environmental Health..........................................          191,850           249,850           193,850            +2,000           -56,000
    Prevention and Public Health Fund.........................          (51,000)          (17,000)          (51,000)  ................         (+34,000)
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Environmental Health, program level.........          242,850           266,850           244,850            +2,000           -22,000
 
Injury Prevention and Control.................................          761,379           843,379           776,379           +15,000           -67,000
Evaluation Funding (PHS Act Sec 241)..........................  ................         (100,000)  ................  ................        (-100,000)
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Injury Prevention and Control, program level....          761,379           843,379           776,379           +15,000           -67,000
 
National Institute for Occupational Safety and Health.........          362,800           363,200           364,030            +1,230              +830
Energy Employees Occupational Illness Compensation Program....           55,358            55,358            55,358   ................  ................
Global Health.................................................          692,843           692,843           697,613            +4,770            +4,770
Public Health Preparedness and Response.......................          938,200           943,300           953,200           +15,000            +9,900
 
CDC-Wide Activities and Program Support:
    Preventive Health and Health Services Block Grant                  (160,000)         (160,000)         (160,000)  ................  ................
     (Prevention and Public Health Fund)......................
    Office of the Director....................................          128,570           128,570           131,570            +3,000            +3,000
    Reserve Fund..............................................           25,000            35,000            25,000   ................          -10,000
    Public Health Infrastructure and Capacity.................          350,000           350,000           365,000           +15,000           +15,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Public Health Infrastructure and Capacity...          350,000           350,000           365,000           +15,000           +15,000
 
    Prevention and Public Health Fund.........................  ................          (50,000)  ................  ................         (-50,000)
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Center for Forecasting and Outbreak           ................           50,000   ................  ................          -50,000
         Analytics............................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, CDC-Wide Activities.............................          503,570           513,570           521,570           +18,000            +8,000
                                                               =========================================================================================
    (Prevention and Public Health Fund).......................         (160,000)         (210,000)         (160,000)  ................         (-50,000)
Buildings and Facilities......................................           40,000            40,000            40,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Centers for Disease Control and Prevention.........        7,992,946         8,452,490         8,098,857          +105,911          -353,633
                                                               =========================================================================================
        Discretionary.........................................       (7,937,588)       (8,397,132)       (8,043,499)        (+105,911)        (-353,633)
        Mandatory.............................................          (55,358)          (55,358)          (55,358)  ................  ................
    (Evaluation Funding (PHS Act Sec 241))....................          (42,944)         (100,000)         (110,033)         (+67,089)         (+10,033)
    (Prevention and Public Health Fund).......................       (1,186,200)       (1,186,200)       (1,186,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Centers for Disease Control, program level.........       (9,222,090)       (9,738,690)       (9,395,090)        (+173,000)        (-343,600)
                                                               =========================================================================================
 
              NATIONAL INSTITUTES OF HEALTH (NIH)
 
National Cancer Institute (NCI)...............................        7,224,159         7,839,141         7,274,159           +50,000          -564,982
    Additional funding (emergency)............................  ................  ................          216,000          +216,000          +216,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, NCI, program level..........................        7,224,159         7,839,141         7,490,159          +266,000          -348,982
 
National Heart, Lung, and Blood Institute (NHLBI).............        3,982,345         3,997,086         3,982,345   ................          -14,741
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NHLBI, program level............................        3,982,345         3,997,086         3,982,345   ................          -14,741
 
National Institute of Dental and Craniofacial Research (NIDCR)          520,163           521,695           520,163   ................           -1,532
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIDCR, program level............................          520,163           521,695           520,163   ................           -1,532
 
National Institute of Diabetes and Digestive and Kidney               2,310,721         2,309,991         2,360,721           +50,000           +50,730
 Diseases [NIDDK].............................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIDDK, program level............................        2,310,721         2,309,991         2,360,721           +50,000           +50,730
 
National Institute of Neurological Disorders and Stroke               2,603,925         2,788,327         2,772,425          +168,500           -15,902
 (NINDS)......................................................
    Additional funding (emergency)............................  ................  ................          179,500          +179,500          +179,500
                                                               -----------------------------------------------------------------------------------------
        Subtotal, NINDS, program level........................        2,603,925         2,788,327         2,951,925          +348,000          +163,598
 
National Institute of Allergy and Infectious Diseases (NIAID).        6,562,279         6,581,291         6,692,279          +130,000          +110,988
National Institute of General Medical Sciences (NIGMS)........        1,832,197         1,230,893         1,857,197           +25,000          +626,304
    Evaluation Funding (PHS Act Sec 241)......................       (1,412,482)       (2,018,482)       (1,412,482)  ................        (-606,000)
                                                               -----------------------------------------------------------------------------------------
        Subtotal, NIGMS, program level........................        3,244,679         3,249,375         3,269,679           +25,000           +20,304
 
Eunice Kennedy Shriver National Institute of Child Health and         1,759,078         1,766,415         1,779,078           +20,000           +12,663
 Human Development (NICHD)....................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NICHD, program level............................        1,759,078         1,766,415         1,779,078           +20,000           +12,663
 
National Eye Institute (NEI)..................................          896,549           898,818           896,549   ................           -2,269
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NEI, program level..............................          896,549           898,818           896,549   ................           -2,269
 
National Institute of Environmental Health Sciences (NIEHS)...          913,979           916,791           913,979   ................           -2,812
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIEHS, program level............................          913,979           916,791           913,979   ................           -2,812
 
National Institute on Aging (NIA).............................        4,507,623         4,425,295         4,645,123          +137,500          +219,828
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIA, program level..............................        4,507,623         4,425,295         4,645,123          +137,500          +219,828
 
National Institute of Arthritis and Musculoskeletal and Skin            685,465           689,697           685,465   ................           -4,232
 Diseases (NIAMS).............................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIAMS, program level............................          685,465           689,697           685,465   ................           -4,232
 
National Institute on Deafness and Other Communication                  534,333           535,929           534,333   ................           -1,596
 Disorders (NIDCD)............................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIDCD, program level............................          534,333           535,929           534,333   ................           -1,596
 
National Institute of Nursing Research (NINR).................          197,693           198,263           197,693   ................             -570
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NINR, program level.............................          197,693           198,263           197,693   ................             -570
 
National Institute on Alcohol Abuse and Alcoholism (NIAAA)....          595,318           598,903           595,318   ................           -3,585
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIAAA, program level............................          595,318           598,903           595,318   ................           -3,585
 
National Institute on Drug Abuse (NIDA).......................        1,662,695         1,668,343         1,667,695            +5,000              -648
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIDA, program level.............................        1,662,695         1,668,343         1,667,695            +5,000              -648
 
National Institute of Mental Health (NIMH)....................        2,187,843         2,503,162         2,462,843          +275,000           -40,319
    Additional funding (emergency)............................  ................  ................          179,500          +179,500          +179,500
                                                               -----------------------------------------------------------------------------------------
        Subtotal, NIMH, program level.........................        2,187,843         2,503,162         2,642,343          +454,500          +139,181
 
National Human Genome Research Institute (NHGRI)..............          663,200           663,660           663,200   ................             -460
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NHGRI, program level............................          663,200           663,660           663,200   ................             -460
 
National Institute of Biomedical Imaging and Bioengineering             440,627           441,944           440,627   ................           -1,317
 (NIBIB)......................................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NIBIB, program level............................          440,627           441,944           440,627   ................           -1,317
 
National Center for Complementary and Integrative Health                170,384           170,894           170,384   ................             -510
 (NCCIH)......................................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NCCIH, program level............................          170,384           170,894           170,384   ................             -510
 
National Institute on Minority Health and Health Disparities            534,395           526,710           539,395            +5,000           +12,685
 (NIMHD)......................................................
John E Fogarty International Center (FIC).....................           95,162            95,415            95,162   ................             -253
National Library of Medicine (NLM)............................          497,548           526,796           597,548          +100,000           +70,752
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NLM, program level..............................          497,548           526,796           597,548          +100,000           +70,752
 
National Center for Advancing Translational Sciences (NCATS)..          928,323           926,086           933,323            +5,000            +7,237
                                                               -----------------------------------------------------------------------------------------
    Subtotal, NCATS, program level............................          928,323           926,086           933,323            +5,000            +7,237
 
Office of the Director........................................        2,592,914         3,000,855         2,471,914          -121,000          -528,941
    Common Fund (non-add).....................................         (672,401)         (722,401)         (692,401)         (+20,000)         (-30,000)
    Office of Research on Women's Health (non-add)............          (76,480)         (153,909)          (76,480)  ................         (-77,429)
    Gabriella Miller Kids First Research Act..................           12,600            12,600            12,600   ................  ................
    Additional funding (emergency)............................  ................  ................          625,000          +625,000          +625,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Office of the Director......................        2,605,514         3,013,455         3,109,514          +504,000           +96,059
 
Buildings and Facilities......................................          350,000           350,000           350,000   ................  ................
NIH Innovation Account, CURES Act.............................         (407,000)         (127,000)         (127,000)        (-280,000)  ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, B&F, program level..............................          757,000           477,000           477,000          -280,000   ................
                                                               =========================================================================================
Advanced Research Projects Agency for Health (ARPA-H) 1/......        1,500,000         1,500,000         1,500,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, National Institutes of Health...................       46,761,518        47,685,000        48,811,518        +2,050,000        +1,126,518
                                                               -----------------------------------------------------------------------------------------
    Total, National Institutes of Health (with CURES Act             47,168,518        47,812,000        48,938,518        +1,770,000        +1,126,518
     funding).................................................
                                                               =========================================================================================
    (Evaluation Funding (PHS Act Sec 241))....................       (1,412,482)       (2,018,482)       (1,412,482)  ................        (-606,000)
                                                               -----------------------------------------------------------------------------------------
    Total, National Institutes of Health, program level (with        48,581,000        49,830,482        50,351,000        +1,770,000          +520,518
     CURES and PHS Evaluation Act Funding)....................
                                                               =========================================================================================
    Total, NIH program level (excluding ARPA-H)...............       47,081,000        48,330,482        48,851,000        +1,770,000          +520,518
                                                               =========================================================================================
 
   SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
                           (SAMHSA)
 
                         Mental Health
 
Programs of Regional and National Significance................        1,068,453         1,226,953         1,107,453           +39,000          -119,500
    Prevention and Public Health Fund.........................          (12,000)          (12,000)          (12,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal..............................................        1,080,453         1,238,953         1,119,453           +39,000          -119,500
 
Mental Health Block Grant (MHBG)..............................          986,532         1,021,532         1,021,532           +35,000   ................
    Evaluation Funding (PHS Act Sec 241)......................          (21,039)          (21,039)          (21,039)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal..............................................        1,007,571         1,042,571         1,042,571           +35,000   ................
 
Certified Community Behavioral Health Clinics.................          385,000           450,000           400,000           +15,000           -50,000
National Child Traumatic Stress Initiative....................           98,887            93,887           103,887            +5,000           +10,000
Children's Mental Health Services.............................          130,000           180,000           130,000   ................          -50,000
Projects for Assistance in Transition from Homelessness (PATH)           66,635            66,635            66,635   ................  ................
Protection and Advocacy for Individuals with Mental Illness              40,000            40,000            40,000   ................  ................
 (PAIMI)......................................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Mental Health...................................        2,775,507         3,079,007         2,869,507           +94,000          -209,500
 
    (Evaluation Funding (PHS Act Sec 241))....................          (21,039)          (21,039)          (21,039)  ................  ................
    (Prevention and Public Health Fund).......................          (12,000)          (12,000)          (12,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Mental Health program level.....................        2,808,546         3,112,046         2,902,546           +94,000          -209,500
 
                   Substance Abuse Treatment
 
Programs of Regional and National Significance................          574,219           588,969           585,219           +11,000            -3,750
    Evaluation Funding (PHS Act Sec 241)......................           (2,000)           (2,000)           (2,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal..............................................          576,219           590,969           587,219           +11,000            -3,750
 
Substance Use Prevention, Treatment, and Recovery Services            1,928,879         1,928,879         1,968,879           +40,000           +40,000
 Block Grant..................................................
    Evaluation Funding (PHS Act Sec 241)......................          (79,200)          (79,200)          (79,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Substance Use Prevention, Treatment, and            2,008,079         2,008,079         2,048,079           +40,000           +40,000
         Recovery Services Block Grant, program level.........
 
State Opioid Response grants..................................        1,575,000         1,595,000         1,000,000          -575,000          -595,000
    Additional funding (emergency)............................  ................  ................          600,000          +600,000          +600,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, State Opioid Response Grants................        1,575,000         1,595,000         1,600,000           +25,000            +5,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Substance Abuse Treatment...................        4,078,098         4,112,848         4,154,098           +76,000           +41,250
 
        (Evaluation Funding (PHS Act Sec 241))................          (81,200)          (81,200)          (81,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Substance Abuse Treatment, program level....        4,159,298         4,194,048         4,235,298           +76,000           +41,250
 
                  Substance Abuse Prevention
 
Programs of Regional and National Significance................          236,879           236,879           246,879           +10,000           +10,000
 
            Health Surveillance and Program Support
 
Health Surveillance and Program Support.......................          138,155           141,155           138,155   ................           -3,000
Community Project Funding / Congressionally Directed Spending.           72,090   ................           63,337            -8,753           +63,337
    Evaluation Funding (PHS Act Sec 241)......................          (31,428)          (31,428)          (31,428)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Health Surveillance and Program Support               241,673           172,583           232,920            -8,753           +60,337
         program level........................................
                                                               -----------------------------------------------------------------------------------------
        Total, SAMHSA.........................................        7,300,729         7,569,889         7,471,976          +171,247           -97,913
                                                               =========================================================================================
        (Evaluation Funding (PHS Act Sec 241))................         (133,667)         (133,667)         (133,667)  ................  ................
        (Prevention and Public Health Fund)...................          (12,000)          (12,000)          (12,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Total, SAMHSA, program level..........................        7,446,396         7,715,556         7,617,643          +171,247           -97,913
                                                               =========================================================================================
 
       AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)
 
                Healthcare Research and Quality
 
Research on Health Costs, Quality, and Outcomes:
    Federal Funds.............................................          224,109           235,067           230,109            +6,000            -4,958
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Research on Health Costs, Quality, and                224,109           235,067           230,109            +6,000            -4,958
         Outcomes, program level..............................
 
Medical Expenditures Panel Surveys:
    Federal Funds.............................................           71,791            74,621            72,791            +1,000            -1,830
 
Program Support:
    Appropriation.............................................           73,100            77,657            73,100   ................           -4,557
                                                               -----------------------------------------------------------------------------------------
        Total, AHRQ...........................................          369,000           387,345           376,000            +7,000           -11,345
                                                               =========================================================================================
        (Evaluation Funding (PHS Act Sec 241))................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Total, AHRQ, program level............................          369,000           387,345           376,000            +7,000           -11,345
                                                               =========================================================================================
        Total, Public Health Service with CURES Act funding...       72,002,980        72,752,288        74,096,707        +2,093,727        +1,344,419
                                                               =========================================================================================
        Total, Public Health Service, program level...........       74,790,273        76,202,637        76,951,089        +2,160,816          +748,452
                                                               =========================================================================================
 
           CENTERS FOR MEDICARE AND MEDICAID SERVICES
 
                 Grants to States for Medicaid
 
Medicaid Current Law Benefits.................................      574,100,474       595,086,095       595,086,095       +20,985,621   ................
State and Local Administration................................       24,622,000        26,392,000        26,392,000        +1,770,000   ................
Vaccines for Children.........................................        5,814,850         7,711,718         7,711,718        +1,896,868   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Medicaid program level, available this fiscal year.      604,537,324       629,189,813       629,189,813       +24,652,489   ................
                                                               =========================================================================================
        Less appropriations provided in prior years...........     -197,580,474      -245,580,414      -245,580,414       -47,999,940   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Grants to States for Medicaid......................      406,956,850       383,609,399       383,609,399       -23,347,451   ................
                                                               =========================================================================================
        New advance, 1st quarter, FY 2026.....................      245,580,414       261,063,820       261,063,820       +15,483,406   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Grants to States for Medicaid, appropriated in this      652,537,264       644,673,219       644,673,219        -7,864,045   ................
     bill.....................................................
                                                               =========================================================================================
 
            Payments to the Health Care Trust Funds
 
Supplemental Medical Insurance................................      373,973,000       408,939,000       408,939,000       +34,966,000   ................
Federal Uninsured Payment.....................................           44,000            37,000            37,000            -7,000   ................
Program Management............................................        1,000,000         1,000,000         1,000,000   ................  ................
General Revenue for Part D Benefit............................      100,805,000       110,786,000       110,786,000        +9,981,000   ................
General Revenue for Part D Administration.....................          523,000           613,000           613,000           +90,000   ................
HCFAC Reimbursement...........................................          375,000           377,000           377,000            +2,000   ................
State Low-Income Determination for Part D.....................            5,000             5,000             5,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Payments to Trust Funds............................      476,725,000       521,757,000       521,757,000       +45,032,000   ................
                                                               =========================================================================================
 
                      Program Management
 
Research, Demonstration, and Evaluation.......................           20,054   ................           20,054   ................          +20,054
Program Operations............................................        2,479,823         2,979,051         2,479,823   ................         -499,228
State Survey and Certification................................          397,334           492,334           397,334   ................          -95,000
Federal Administration........................................          772,533           857,615           772,533   ................          -85,082
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Program Management..............................        3,669,744         4,329,000         3,669,744   ................         -659,256
                                                               -----------------------------------------------------------------------------------------
    Total, Program Management.................................        3,669,744         4,329,000         3,669,744   ................         -659,256
                                                               =========================================================================================
 
          Health Care Fraud and Abuse Control Account
 
Centers for Medicare and Medicaid Services....................          675,058           703,868           699,058           +24,000            -4,810
HHS Office of Inspector General...............................          107,735           111,508           108,735            +1,000            -2,773
Department of Justice.........................................          132,207           125,624           133,207            +1,000            +7,583
Senior Medicare Patrol (non-add)..............................          (35,000)          (35,000)          (35,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Health Care Fraud and Abuse Control................          915,000           941,000           941,000           +26,000   ................
                                                               =========================================================================================
        Program integrity (cap adjustment)....................         (604,000)         (630,000)         (630,000)         (+26,000)  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Centers for Medicare and Medicaid Services.........    1,133,847,008     1,171,700,219     1,171,040,963       +37,193,955          -659,256
                                                               =========================================================================================
        Federal funds.........................................   (1,129,262,264)   (1,166,430,219)   (1,166,430,219)     (+37,167,955)  ................
            Current year appropriations.......................     (883,681,850)     (905,366,399)     (905,366,399)     (+21,684,549)  ................
            Advance appropriations............................     (245,580,414)     (261,063,820)     (261,063,820)     (+15,483,406)  ................
        Trust Funds...........................................       (4,584,744)       (5,270,000)       (4,610,744)         (+26,000)        (-659,256)
 
         ADMINISTRATION FOR CHILDREN AND FAMILIES (ACF)
 
  Payments to States for Child Support Enforcement and Family
                       Support Programs
 
Payments to Territories.......................................           33,000            33,000            33,000   ................  ................
Repatriation..................................................           18,199            22,656            22,656            +4,457   ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Payments to States for Child Support Enforcement           51,199            55,656            55,656            +4,457   ................
     and Family Support Programs..............................
 
Child Support Enforcement:
    State and Local Administration............................        3,840,888         4,540,071         4,540,071          +699,183   ................
    Federal Incentive Payments................................          706,913           718,273           718,273           +11,360   ................
    Access and Visitation.....................................           10,000            10,000            10,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Child Support Enforcement...................        4,557,801         5,268,344         5,268,344          +710,543   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Child Support Enforcement and Family Support               4,609,000         5,324,000         5,324,000          +715,000   ................
     Payments, program level available this fiscal year.......
                                                               =========================================================================================
        New advance, 1st quarter, FY 2026.....................        1,400,000         1,600,000         1,700,000          +300,000          +100,000
        Less appropriations provided in prior years...........       -1,300,000        -1,400,000        -1,400,000          -100,000   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Current Year.......................................        3,309,000         3,924,000         3,924,000          +615,000   ................
                                                               =========================================================================================
    Total, Child Support Enforcement and Family Support               4,709,000         5,524,000         5,624,000          +915,000          +100,000
     Payments, appropriated in this bill......................
                                                               =========================================================================================
 
               Low Income Home Energy Assistance
 
Formula Grants................................................        4,025,000         1,536,000         1,625,000        -2,400,000           +89,000
    Additional funding (emergency)............................  ................        2,575,000         2,500,000        +2,500,000           -75,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal..............................................        4,025,000         4,111,000         4,125,000          +100,000           +14,000
                                                               -----------------------------------------------------------------------------------------
        Total, LIHEAP, program level..........................        4,025,000         4,111,000         4,125,000          +100,000           +14,000
                                                               =========================================================================================
 
                Refugee and Entrant Assistance
 
Transitional and Medical Services.............................          564,000           564,000           591,000           +27,000           +27,000
Refugee Support Services......................................          307,201           307,201           307,201   ................  ................
Victims of Trafficking........................................           30,755            30,755            31,755            +1,000            +1,000
Unaccompanied Children........................................        5,406,258         5,506,258         5,406,258   ................         -100,000
Survivors of Torture..........................................           19,000            19,000            19,000   ................  ................
Additional funding (emergency)................................  ................        2,914,179   ................  ................       -2,914,179
                                                               -----------------------------------------------------------------------------------------
    Total, Refugee and Entrant Assistance.....................        6,327,214         9,341,393         6,355,214           +28,000        -2,986,179
                                                               =========================================================================================
    Total, Refugee and Entrant Assistance excluding                   6,327,214         6,427,214         6,355,214           +28,000           -72,000
     emergencies..............................................
                                                               =========================================================================================
 
               Promoting Safe and Stable Families
 
Promoting Safe and Stable Families............................          345,000           345,000           345,000   ................  ................
    Discretionary Funds.......................................           72,515            76,515            72,515   ................           -4,000
                                                               -----------------------------------------------------------------------------------------
        Total, Promoting Safe and Stable Families.............          417,515           421,515           417,515   ................           -4,000
                                                               =========================================================================================
Payments to States for the Child Care and Development Block           8,746,387         8,521,387         9,846,387        +1,100,000        +1,325,000
 Grant........................................................
    Additional funding (emergency)............................  ................  ................          500,000          +500,000          +500,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Payments to States for the Child Care and           8,746,387         8,521,387        10,346,387        +1,600,000        +1,825,000
         Development Block Grant..............................
 
Social Services Block Grant (Title XX)........................        1,700,000         1,700,000         1,700,000   ................  ................
 
            Children and Families Services Programs
 
Programs for Children, Youth and Families:
    Head Start................................................       12,271,820        12,540,519        12,271,820   ................         -268,699
    Additional funding (emergency)............................  ................  ................          700,000          +700,000          +700,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Head Start..................................       12,271,820        12,540,519        12,971,820          +700,000          +431,301
 
    Preschool Development Grants..............................          315,000           250,000           315,000   ................          +65,000
    Runaway and Homeless Youth Program........................          125,283           125,283           125,283   ................  ................
    Prevention Grants to Reduce Abuse of Runaway Youth........           21,000            21,000            21,000   ................  ................
    Child Abuse State Grants..................................          105,091           105,091           110,091            +5,000            +5,000
    Child Abuse Discretionary Activities......................           36,000            38,000            36,000   ................           -2,000
    Community Based Child Abuse Prevention....................           70,660            90,000            74,660            +4,000           -15,340
    Child Welfare Services....................................          268,735           268,735           268,735   ................  ................
    Child Welfare Research, Training, and Demonstration.......           21,984            45,984            21,984   ................          -24,000
    Adoption Opportunities....................................           53,000            51,000            54,000            +1,000            +3,000
    Adoption and Legal Guardianship Incentive Payments........           75,000            75,000            75,000   ................  ................
    Social Services Research and Demonstration................           35,012            30,512            36,012            +1,000            +5,500
        Community Project Funding / Congressionally Directed             40,011   ................           42,850            +2,839           +42,850
         Spending.............................................
Native American Programs......................................           60,500            65,500            60,500   ................           -5,000
 
Community Services:
    Community Services Block Grant Act programs:
        Grants to States for Community Services...............          770,000           770,000           770,000   ................  ................
        Economic Development..................................           22,383            22,383            22,383   ................  ................
        Rural Community Facilities............................           12,000            12,000            12,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, Community Services Block Grant Act                804,383           804,383           804,383   ................  ................
             programs.........................................
 
National Domestic Violence Hotline............................           20,500            20,500            20,500   ................  ................
Family Violence Prevention and Services.......................          240,000           240,000           242,000            +2,000            +2,000
Chafee Education and Training Vouchers........................           44,257            48,257            44,257   ................           -4,000
Disaster Human Services Case Management.......................            1,864             1,864             1,864   ................  ................
Program Direction.............................................          219,000           230,500           219,000   ................          -11,500
                                                               -----------------------------------------------------------------------------------------
    Total, Children and Families Services Programs............       14,829,100        15,052,128        15,544,939          +715,839          +492,811
                                                               =========================================================================================
 
            Payments for Foster Care and Permanency
 
Foster Care...................................................        6,615,000         4,796,000         4,796,000        -1,819,000   ................
Adoption Assistance...........................................        4,706,000         4,659,000         4,659,000           -47,000   ................
Guardianship..................................................          330,000           365,000           365,000           +35,000   ................
Independent Living............................................          143,000           143,000           143,000   ................  ................
Foster Care Prevention Services...............................  ................          205,000           205,000          +205,000   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Payments to States available this fiscal year......       11,794,000        10,168,000        10,168,000        -1,626,000   ................
                                                               =========================================================================================
    Advance appropriations, 1st quarter, FY 2026..............        3,400,000         3,600,000         3,600,000          +200,000   ................
    less appropriations provided in prior years...............       -3,200,000        -3,400,000        -3,400,000          -200,000   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Current Year.......................................        8,594,000         6,768,000         6,768,000        -1,826,000   ................
                                                               =========================================================================================
        Total, Payments to States available in this bill......       11,994,000        10,368,000        10,368,000        -1,626,000   ................
                                                               =========================================================================================
    Total, Administration for Children and Families...........       52,748,216        55,039,423        54,481,055        +1,732,839          -558,368
                                                               =========================================================================================
        Current year appropriations...........................      (47,948,216)      (49,839,423)      (49,181,055)      (+1,232,839)        (-658,368)
        Advance appropriations................................       (4,800,000)       (5,200,000)       (5,300,000)        (+500,000)        (+100,000)
                                                               -----------------------------------------------------------------------------------------
    Total, Administration for Children and Families,                (34,000,216)      (37,102,423)      (36,444,055)      (+2,443,839)        (-658,368)
     discretionary............................................
                                                               =========================================================================================
    Total, ACF (excluding emergencies)........................       52,748,216        49,550,244        50,781,055        -1,967,161        +1,230,811
                                                               =========================================================================================
 
              ADMINISTRATION FOR COMMUNITY LIVING
 
            Aging and Disability Services Programs
 
Grants to States:
    Home and Community-Based Supportive Services..............          410,000           410,000           410,000   ................  ................
    Preventive Health.........................................           26,339            26,339            26,339   ................  ................
    Protection of Vulnerable Older Americans-Title VII........           26,658            26,658            26,658   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal..............................................          462,997           462,997           462,997   ................  ................
 
    Family Caregivers.........................................          207,000           205,000           209,000            +2,000            +4,000
    Native American Caregivers Support........................           12,000            12,000            12,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Caregivers..................................          219,000           217,000           221,000            +2,000            +4,000
 
    Nutrition:
        Congregate Meals......................................          565,342           621,692           565,342   ................          -56,350
        Home Delivered Meals..................................          381,342           447,692           381,342   ................          -66,350
        Nutrition Services Incentive Program..................          112,000            80,069           112,000   ................          +31,931
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Nutrition...................................        1,058,684         1,149,453         1,058,684   ................          -90,769
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Grants to States............................        1,740,681         1,829,450         1,742,681            +2,000           -86,769
 
Grants for Native Americans...................................           38,264            38,264            38,264   ................  ................
Aging Network Support Activities..............................           30,461            40,461            30,461   ................          -10,000
 
Alzheimer's Disease Program:
    Appropriation.............................................           16,800            16,800            16,800   ................  ................
    Prevention and Public Health Fund.........................          (14,700)          (14,700)          (14,700)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Alzheimer's Disease Demonstrations, program            31,500            31,500            31,500   ................  ................
         level................................................
                                                               =========================================================================================
Lifespan Respite Care.........................................           10,000            10,000            11,000            +1,000            +1,000
 
Chronic Disease Self-Management:
    Prevention and Public Health Fund.........................           (8,000)           (8,000)           (8,000)  ................  ................
 
Elder Falls Prevention:
    Appropriation.............................................            2,500             2,500             2,500   ................  ................
    Prevention and Public Health Fund.........................           (5,000)           (5,000)           (5,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Elder Falls Prevention, program level.......            7,500             7,500             7,500   ................  ................
 
Elder Rights Support Activities...............................           33,874            33,874            33,874   ................  ................
Aging and Disability Resources................................            8,619             8,619             8,619   ................  ................
State Health Insurance Assistance Program (SHIP)..............           55,242            55,242            55,242   ................  ................
 
Paralysis Resource Center:
    Appropriation.............................................           10,700            10,700            10,700   ................  ................
 
Limb Loss Resource Center:
    Appropriation.............................................            4,200             4,200             4,200   ................  ................
 
Traumatic Brain Injury:
    Appropriation.............................................           13,118            13,118            13,118   ................  ................
 
Developmental Disabilities Programs:
    State Councils............................................           81,000            81,000            81,000   ................  ................
    Protection and Advocacy...................................           45,000            45,000            45,000   ................  ................
    Voting Access for Individuals with Disabilities...........           10,000            10,000            10,000   ................  ................
    Developmental Disabilities Projects of National                      12,250            15,350            12,250   ................           -3,100
     Significance.............................................
    University Centers for Excellence in Developmental                   43,119            43,119            43,119   ................  ................
     Disabilities.............................................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Developmental Disabilities Programs.........          191,369           194,469           191,369   ................           -3,100
 
Workforce Innovation and Opportunity Act:
    Independent Living........................................          128,183           132,083           128,183   ................           -3,900
    National Institute on Disability, Independent Living, and           119,000           119,000           119,000   ................  ................
     Rehabilitation Research..................................
    Assistive Technology......................................           40,000            40,000            40,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Workforce Innovation and Opportunity Act....          287,183           291,083           287,183   ................           -3,900
 
Community Project Funding / Congressionally Directed Spending.           29,268   ................           22,043            -7,225           +22,043
Program Administration........................................           48,063            55,063            48,063   ................           -7,000
White House Conference on Aging...............................  ................            2,500   ................  ................           -2,500
                                                               -----------------------------------------------------------------------------------------
    Total, Administration for Community Living................        2,520,342         2,606,343         2,516,117            -4,225           -90,226
                                                               =========================================================================================
        Federal funds.........................................       (2,465,100)       (2,551,101)       (2,460,875)          (-4,225)         (-90,226)
        Trust Funds...........................................          (55,242)          (55,242)          (55,242)  ................  ................
    (Prevention and Public Health Fund).......................          (27,700)          (27,700)          (27,700)  ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Administration for Community Living, program level.        2,548,042         2,634,043         2,543,817            -4,225           -90,226
                                                               =========================================================================================
 
   ADMINISTRATION FOR STRATEGIC PREPAREDNESS AND RESPONSE-1/
 
            Research, Development, and Procurement
 
Biomedical Advanced Research and Development Authority (BARDA)        1,015,000           970,000           320,000          -695,000          -650,000
    Additional funding (emergency)............................  ................  ................          750,000          +750,000          +750,000
Project BioShield.............................................          825,000           820,000            85,000          -740,000          -735,000
    Additional funding (emergency)............................  ................  ................          750,000          +750,000          +750,000
Strategic National Stockpile..................................          980,000           965,000         1,010,000           +30,000           +45,000
 
Pandemic Influenza Preparedness:
    Pandemic Influenza Preparedness...........................          315,000           327,991           335,991           +20,991            +8,000
    Pandemic Influenza Balances (non-add).....................          (20,000)  ................  ................         (-20,000)  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Pandemic Influenza Preparedness, program             (335,000)         (327,991)         (335,991)            (+991)          (+8,000)
         level................................................
                                                               -----------------------------------------------------------------------------------------
        Subtotal Research, Development, and Procurement.......        3,135,000         3,082,991         3,250,991          +115,991          +168,000
 
       Operations, Preparedness, and Emergency Response
 
Operations....................................................           34,376            79,867            34,376   ................          -45,491
H-Core........................................................           15,000            75,000            15,000   ................          -60,000
Preparedness and Emergency Operations.........................           31,154            31,154            31,154   ................  ................
National Disaster Medical System..............................           78,904            65,904            81,904            +3,000           +16,000
Hospital Preparedness Program.................................          305,055           317,055           309,055            +4,000            -8,000
    Formula Grants (non-add)..................................         (240,000)         (240,000)         (240,000)  ................  ................
Policy and Planning...........................................           14,877            14,877            14,877   ................  ................
Medical Reserve Corps.........................................            6,240             6,240             6,240   ................  ................
Preparedness and Response Innovation..........................            4,000   ................            4,000   ................           +4,000
Pandemic Preparedness and Biodefense..........................           10,000   ................           80,000           +70,000           +80,000
Biodefense Production of Medical Countermeasures and Essential  ................           95,000   ................  ................          -95,000
 Medicines....................................................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Pandemic Preparedness and Biodefense............           10,000            95,000            80,000           +70,000           -15,000
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Operations and Emergency Response...............          499,606           685,097           576,606           +77,000          -108,491
                                                               -----------------------------------------------------------------------------------------
    Total, Administration for Strategic Preparedness and              3,634,606         3,768,088         3,827,597          +192,991           +59,509
     Response.................................................
                                                               =========================================================================================
 
                  DEPARTMENTAL MANAGEMENT 1/
 
                General Departmental Management
 
General Departmental Management, Federal Funds................          221,169           228,503           221,169   ................           -7,334
Other Programs, Projects, and Activities (PPAs)...............  ................           13,462   ................  ................          -13,462
Teen Pregnancy Prevention Community Grants....................          101,000           101,000           101,000   ................  ................
    Evaluation Funding (PHS Act Sec 241)......................           (6,800)           (7,400)           (6,800)  ................            (-600)
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Teen Pregnancy Prevention Community Grants,           107,800           108,400           107,800   ................             -600
         program level........................................
 
Sexual Risk Avoidance.........................................           35,000   ................           35,000   ................          +35,000
Office of Minority Health.....................................           74,835            74,835            74,835   ................  ................
Office on Women's Health......................................           44,140            54,140            44,140   ................          -10,000
Minority HIV/AIDS Fund........................................           60,000            60,000            60,000   ................  ................
Embryo Adoption Awareness Campaign............................            1,000             1,000             1,000   ................  ................
Planning and Evaluation, Evaluation Funding (PHS Act Sec 241).          (58,028)          (67,094)          (58,028)  ................          (-9,066)
                                                               -----------------------------------------------------------------------------------------
    Subtotal, General Departmental Management.................          537,144           532,940           537,144   ................           +4,204
 
    Cybersecurity.............................................          100,000   ................          110,000           +10,000          +110,000
    Office of National Security...............................            8,983   ................            8,983   ................           +8,983
Office of Global Affairs......................................  ................  ................            7,009            +7,009            +7,009
                                                               -----------------------------------------------------------------------------------------
    Total, General Departmental Management....................          646,127           532,940           663,136           +17,009          +130,196
                                                               =========================================================================================
    (Evaluation Funding (PHS Act Sec 241))....................          (64,828)          (74,494)          (64,828)  ................          (-9,666)
                                                               -----------------------------------------------------------------------------------------
    Total, General Departmental Management fiscal year program          710,955           607,434           727,964           +17,009          +120,530
     level....................................................
                                                               =========================================================================================
 
                    Office for Civil Rights
 
Federal Funds.................................................           39,798            56,798            39,798   ................          -17,000
 
Office of the National Coordinator for Health Information
 Technology:
    Evaluation Funding (PHS Act Sec 241)......................          (69,238)          (86,000)          (69,238)  ................         (-16,762)
                                                               -----------------------------------------------------------------------------------------
        Total, Program Level..................................           69,238            86,000            69,238   ................          -16,762
                                                               =========================================================================================
Medicare Hearings and Appeals.................................          196,000           196,000           196,000   ................  ................
 
 Public Health and Social Services Emergency Fund (PHSSEF) 1/
 
    Cybersecurity.............................................  ................          140,500   ................  ................         -140,500
    Office of National Security...............................  ................           14,983   ................  ................          -14,983
Public Health Emergency Fund..................................  ................            7,009   ................  ................           -7,009
Supply Chain Coordination Office..............................  ................           10,000   ................  ................          -10,000
                                                               -----------------------------------------------------------------------------------------
    Total, PHSSEF.............................................  ................          172,492   ................  ................         -172,492
                                                               =========================================================================================
 
                      Customer Experience
 
Customer Experience...........................................  ................           14,000   ................  ................          -14,000
 
                Office of the Inspector General
 
Office of Inspector General...................................           87,000            97,384            87,000   ................          -10,384
 
 Retirement Pay and Medical Benefits for Commissioned Officers
 
Retirement Payments...........................................          657,647           725,619           725,619           +67,972   ................
Survivors Benefits............................................           37,681            46,719            46,719            +9,038   ................
Dependents' Medical Care......................................           97,363           122,457           122,457           +25,094   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Medical Benefits for Commissioned Officers.........          792,691           894,795           894,795          +102,104   ................
                                                               =========================================================================================
    Total, Office of the Secretary............................        1,761,616         1,964,409         1,880,729          +119,113           -83,680
                                                               =========================================================================================
        Federal Funds.........................................       (1,565,616)       (1,768,409)       (1,684,729)        (+119,113)         (-83,680)
        Trust Funds...........................................         (196,000)         (196,000)         (196,000)  ................  ................
    (Evaluation Funding (PHS Act Sec 241))....................         (134,066)         (160,494)         (134,066)  ................         (-26,428)
                                                               -----------------------------------------------------------------------------------------
    Total, Office of the Secretary, program level.............        1,895,682         2,124,903         2,014,795          +119,113          -110,108
                                                               =========================================================================================
 
  GENERAL PROVISIONS DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
Medicare Operations (Sec 227).................................          455,000   ................          525,000           +70,000          +525,000
                                                               -----------------------------------------------------------------------------------------
    Total, Title II, Department of Health and Human Services..    1,266,562,768     1,307,703,770     1,308,241,168       +41,678,400          +537,398
                                                               =========================================================================================
        Federal Funds.........................................    1,260,995,085     1,301,895,601     1,302,572,255       +41,577,170          +676,654
            Current Year appropriations.......................   (1,010,614,671)   (1,030,142,602)   (1,029,208,435)     (+18,593,764)        (-934,167)
            Emergency appropriations..........................  ................       (5,489,179)       (7,000,000)      (+7,000,000)      (+1,510,821)
            Advance appropriations, FY 2026...................     (250,380,414)     (266,263,820)     (266,363,820)     (+15,983,406)        (+100,000)
        Trust Funds...........................................       (5,567,683)       (5,808,169)       (5,668,913)        (+101,230)        (-139,256)
    CURES Act.................................................         (407,000)         (127,000)         (127,000)        (-280,000)  ................
    Prevention and Public Health Fund.........................       (1,225,900)       (1,225,900)       (1,225,900)  ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Title II, Department of Health and Human Services        117,442,958       122,119,671       122,557,069        +5,114,111          +437,398
     discretionary............................................
                                                               =========================================================================================
 
              TITLE III--DEPARTMENT OF EDUCATION
 
         OFFICE OF ELEMENTARY AND SECONDARY EDUCATION
 
                Education for the Disadvantaged
 
Grants to Local Educational Agencies (LEAs)...................  ................  ................  ................  ................  ................
 
    Basic Grants:
    Appropriations from prior year advances...................          763,776           763,776           763,776   ................  ................
    Forward funded............................................        5,690,625         5,690,625         5,690,625   ................  ................
    Current appropriation.....................................            5,000             5,000             5,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Basic Grants available this fiscal year.....        5,695,625         5,695,625         5,695,625   ................  ................
 
    Advance appropriations, FY 2026...........................          763,776           763,776           763,776   ................  ................
    less appropriations available from prior year advances....         -763,776          -763,776          -763,776   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Basic Grants, appropriated in this bill.....        6,459,401         6,459,401         6,459,401   ................  ................
 
    Concentration Grants:
        Appropriations from prior year advances...............        1,362,301         1,362,301         1,362,301   ................  ................
        Advance appropriations FY 2026........................        1,362,301         1,362,301         1,362,301   ................  ................
        less appropriations provided from prior year advances.       -1,362,301        -1,362,301        -1,362,301   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Concentration Grants, appropriated in this          1,362,301         1,362,301         1,362,301   ................  ................
         bill.................................................
 
    Targeted Grants:
        Appropriations from prior year advances...............        4,357,550         4,357,550         4,357,550   ................  ................
        Forward funded........................................          935,000         1,025,000         1,075,000          +140,000           +50,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Targeted Grants available this fiscal year..        5,292,550         5,382,550         5,432,550          +140,000           +50,000
 
        Advance appropriations FY 2026........................        4,357,550         4,357,550         4,357,550   ................  ................
        less appropriations provided from prior year advances.       -4,357,550        -4,357,550        -4,357,550   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Targeted Grants, appropriated in this bill..        5,292,550         5,382,550         5,432,550          +140,000           +50,000
 
    Education Finance Incentive Grants:
        Appropriations from prior year advances...............        4,357,550         4,357,550         4,357,550   ................  ................
        Forward Funded........................................          935,000         1,025,000         1,075,000          +140,000           +50,000
        Advance appropriations, FY 2026.......................        4,357,550         4,357,550         4,357,550   ................  ................
        less appropriations provided from prior year advances.       -4,357,550        -4,357,550        -4,357,550   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Education Finance Incentive Grants,                 5,292,550         5,382,550         5,432,550          +140,000           +50,000
         appropriated in this bill............................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Grants to LEAs, fiscal year program level...       18,406,802        18,586,802        18,686,802          +280,000          +100,000
 
Innovative Approaches to Literacy.............................           30,000            30,000            30,000   ................  ................
Comprehensive literacy development grants.....................          194,000           194,000           194,000   ................  ................
 
State Agency Programs:
    Migrant...................................................          375,626           375,626           375,626   ................  ................
    Neglected and Delinquent/High Risk Youth..................           49,239            49,239            49,239   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, State Agency Programs.......................          424,865           424,865           424,865   ................  ................
 
Special Programs for Migrant Students (Sec 418A, HEA).........           52,123            52,123            52,123   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Education for the Disadvantaged....................       19,107,790        19,287,790        19,387,790          +280,000          +100,000
                                                               =========================================================================================
        Current year appropriations...........................       (8,266,613)       (8,446,613)       (8,546,613)        (+280,000)        (+100,000)
            (Forward Funded)..................................       (8,179,490)       (8,359,490)       (8,459,490)        (+280,000)        (+100,000)
        Advance appropriations................................      (10,841,177)      (10,841,177)      (10,841,177)  ................  ................
 
                          Impact Aid
 
Basic Support Payments........................................        1,474,000         1,468,242         1,490,500           +16,500           +22,258
Payments for Children with Disabilities.......................           48,316            48,316            48,316   ................  ................
Facilities Maintenance (Sec 8008).............................            4,835             4,835             4,835   ................  ................
Construction (Sec 8007).......................................           19,000            18,406            20,500            +1,500            +2,094
Payments for Federal Property (Sec 8002)......................           79,000            78,313            81,000            +2,000            +2,687
                                                               -----------------------------------------------------------------------------------------
    Total, Impact aid.........................................        1,625,151         1,618,112         1,645,151           +20,000           +27,039
                                                               =========================================================================================
 
                School Improvement Programs 2/
 
Supporting Effective Instruction State Grants.................          508,639           508,639           508,639   ................  ................
    Appropriations from prior year advances...................        1,681,441         1,681,441         1,681,441   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Supporting Effective Instruction State              2,190,080         2,190,080         2,190,080   ................  ................
         Grants available this fiscal year....................
 
    Advance appropriations, FY 2026...........................        1,681,441         1,681,441         1,681,441   ................  ................
    less appropriations provided from prior year advances.....       -1,681,441        -1,681,441        -1,681,441   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Supporting Effective Instruction State              2,190,080         2,190,080         2,190,080   ................  ................
         Grants appropriated in this bill.....................
 
State Assessments.............................................          380,000           390,000           380,000   ................          -10,000
Education for Homeless Children and Youth.....................          129,000           129,000           129,000   ................  ................
Training and Advisory Services (Civil Rights).................            6,575             6,575             6,575   ................  ................
Nita M Lowey 21st Century Community Learning Centers..........        1,329,673         1,329,673         1,329,673   ................  ................
Student Support and Academic Enrichment grants................        1,380,000         1,380,000         1,390,000           +10,000           +10,000
Rural Education...............................................          220,000           215,000           230,000           +10,000           +15,000
Native Hawaiian Education.....................................           45,897            45,897            45,897   ................  ................
Alaska Native Education.......................................           44,953            44,953            44,953   ................  ................
Comprehensive Centers.........................................           50,000            50,000            50,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, School Improvement Programs........................        5,776,178         5,781,178         5,796,178           +20,000           +15,000
                                                               =========================================================================================
        Current year appropriations...........................       (4,094,737)       (4,099,737)       (4,114,737)         (+20,000)         (+15,000)
            (Forward Funded)..................................       (3,947,312)       (3,952,312)       (3,967,312)         (+20,000)         (+15,000)
        Advance appropriations................................       (1,681,441)       (1,681,441)       (1,681,441)  ................  ................
 
                       School Readiness
 
Preschool Incentive Demonstration Program (legislative          ................           25,000   ................  ................          -25,000
 proposal)....................................................
 
            Safe Schools and Citizenship Education
 
Promise Neighborhoods.........................................           91,000            91,000            93,000            +2,000            +2,000
School Safety National Activities.............................          216,000           216,000           221,000            +5,000            +5,000
Full-Service Community Schools................................          150,000           200,000           150,000   ................          -50,000
                                                               -----------------------------------------------------------------------------------------
    Total, Safe Schools and Citizenship Education.............          457,000           507,000           464,000            +7,000           -43,000
                                                               =========================================================================================
 
                       Indian Education
 
Grants to Local Educational Agencies..........................          110,381           110,381           110,381   ................  ................
 
Federal Programs:
    Special Programs for Indian Children......................           72,000            72,000            72,000   ................  ................
    National Activities.......................................           12,365            12,365            12,365   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Federal Programs............................           84,365            84,365            84,365   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Indian Education...................................          194,746           194,746           194,746   ................  ................
                                                               =========================================================================================
    Total, Office of Elementary and Secondary Education.......       27,160,865        27,413,826        27,487,865          +327,000           +74,039
                                                               =========================================================================================
 
                  Innovation and Improvement
 
American History and Civics Academies.........................            3,000             3,000             3,000   ................  ................
American History and Civics National Activities...............           20,000            20,000            20,000   ................  ................
Teacher and School Leader Incentive Grants....................           60,000           173,000            60,000   ................         -113,000
Supporting Effective Educator Development (SEED)..............           90,000            90,000            90,000   ................  ................
Charter Schools Grants........................................          440,000           400,000           440,000   ................          +40,000
Magnet Schools Assistance.....................................          139,000           139,000           139,000   ................  ................
Ready-to-Learn Television.....................................           31,000            31,000            31,000   ................  ................
Arts in Education.............................................           36,500            36,500            36,500   ................  ................
Javits Gifted and Talented Education..........................           16,500            16,500            16,500   ................  ................
Statewide Family Engagement Centers...........................           20,000            20,000            20,000   ................  ................
Education Innovation and Research.............................          259,000           269,000           259,000   ................          -10,000
Fostering Diverse Schools (legislative proposal)..............  ................           10,000   ................  ................          -10,000
                                                               -----------------------------------------------------------------------------------------
    Total, Office of Innovation and Improvement...............        1,115,000         1,208,000         1,115,000   ................          -93,000
                                                               =========================================================================================
 
            OFFICE OF ENGLISH LANGUAGE ACQUISITION
 
                 English Language Acquisition
 
Current year appropriations...................................           57,850            75,200            58,175              +325           -17,025
Forward funded................................................          832,150           864,800           836,825            +4,675           -27,975
                                                               -----------------------------------------------------------------------------------------
    Total, Office of English Language Acquisition.............          890,000           940,000           895,000            +5,000           -45,000
                                                               =========================================================================================
 
   OFFICE OF SPECIAL EDUCATION AND REHABILIITATIVE SERVICES
 
                       Special Education
 
State Grants:
    Grants to States Part B current year......................        4,930,321         5,110,321         5,225,321          +295,000          +115,000
        Part B advance from prior year........................       (9,283,383)       (9,283,383)       (9,283,383)  ................  ................
    Grants to States Part B (FY 2026).........................        9,283,383         9,283,383         9,283,383   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, program level...............................       14,213,704        14,393,704        14,508,704          +295,000          +115,000
 
    Preschool Grants..........................................          420,000           425,000           420,000   ................           -5,000
    Grants for Infants and Families...........................          540,000           545,000           545,000            +5,000   ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, program level...............................       15,173,704        15,363,704        15,473,704          +300,000          +110,000
 
IDEA National Activities (current funded):
    State Personnel Development...............................           38,630            38,630            38,630   ................  ................
    Technical Assistance and Dissemination....................           39,345            45,345            39,345   ................           -6,000
    Personnel Preparation.....................................          115,000           125,000           115,000   ................          -10,000
    Parent Information Centers................................           33,152            33,152            33,152   ................  ................
    Educational Technology, Media, and Materials..............           31,433            31,433            31,433   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, IDEA National Activities....................          257,560           273,560           257,560   ................          -16,000
 
Special Olympics Education Programs...........................           36,000            36,000            37,000            +1,000            +1,000
                                                               -----------------------------------------------------------------------------------------
    Total, Special Education..................................       15,467,264        15,673,264        15,768,264          +301,000           +95,000
                                                               =========================================================================================
        Current Year appropriations...........................       (6,183,881)       (6,389,881)       (6,484,881)        (+301,000)         (+95,000)
            (Forward Funded)..................................       (5,890,321)       (6,080,321)       (6,190,321)        (+300,000)        (+110,000)
        Advance appropriations................................       (9,283,383)       (9,283,383)       (9,283,383)  ................  ................
 
                    Rehabilitation Services
 
Vocational Rehabilitation State Grants........................        3,949,707         4,253,834         4,076,098          +126,391          -177,736
Client Assistance State grants................................           13,000            13,000            13,000   ................  ................
Training......................................................           29,388            23,388            29,388   ................           +6,000
Demonstration and Training programs...........................            5,796            11,796             5,796   ................           -6,000
Protection and Advocacy of Individual Rights [PAIR]...........           20,150            20,150            20,150   ................  ................
Supported Employment State grants.............................           22,548            22,548            22,548   ................  ................
Services for Older Blind Individuals..........................           33,317            33,317            33,317   ................  ................
Helen Keller National Center for Deaf/Blind Youth and.........  ................  ................  ................  ................  ................
    Adults....................................................           19,000            19,000            19,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Total, Rehabilitation Services........................        4,092,906         4,397,033         4,219,297          +126,391          -177,736
                                                               =========================================================================================
            (Discretionary)...................................         (143,199)         (143,199)         (143,199)  ................  ................
            (Mandatory).......................................       (3,949,707)       (4,253,834)       (4,076,098)        (+126,391)        (-177,736)
 
      Special Institutions for Persons with Disabilities
 
American Printing House for the Blind.........................           43,431            43,431            53,431           +10,000           +10,000
 
National Technical Institute for the Deaf [NTID]:
    Operations................................................           92,500            92,500            96,500            +4,000            +4,000
 
Gallaudet University:
    Operations................................................          167,361           165,361           171,361            +4,000            +6,000
                                                               -----------------------------------------------------------------------------------------
        Total, Special Institutions for Persons with                    303,292           301,292           321,292           +18,000           +20,000
         Disabilities.........................................
                                                               =========================================================================================
        Total, Office of Special Education and Rehabilitative        19,863,462        20,371,589        20,308,853          +445,391           -62,736
         Services.............................................
                                                               =========================================================================================
 
       OFFICE OF CAREER, TECHNICAL, AND ADULT EDUCATION
 
           Career, Technical, and Adult Education 2/
 
Career and Technical Education:
    Basic State Grants:
        State Grants..........................................          648,848           678,848           683,848           +35,000            +5,000
        Appropriations available from prior year advances.....          791,000           791,000           791,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Total, Basic State Grants, fiscal year program            1,439,848         1,469,848         1,474,848           +35,000            +5,000
             level............................................
                                                               =========================================================================================
        Advance appropriations, FY 2026.......................          791,000           791,000           791,000   ................  ................
        less appropriations provided in prior years...........         -791,000          -791,000          -791,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, Basic State Grants appropriated in this         1,439,848         1,469,848         1,474,848           +35,000            +5,000
             bill.............................................
 
    National Programs.........................................           12,421            64,421            22,421           +10,000           -42,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Career Education............................        1,452,269         1,534,269         1,497,269           +45,000           -37,000
 
Adult Education:
    State Grants/Adult Basic and Literacy Education:
        State Grants, forward funded..........................          715,455           715,455           715,455   ................  ................
    National Leadership Activities............................           13,712            18,712            13,712   ................           -5,000
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Adult Education.............................          729,167           734,167           729,167   ................           -5,000
                                                               -----------------------------------------------------------------------------------------
        Total, Office of Career, Technical, and Adult                 2,181,436         2,268,436         2,226,436           +45,000           -42,000
         Education............................................
                                                               =========================================================================================
            Current Year appropriations.......................       (1,390,436)       (1,477,436)       (1,435,436)         (+45,000)         (-42,000)
                (Forward Funded)..............................       (1,390,436)       (1,477,436)       (1,435,436)         (+45,000)         (-42,000)
            Advance appropriations............................         (791,000)         (791,000)         (791,000)  ................  ................
 
               OFFICE OF POSTSECONDARY EDUCATION
 
                      Higher Education 2/
 
Aid for Institutional Development:
    Strengthening Institutions Program........................          112,070           140,000           113,719            +1,649           -26,281
    Developing Hispanic-Serving Institutions..................          228,890           246,547           232,257            +3,367           -14,290
    Promoting Postbaccalaureate Opportunities for Hispanic               27,451            29,769            27,855              +404            -1,914
     Americans................................................
    Strengthening Historically Black Colleges and Universities          400,966           431,585           406,865            +5,899           -24,720
     (HBCUs)..................................................
    Strengthening Historically Black Graduate Institutions....          101,286           108,462           102,776            +1,490            -5,686
    Strengthening Predominantly Black Institutions............           22,412            23,672            22,742              +330              -930
    Strengthening Asian American and Native American Pacific             18,682            19,899            18,957              +275              -942
     Islander-Serving Institutions............................
    Strengthening Alaska Native and Native Hawaiian-Serving              24,555            25,840            24,916              +361              -924
     Institutions.............................................
    Strengthening Native American-Serving Nontribal                      11,462            11,595            11,630              +168               +35
     Institutions.............................................
    Strengthening Tribal Colleges.............................           51,807            56,408            52,569              +762            -3,839
    Strengthening HBCU Masters programs.......................           20,037            21,269            20,332              +295              -937
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Aid for Institutional Development...........        1,019,618         1,115,046         1,034,618           +15,000           -80,428
 
International Education and Foreign Language:
    Domestic Programs.........................................           75,353            73,282            75,353   ................           +2,071
    Overseas Programs.........................................           10,311             8,249            10,311   ................           +2,062
                                                               -----------------------------------------------------------------------------------------
        Subtotal, International Education and Foreign Language           85,664            81,531            85,664   ................           +4,133
 
Transition and Postsecondary Programs for Students with                  13,800            13,800            13,800   ................  ................
 Intellectual Disabilities....................................
Minority Science and Engineering Improvement..................           16,370            16,370            16,370   ................  ................
Tribally Controlled Postsec Voc/Tech Institutions.............           11,953            11,953            11,953   ................  ................
Federal TRIO Programs.........................................        1,191,000         1,211,000         1,211,000           +20,000   ................
GEAR UP.......................................................          388,000           398,000           393,000            +5,000            -5,000
Graduate Assistance in Areas of National Need.................           23,547            23,547            23,547   ................  ................
Teacher Quality Partnerships..................................           70,000            95,000            70,000   ................          -25,000
Child Care Access Means Parents in School.....................           75,000            80,000            80,000            +5,000   ................
Fund for the Improvement of Postsecondary Education (FIPSE)...          171,000           262,000           191,000           +20,000           -71,000
Community Project Funding / Congressionally Directed Spending.          202,344   ................          206,150            +3,806          +206,150
Hawkins Centers of Excellence.................................           15,000            30,000            15,000   ................          -15,000
Graduate Fellowships to Prepare Faculty.......................  ................            5,000   ................  ................           -5,000
                                                               -----------------------------------------------------------------------------------------
    Total, Higher Education...................................        3,283,296         3,343,247         3,352,102           +68,806            +8,855
                                                               =========================================================================================
 
                       Howard University
 
Academic Program..............................................          223,288           223,288           223,288   ................  ................
Endowment Program.............................................            3,405             3,405             3,405   ................  ................
Howard University Hospital....................................           77,325            70,325            70,325            -7,000   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Howard University..................................          304,018           297,018           297,018            -7,000   ................
                                                               =========================================================================================
College Housing and Academic Facilities Loans Program.........              298               328               298   ................              -30
 
    Historically Black College and University [HBCU] Capital
                   Financing Program Account
 
HBCU Federal Administration...................................              528               581               528   ................              -53
HBCU Loan Subsidies...........................................           20,150            20,150            20,150   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, HBCU Capital Financing Program Account.............           20,678            20,731            20,678   ................              -53
                                                               =========================================================================================
    Total, Office of Postsecondary Education..................        3,608,290         3,661,324         3,670,096           +61,806            +8,772
                                                               =========================================================================================
 
                 OFFICE OF FEDERAL STUDENT AID
 
                 Student Financial Assistance
 
Pell Grants--maximum grant (NA)...............................           (6,335)           (6,435)           (6,435)            (+100)  ................
Pell Grants...................................................       22,475,352        24,576,352        22,475,352   ................       -2,101,000
Federal Supplemental Educational Opportunity Grants...........          910,000           910,000           910,000   ................  ................
Federal Work Study............................................        1,230,000         1,230,000         1,230,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Student Financial Assistance.......................       24,615,352        26,716,352        24,615,352   ................       -2,101,000
                                                               =========================================================================================
 
                  Student Aid Administration
 
Salaries and Expenses.........................................        1,058,943         1,334,743         1,098,943           +40,000          -235,800
Servicing Activities..........................................        1,000,000         1,324,383         1,060,000           +60,000          -264,383
                                                               -----------------------------------------------------------------------------------------
    Total, Student Aid Administration.........................        2,058,943         2,659,126         2,158,943          +100,000          -500,183
                                                               =========================================================================================
    Total, Office of Federal Student Aid......................       26,674,295        29,375,478        26,774,295          +100,000        -2,601,183
                                                               =========================================================================================
 
             INSTITUTE OF EDUCATION SCIENCES (IES)
 
Research, Development, and Dissemination......................          245,000           245,000           245,000   ................  ................
Statistics....................................................          121,500           121,500           121,500   ................  ................
Regional Educational Laboratories.............................           53,733            58,733            53,733   ................           -5,000
Research in Special Education.................................           64,255            64,255            64,255   ................  ................
Special Education Studies and Evaluations.....................           13,318            13,318            13,318   ................  ................
Statewide Longitudinal Data Systems...........................           28,500            38,500            33,500            +5,000            -5,000
 
Assessment:
    National Assessment.......................................          185,000           185,000           185,000   ................  ................
    National Assessment Governing Board.......................            8,300             8,299             8,300   ................               +1
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Assessment..................................          193,300           193,299           193,300   ................               +1
 
Program Administration........................................           73,500            80,850            73,500   ................           -7,350
                                                               -----------------------------------------------------------------------------------------
    Total, Institute of Education Sciences....................          793,106           815,455           798,106            +5,000           -17,349
                                                               =========================================================================================
 
                    DEPARTMENTAL MANAGEMENT
 
Program Administration:
    Salaries and Expenses.....................................          419,907           476,846           419,907   ................          -56,939
Office for Civil Rights.......................................          140,000           162,359           150,000           +10,000           -12,359
Office of Inspector General...................................           67,500            77,497            67,500   ................           -9,997
                                                               -----------------------------------------------------------------------------------------
    Total, Departmental Management............................          627,407           716,702           637,407           +10,000           -79,295
                                                               =========================================================================================
 
          GENERAL PROVISIONS DEPARTMENT OF EDUCATION
 
Community Project Funding / Congressionally Directed Spending.           88,084   ................          116,461           +28,377          +116,461
                                                               -----------------------------------------------------------------------------------------
    Total, Title III, Department of Education.................       83,001,945        86,770,810        84,029,519        +1,027,574        -2,741,291
                                                               =========================================================================================
        Current Year appropriations...........................      (60,404,944)      (64,173,809)      (61,432,518)      (+1,027,574)      (-2,741,291)
        Advance appropriations................................      (22,597,001)      (22,597,001)      (22,597,001)  ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Title III Related Agencies discretionary...........       79,052,238        82,516,976        79,953,421          +901,183        -2,563,555
                                                               =========================================================================================
 
                  TITLE IV--RELATED AGENCIES
 
  COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERLY
                           DISABLED
 
Salaries and Expenses.........................................           13,124            14,800            13,124   ................           -1,676
    Office of Inspector General...............................           (3,150)  ................           (3,150)  ................          (+3,150)
 
        CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
 
                      Operating Expenses
 
Domestic Volunteer Service Programs:
    Volunteers in Service to America [VISTA]..................          103,285           136,517           103,285   ................          -33,232
 
    National Senior Volunteer Corps:
        Foster Grandparents Program...........................          125,363           124,625           125,363   ................             +738
        Senior Companion Program..............................           56,449            54,303            56,449   ................           +2,146
        Retired Senior Volunteer Program......................           55,105            56,510            55,105   ................           -1,405
                                                               -----------------------------------------------------------------------------------------
            Subtotal, Senior Volunteer Corps..................          236,917           235,438           236,917   ................           +1,479
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Domestic Volunteer Service Programs.........          340,202           371,955           340,202   ................          -31,753
 
National and Community Service Programs:
    AmeriCorps State and National Grants......................          557,094           591,336           592,094           +35,000              +758
    Innovation, Assistance, and Other Activities..............           14,706            14,706            14,706   ................  ................
    Evaluation................................................            6,250             6,250             6,250   ................  ................
    National Civilian Community Corps (subtitle E)............           37,735            42,491            37,735   ................           -4,756
    State Commission Support Grants...........................           19,538            19,538            19,538   ................  ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, National and Community Service Programs.....          635,323           674,321           670,323           +35,000            -3,998
                                                               -----------------------------------------------------------------------------------------
    Total, Operating expenses.................................          975,525         1,046,276         1,010,525           +35,000           -35,751
                                                               =========================================================================================
Payment to the National Service Trust.........................          180,000           159,951           160,000           -20,000               +49
Salaries and Expenses.........................................           99,686           127,104            99,686   ................          -27,418
Office of Inspector General...................................            7,595             8,762             7,595   ................           -1,167
                                                               -----------------------------------------------------------------------------------------
    Total, Corporation for National and Community Service.....        1,262,806         1,342,093         1,277,806           +15,000           -64,287
                                                               =========================================================================================
 
              CORPORATION FOR PUBLIC BROADCASTING
 
Appropriation available from FY 2023 advance..................          525,000           535,000           535,000           +10,000   ................
                                                               -----------------------------------------------------------------------------------------
    Total, available this fiscal year.........................          525,000           535,000           535,000           +10,000   ................
                                                               =========================================================================================
Advance appropriation, FY 2027................................          535,000           595,000           535,000   ................          -60,000
less appropriations provided from prior year advances (FY              -525,000          -535,000          -535,000           -10,000   ................
 2023)........................................................
Public television interconnection system......................           60,000            60,000            60,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total Corporation for Public Broadcasting, appropriated in          595,000           655,000           595,000   ................          -60,000
     this bill................................................
                                                               =========================================================================================
 
          FEDERAL MEDIATION AND CONCILIATION SERVICE
 
Salaries and Expenses.........................................           53,705            53,705            53,705   ................  ................
 
       FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION
 
Salaries and Expenses.........................................           18,012            17,572            17,572              -440   ................
 
           INSTITUTE OF MUSEUM AND LIBRARY SERVICES
 
Office of Museum and Library Services: Grants and                       294,800           280,000           294,800   ................          +14,800
 Administration...............................................
 
        MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION
 
Salaries and Expenses.........................................            9,405            10,698            10,000              +595              -698
 
             MEDICARE PAYMENT ADVISORY COMMISSION
 
Salaries and Expenses.........................................           13,824            14,477            14,477              +653   ................
 
                NATIONAL COUNCIL ON DISABILITY
 
Salaries and Expenses.........................................            3,850             4,000             4,000              +150   ................
 
                NATIONAL LABOR RELATIONS BOARD
 
Salaries and Expenses.........................................          299,224           320,002           299,224   ................          -20,778
 
                   NATIONAL MEDIATION BOARD
 
Salaries and Expenses.........................................           15,113            15,113            15,113   ................  ................
 
       OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION
 
Salaries and Expenses.........................................           15,449            16,278            15,449   ................             -829
 
                   RAILROAD RETIREMENT BOARD
 
Dual Benefits Payments Account................................            8,000             7,000             7,000            -1,000   ................
    Less Income Tax Receipts on Dual Benefits.................           -1,000   ................  ................           +1,000   ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Dual Benefits...............................            7,000             7,000             7,000   ................  ................
 
Federal Payments to the Railroad Retirement Accounts..........              150               150               150   ................  ................
Limitation on administrative expenses.........................          126,000           134,000           129,000            +3,000            -5,000
Limitation on the Office of Inspector General.................           14,000            14,600            14,000   ................             -600
                                                               -----------------------------------------------------------------------------------------
    Total, Railroad Retirement Board..........................          147,150           155,750           150,150            +3,000            -5,600
                                                               =========================================================================================
 
                SOCIAL SECURITY ADMINISTRATION
 
Payments to Social Security Trust Funds.......................           10,000            15,000            15,000            +5,000   ................
 
             Supplemental Security Income Program
 
Federal Benefit Payments......................................       56,328,000        63,108,000        63,108,000        +6,780,000   ................
Beneficiary Services..........................................          137,000           144,000           144,000            +7,000   ................
Research and Demonstration....................................           91,000            91,000            91,000   ................  ................
Administration................................................        4,609,042         4,912,635         4,745,833          +136,791          -166,802
                                                               -----------------------------------------------------------------------------------------
    Subtotal, available this fiscal year......................       61,165,042        68,255,635        68,088,833        +6,923,791          -166,802
 
Less appropriations provided from prior year advances.........      -15,800,000       -21,700,000       -21,700,000        -5,900,000   ................
                                                               -----------------------------------------------------------------------------------------
    Subtotal, current year appropriation......................       45,365,042        46,555,635        46,388,833        +1,023,791          -166,802
                                                               -----------------------------------------------------------------------------------------
    Subtotal, Mandatory.......................................       40,756,000        41,643,000        41,643,000          +887,000   ................
 
Advance appropriations, 1st quarter, FY 2026..................       21,700,000        22,100,000        22,100,000          +400,000   ................
                                                               -----------------------------------------------------------------------------------------
    Total, SSI program appropriated in this bill..............       67,065,042        68,655,635        68,488,833        +1,423,791          -166,802
                                                               =========================================================================================
 
             Limitation on Administrative Expenses
 
OASI/DI Trust Funds...........................................        5,961,023         6,082,378         5,776,834          -184,189          -305,544
HI/SMI Trust Funds............................................        3,114,163         3,888,986         3,695,543          +581,380          -193,443
Social Security Advisory Board................................            2,700             3,150             2,993              +293              -157
SSI...........................................................        3,147,092         3,353,410         3,186,608           +39,516          -166,802
                                                               -----------------------------------------------------------------------------------------
    Subtotal..................................................       12,224,978        13,327,924        12,661,978          +437,000          -665,946
 
User Fees:
    SSI User Fee activities...................................          150,000           170,000           170,000           +20,000   ................
    SSPA User Fee Activities..................................            1,000             1,000             1,000   ................  ................
        CBO adjustment........................................           -1,000            -1,000            -1,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
            Subtotal, User fees...............................          150,000           170,000           170,000           +20,000   ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Limitation on administrative expenses.......       12,374,978        13,497,924        12,831,978          +457,000          -665,946
 
Program Integrity:
    OASDI Trust Funds.........................................          389,050           343,775           343,775           -45,275   ................
    SSI.......................................................        1,461,950         1,559,225         1,559,225           +97,275   ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, Program integrity funding...................        1,851,000         1,903,000         1,903,000           +52,000   ................
 
            Base Program Integrity............................         (273,000)         (273,000)         (273,000)  ................  ................
            Program Integrity (cap adjustment)................       (1,578,000)       (1,630,000)       (1,630,000)         (+52,000)  ................
                                                               -----------------------------------------------------------------------------------------
        Total, Limitation on Administrative Expenses..........       14,225,978        15,400,924        14,734,978          +509,000          -665,946
                                                               =========================================================================================
        Total, Limitation on Administrative Expenses (less           14,075,978        15,230,924        14,564,978          +489,000          -665,946
         user fees)...........................................
                                                               =========================================================================================
 
                  Office of Inspector General
 
Federal Funds.................................................           32,000            34,000            32,000   ................           -2,000
Trust Funds...................................................           82,665            87,254            82,665   ................           -4,589
                                                               -----------------------------------------------------------------------------------------
    Total, Office of Inspector General........................          114,665           121,254           114,665   ................           -6,589
                                                               =========================================================================================
Adjustment: Trust fund transfers from general revenues........       -4,609,042        -4,912,635        -4,745,833          -136,791          +166,802
                                                               -----------------------------------------------------------------------------------------
    Total, Social Security Administration.....................       76,806,643        79,280,178        78,607,643        +1,801,000          -672,535
                                                               =========================================================================================
        Federal funds.........................................      (67,257,042)      (68,874,635)      (68,705,833)      (+1,448,791)        (-168,802)
            Current year......................................      (45,557,042)      (46,774,635)      (46,605,833)      (+1,048,791)        (-168,802)
            New advances, 1st quarter, FY 2026................      (21,700,000)      (22,100,000)      (22,100,000)        (+400,000)  ................
        Trust funds...........................................       (9,549,601)      (10,405,543)       (9,901,810)        (+352,209)        (-503,733)
                                                               -----------------------------------------------------------------------------------------
    Total, Title IV, Related Agencies.........................       79,548,105        82,179,666        81,368,063        +1,819,958          -811,603
                                                               =========================================================================================
        Federal Funds.........................................      (69,844,680)      (71,611,046)      (71,308,776)      (+1,464,096)        (-302,270)
            Current Year......................................      (47,609,680)      (48,916,046)      (48,673,776)      (+1,064,096)        (-242,270)
            FY 2026 Advance...................................      (21,700,000)      (22,100,000)      (22,100,000)        (+400,000)  ................
            FY 2027 Advance...................................         (535,000)         (595,000)         (535,000)  ................         (-60,000)
        Trust Funds...........................................       (9,703,425)      (10,568,620)      (10,059,287)        (+355,862)        (-509,333)
                                                               -----------------------------------------------------------------------------------------
    Total, Title IV Related Agencies discretionary............       17,081,955        18,421,516        17,609,913          +527,958          -811,603
                                                               =========================================================================================
Grand total...................................................    1,444,088,656     1,492,172,089     1,488,767,956       +44,679,300        -3,404,133
                                                               =========================================================================================
    (Mandatory)...............................................   (1,216,815,656)   (1,254,939,692)   (1,254,861,956)     (+38,046,300)         (-77,736)
    (Discretionary)...........................................     (227,273,000)     (237,232,397)     (233,906,000)      (+6,633,000)      (-3,326,397)
 
                   DISCRETIONARY RESCISSIONS
 
Nonrecurring expenses fund, HHS (rescission)..................       -1,250,000          -490,000        -1,656,000          -406,000        -1,166,000
Nonrecurring expenses fund, HHS (rescission) (emergency)......  ................          -10,000   ................  ................          +10,000
Adoption Incentives (rescission)..............................          -70,000           -71,000   ................          +70,000           +71,000
Institute of Education Sciences (Sec314) (rescission).........  ................          -25,000   ................  ................          +25,000
Nonrecurring expenses fund, Education (rescission)............          -25,000   ................  ................          +25,000   ................
CNCS National Service Trust (rescission)......................         -243,000           -25,000           -15,000          +228,000           +10,000
Dislocated Worker National Reserve (rescission)...............          -75,000   ................          -65,000           +10,000           -65,000
                                                               -----------------------------------------------------------------------------------------
    Total, Discretionary Rescissions..........................       -1,663,000          -621,000        -1,736,000           -73,000        -1,115,000
                                                               =========================================================================================
 
            CHANGES IN MANDATORY PROGRAMS (CHIMPS)
 
Surplus property (DOL)........................................            2,000             2,000   ................           -2,000            -2,000
H-1B (rescission) (DOL).......................................         -206,000   ................         -217,000           -11,000          -217,000
Child Enrollment Contingency Fund (HHS-CMS)...................      -14,224,000       -21,380,813       -21,380,813        -7,156,813   ................
Performance Bonus Payments (HHS-CMS)..........................  ................      -12,550,000   ................  ................      +12,550,000
Children's Health Insurance Program Allotments to States (HHS-  ................       -7,425,187        -2,028,187        -2,028,187        +5,397,000
 CMS).........................................................
Pell: Increase maximum award..................................  ................           15,000            15,000           +15,000   ................
Pell max award (rescission)...................................  ................          -15,000           -15,000           -15,000   ................
Vocational Rehabilitation (Education).........................  ................         -415,000          -314,000          -314,000          +101,000
Internal Revenue Service Operations (rescission)..............      -10,000,000   ................  ................      +10,000,000   ................
American Rescue Plan balances (rescission)....................       -4,309,000   ................          -10,000        +4,299,000           -10,000
                                                               -----------------------------------------------------------------------------------------
    Total, Changes in Mandatory Programs......................      -28,737,000       -41,769,000       -23,950,000        +4,787,000       +17,819,000
                                                               =========================================================================================
 
                     OTHER APPROPRIATIONS
 
       THE INFRASTRUCTURE INVESTMENT AND JOBS ACT, 2022
 
                         (P L 117-58)
 
                  DIVISION J--APPROPRIATIONS
 
            DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
           Administration for Children and Families
 
Low Income Home Energy Assistance:
    Appropriations available from prior year (emergency)......         (100,000)         (100,000)         (100,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Total, Low Income Home Energy Assistance..............  ................  ................  ................  ................  ................
                                                               =========================================================================================
    Total, Infrastructure Investment and Jobs Act.............  ................  ................  ................  ................  ................
                                                               =========================================================================================
 
 BIPARTISAN SAFER COMMUNITIES SUPPLEMENTAL APPROPRIATIONS ACT,
                             2022
 
                         (P L 117-159)
 
                  DIVISION B--APPROPRIATIONS
 
            DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
Health Workforce (by transfer) (emergency)....................          (12,000)          (12,000)          (12,000)  ................  ................
Maternal and Child Health (by transfer) (emergency)...........          (20,000)          (20,000)          (20,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Health Resources and Services Administration.......  ................  ................  ................  ................  ................
                                                               =========================================================================================
 
   Substance Abuse and Mental Health Services Administration
 
Health Surveillance and Program Support:
    Appropriations available from prior year advances                  (162,500)         (162,500)         (162,500)  ................  ................
     (emergency)..............................................
                                                               -----------------------------------------------------------------------------------------
        Total, Health Surveillance and Program Support........  ................  ................  ................  ................  ................
                                                               =========================================================================================
 
                    Office of the Secretary
 
Public Health and Social Services Emergency Fund:
    (transfer out) (emergency)................................         (-32,000)         (-32,000)         (-32,000)  ................  ................
    Appropriations available from prior year advances                   (32,000)          (32,000)          (32,000)  ................  ................
     (emergency)..............................................
                                                               -----------------------------------------------------------------------------------------
        Total, Public Health and Social Services Emergency      ................  ................  ................  ................  ................
         Fund.................................................
                                                               =========================================================================================
    Total Department of Health and Human Services.............  ................  ................  ................  ................  ................
                                                               =========================================================================================
 
                    DEPARTMENT OF EDUCATION
 
Safe Schools and Citizenship Education:
    Appropriations available from prior year advances                  (200,000)         (200,000)         (200,000)  ................  ................
     (emergency)..............................................
                                                               -----------------------------------------------------------------------------------------
        Total, Safe Schools and Citizenship Education.........  ................  ................  ................  ................  ................
                                                               =========================================================================================
        Total, Bipartisan Safer Communities Supplemental        ................  ................  ................  ................  ................
         Appropriations Act, 2022.............................
                                                               =========================================================================================
 
    UKRAINE SECURITY SUPPLEMENTAL APPROPRIATIONS ACT, 2024
 
           Administration for Children and Families
 
    Refugee and Entrant Assistance (emergency)................          481,000   ................  ................         -481,000   ................
 
                      GENERAL PROVISIONS
 
Refugee and Entrant Assistance (emergency)....................           50,000   ................  ................          -50,000   ................
                                                               -----------------------------------------------------------------------------------------
    Total, Ukraine Security Supplemental Appropriations Act,            531,000   ................  ................         -531,000   ................
     2024.....................................................
                                                               =========================================================================================
    Total, Other Appropriations...............................          531,000   ................  ................         -531,000   ................
                                                               =========================================================================================
Grand Total...................................................    1,414,219,656     1,449,782,089     1,463,081,956       +48,862,300       +13,299,867
                                                               =========================================================================================
    Appropriations............................................   (1,113,281,839)   (1,110,567,779)   (1,124,603,641)     (+11,321,802)     (+14,035,862)
    Emergency appropriations..................................         (531,000)       (5,489,179)       (7,000,000)      (+6,469,000)      (+1,510,821)
    Trust funds...............................................      (19,593,402)      (21,027,310)      (20,082,494)        (+489,092)        (-944,816)
    Advance Appropriations, FY 2025...........................     (296,456,415)     (312,738,821)     (312,838,821)     (+16,382,406)        (+100,000)
    Advance appropriations, FY 2026...........................         (535,000)         (595,000)         (535,000)  ................         (-60,000)
    Rescissions...............................................     (-16,178,000)        (-626,000)      (-1,978,000)     (+14,200,000)      (-1,352,000)
21st Century CURES Act funding................................         (407,000)         (127,000)         (127,000)        (-280,000)  ................
--------------------------------------------------------------------------------------------------------------------------------------------------------


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